SAFETY TIPS: COLD RELATED STRESS AND ILLNESS

SAFETY TIPS: COLD RELATED STRESS AND ILLNESS



Winter sports are a great way to be physically active while having fun.
But prolonged exposure to freezing temperatures under certain
conditions can result in serious cold-related health conditions and can
even be fatal.

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The following fact *** defines the harmful effects of prolonged
exposure to cold, provides guidelines and recommendations for
cold-related illnesses and stress, and discusses immediate first aid
measures. The information, developed by the U.S. Department of Labor,
Occupational Safety and Health Administration (OSHA), has been adapted
here for application to winter sports.

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THE COLD ENVIRONMENT

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The four environmental conditions that cause cold-related stress are
low temperatures, high/cool winds, dampness and cold water. Wind chill,
a combination of temperature and velocity, is a crucial factor to
consider. A dangerous situation of rapid heat loss may arise for any
individual exposed to high winds and cold temperatures.

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An individual gains body heat from food and muscular activity and loses
it through convection, conduction, radiation and sweating to maintain a
constant body temperature. When body temperature drops even a few
degrees below its normal temperature of 98.6ºF (37ºC), the blood
vessels constrict, decreasing peripheral blood flow to reduce heat loss
from the surface of the skin. Shivering generates heat by increasing
the body's metabolic rate.

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For example, when the actual air temperature of the wind is 40ºF
(4ºC) and its velocity is 35 mph, the exposed skin receives conditions
equivalent to the still-air temperature being 11ºF (-11ºC)!

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During cold weather about 60 percent of a person's body fuel is used to
heat the body. When exposed to frigid temperatures, particularly for
extended periods of time, a person will tire easily, and exposed skin
will cool rapidly. This is prime breeding ground for the dangerous
effects of the cold - hypothermia and frostbite. Combine cold
temperatures with water, including actual immersion, and trench foot
becomes another potential serious ailment.

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MAJOR RISK FACTORS FOR COLD-RELATED STRESSES

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! Wearing inadequate or wet clothing (increases the effects of cold on
the body).

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! Taking certain drugs or medications such as alcohol, nicotine,
caffeine, and medication that inhibit the body's response to the cold
or impairs judgment.

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! Having a cold or certain diseases, such as diabetes, heart, vascular,
and thyroid problems (may make a person more susceptible to the winter
elements).

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! Being male (men have far greater death rates from cold exposure than
women, perhaps due to inherent risk-taking activities, body-fat
composition or other physiological differences).

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! Becoming exhausted or immobilized, especially due to injury or
entrapment (may speed up the effects of cold weather.

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! Being elderly.

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WEARING THE RIGHT CLOTHING

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Wearing the right clothing is extremely important when participating in
cold weather sports. Dress in layers, wearing warm,
waterproof/resistant clothing. Clothing for cross-country skiing
should protect the participant from cold, wind, and precipitation and
should also provide ventilation-be "breathable". To reduce wind
resistance, the clothing should fit snugly to the body. Pay special
attention to protecting feet, hands, face and head. Up to 40 percent of
body heat can be lost when the head is exposed. Footgear should be
insulated to protect against cold and dampness.

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Wearing multiple layers of varying thickness allows you to regulate
your body temperature. You should flexibly layer the clothing and use
proper materials so you will stay warm and still not restrict your
movement. Many peel off layers when cross-country skiing, and replace
those layers when stopping to rest and rehydrate.

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Wear at least three layers of clothing.

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! An outer layer to break the wind and allow some ventilation (like
Gore-Tex® or nylon).

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! A middle layer of wool or synthetic fabric (Qualofil or Pile) to
absorb sweat and retain insulation in a damp environment. Down is a
useful lightweight insulator; however, it is ineffective once it
becomes wet.

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! An inner layer of synthetic weave to allow ventilation. Synthetic
materials such as supplex and coolmax are ideal because they keep you
warm and dry.

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HARMFUL & PERMANENT EFFECTS OF COLD: FROSTBITE AND HYPOTHERMIA

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Frostbite occurs when the skin tissue actually freezes, causing ice
crystals to form between cells and draw water from them, which leads to
cellular dehydration. Although this typically occurs at temperatures
below 30ºF (-1ºC), wind chill effects can cause frostbite at
above-freezing temperatures.

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Symptoms of Frostbite

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! Initial effects of frostbite include uncomfortable sensations of
coldness; tingling, stinging or aching feeling of the exposed area
followed by numbness. Ears, fingers, toes, cheeks, and noses are
primarily affected. Frostbitten areas appear white and cold to the
touch. The appearance of frostbite varies depending on whether
rewarming has occurred.

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! Deeper frostbite involves freezing of deeper tissues (muscles,
tendons, etc.) causing exposed areas to become numb, painless, hard to
the touch.



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Treatment for Frostbite

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If you suspect frostbite, you should seek medical assistance
immediately. Any existing hypothermia should be treated first (See
Hypothermia below). Frostbitten parts should be covered with dry,
sterile gauze or soft, clean cloth bandages. Do not massage frostbitten
tissue because this sometimes causes greater injury.

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Severe cases may require hospitalization and even amputation of
affected tissue.

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Take measures to prevent further cold injury. If formal medical
treatment will be delayed, consult with a licensed health care
professional for training on rewarming techniques.

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General Hypothermia occurs when body temperature falls to a level where
normal muscular and cerebral functions are impaired. While hypothermia
is generally associated with freezing temperatures, it may occur in any
climate where a person's body temperature falls below normal. For
instance, hypothermia is common among the elderly who live in cold
houses.

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Symptoms of Hypothermia

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! The first symptoms of hypothermia, shivering, an inability to do
complex motor functions, lethargy, and mild confusion, occur as the
core body temperature decreases to around 95ºF (35ºC).

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! As body temperature continues to fall, hypothermia becomes more
severe. The individual falls into a state of dazed consciousness,
failing to complete even simple motor functions. The victim's speech
becomes slurred and his or her behavior may become irrational.

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! The most severe state of hypothermia occurs when body temperature
falls below 90ºF (32ºC). As a result, the body moves into a state of
hibernation, slowing the heart rate, blood flow, and breathing.
Unconsciousness and full heart failure can occur in the severely
hypothermic state.

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Treatment of Hypotheria

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! Treatment of hypothermia involves conserving the victim's remaining
body heat and providing additional heat sources. Specific measures will
vary depending upon the severity and setting (field or hospital).

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! Handle hypothermic people very carefully because of the increased
irritability of the cold heart. Seek medical assistance for persons
suspected of being moderately or severely hypothermic.

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! If the person is unresponsive and not shivering, assume he or she is
suffering from severe hypothermia. Reduction of heat loss can be
accomplished by various means: obtaining shelter, removal of wet
clothing, adding layers of dry clothing, blankets, or using a
pre-warmed sleeping bag.

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! For mildly hypothermic cases or those more severe cases where medical
treatment will be significantly delayed, external rewarming techniques
may be applied. This includes body-to-body contact (e.g., placing the
person in a prewarmed sleeping bag with a person of normal body
temperature), chemical heat packs, or insulated hot water bottles. Good
areas to place these packs are the armpits, neck, chest, and groin. It
is best to have the person lying down when applying external rewarming.
You also may give mildly hypothermic people warm fluids orally, but
avoid beverages containing alcohol or caffeine.

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