Cold Stress Symptoms Can Affect Workers Whenever Temperatures Drop

Even though the Cape Girardeau area may not be the coldest region in the country, workers who spend time outside during the winter or in cold indoor environments could be at risk for developing symptoms of cold stress.

According to the National Institute for Occupational Safety and Health (NIOSH), workers are at risk for cold stress whenever temperatures drop significantly below normal, especially in near-freezing conditions. Wind chills – determined by factoring in wind speeds – can cause heat to leave the body even more rapidly.

Employers should take the following steps to protect their workers from cold stress:

  • Reduce the physical demands of workers during cold periods
  • Use relief workers or assign extra workers for long, demanding jobs
  • Provide warm liquids
  • Provide warm areas for use during breaks
  • Monitor workers who are at risk of cold stress
  • Provide cold stress training that includes information on risks, symptoms, prevention and treatment

Here are five primary types of cold stress for which workers are susceptible:


Hypothermia occurs when the body loses heat faster than it can produce it. The body works hard to generate enough heat to maintain a healthy temperature, but prolonged exposure to the cold eventually will use up its energy reserves.

The resulting low body temperature affects brain function, slowing the person’s ability to think clearly or move normally. This makes hypothermia particularly dangerous, because the victim may not realize what is happening and will be unable to do anything about it.

Early symptoms include shivering, fatigue, loss of coordination and confusion. Advanced symptoms may include blue skin, a lack of shivering, dilated pupils, slowed pulse and breathing and, eventually, loss of consciousness.


This injury to tissues produces a loss of feeling and color in the damaged areas. It most commonly affects fingers and toes, as well as the nose, ears, cheeks and chin. Severe cases can even result in amputation of digits and extremities.

Workers who are not dressed properly for the elements are at increased risk for a reduction in blood circulation. Symptoms include numbness, tingling or stinging sensations, along with bluish, pale skin.

Avoid walking on frostbitten feet or toes, and do not rub or massage a frostbitten area because these actions can increase the damage. Workers should get into a warm area as soon as possible and use body heat or lukewarm water to gently warm the affected areas.

Cold Water Immersion

This type of cold stress is not an issue for most workers, but it can be deadly for those who spend time in the water. Immersion hypothermia develops much more quickly because water conducts heat away from the body 25 times faster than air.

Immersion hypothermia can occur in water temperatures below 70 degrees, making this more than just a cold-weather risk. Wearing proper clothing, using a personal flotation device or life vest, and having a means to signal rescuers are keys to survival.

Trench Foot

This is kind of the land version of cold water immersion. Also known as immersion foot, trench foot is an injury to the feet caused by prolonged exposure to wet and cold conditions. It can occur at temperatures as high as 60 degrees if the feet are constantly wet.

Similar to cold water immersion, trench foot occurs because wet feet lose heat 25 times faster than dry feet. The body attempts to counteract this by constricting blood vessels to limit circulation in the feet. The skin tissue begins to die because of lack of oxygen and nutrients, as well as a buildup of toxins.

Symptoms include reddening of the skin, numbness, leg cramps, swelling, tingling pain, blisters, bleeding under the skin and gangrene (the foot may turn dark purple, blue or gray).

Workers suffering from trench foot should remove wet footwear and dry their feet, and avoid walking on them because that may cause tissue damage.


While not as well-known as other types of cold stress, chilblains can produce serious long-term tissue damage.

Chilblains arise from the repeated exposure of skin to temperatures just above freezing to as high as 60 degrees. The cold exposure damages groups of small blood vessels in the skin known as capillary beds.

This damage is permanent, and its telltale redness and itching returns with additional exposure. The most common areas affected are cheeks, ears, fingers and toes.

Workers with this condition should avoid scratching and use corticosteroid creams to relieve itching and swelling.

For more information about preventing cold stress, please call Chad Clippard, business liaison, at 573-331-3019.