What is cold temperature exposure and injury?

It's easy to get cold quickly if you are outside in wet, windy, or cold weather. Cold temperature exposure can also happen if you spend time in a dwelling or other building that isn't well heated during cold weather.

Injuries from cold exposure

• "Frostnip" usually affects the skin on the face, ears, or fingertips. It may cause numbness or blue-white skin color for a short time. But normal feeling and color return quickly when you get warm. No permanent tissue damage occurs.
• Frostbite is freezing of the skin and the tissues under the skin because of temperatures below freezing. Frostbitten skin looks pale or blue. It feels cold, numb, and stiff or rubbery to the touch. You can also get a skin injury by touching cold items such as dry ice without protection.
• Cold injuries, such as trench foot and chilblains, may cause pale and blistered skin like frostbite after the skin has warmed. These injuries occur from spending too much time in temperatures that are cold, but not freezing. The skin doesn't actually freeze.
• Eye pain or vision changes caused by cold exposure most often occur in people who try to force their eyes open in high winds or cold weather, or during activities such as snowmobiling or cross-country skiing. Snow blindness isn't directly caused by cold temperatures. But it does occur in snow conditions. Sunlight reflecting off the snow can cause a corneal injury or burn. Eyelids may become red and swollen. Eyes may feel dry and like they have sand in them.
• An abnormally low body temperature (hypothermia) occurs when the body loses heat faster than it can make heat. (There may be other reasons a person has a low body temperature.) Early symptoms of hypothermia include shivering (in adults and older children); clumsy movements; apathy (lack of concern); poor judgment; and cold, pale, or blue-gray skin. Hypothermia is an emergency condition. It can quickly lead to unconsciousness and death if the heat loss isn't stopped.

Risk factors for cold exposure injury

There are many things that increase your risk of injury from exposure to cold temperatures. They include:

• Being a baby. A baby's ability to regulate body temperatures isn't well developed. And a baby's body heat is lost faster when exposed to cold weather conditions.
• Being an older adult. Older people don't produce as much heat energy. And they may have health conditions that make it harder for them to regulate their body temperature as well as other people do.
• Drinking alcohol. Alcohol may affect your judgment. For example, a person may not put on more clothing when it's needed if their judgment is affected by alcohol.
• Being in outdoor conditions, such as high altitudes or wet and windy weather, or being immersed in cold water.
• Not being dressed properly, having wet skin, or wearing wet clothing.
• Being tired or dehydrated.
• Being exposed to cold temperatures in your workplace, such as working in cold-storage units.
• Having certain health risks. Health conditions, such as diabetes or cancer, or any medicines you take may affect how you regulate your body temperature.

Many people get cold hands or feet. This is often bothersome, but it's not a serious health problem. You're more likely to feel cold easily if:

• You don't have much body fat. Fat under the skin helps keep you warm. People who have low body fat may be more likely to get hypothermia. Babies, older or ill adults, and malnourished people have low body fat.
• You smoke cigarettes or drink caffeine. Nicotine (from tobacco) and caffeine cause narrowing of the blood vessels in the hands and feet. When blood vessels are narrowed, less blood flows to these areas. This causes the hands and feet to feel cold.
• You're under a lot of stress or feel tired. Chronic stress or anxiety can cause your nervous system to release adrenaline. It narrows the blood vessels that supply blood to the hands and feet.
• You have a medical condition, such as hypothyroidism or Raynaud's phenomenon, that makes you feel or react more strongly to cold temperatures.

To prevent getting too cold, wear proper clothing and shoes, such as:

• A hat and face mask.
• Layers of clothing to keep you warm and dry.
• Clothing made of wool or synthetic (not cotton) fabric. These are good insulators and will prevent loss of body heat even when the fabric gets wet.
• Wind- and waterproof outer layers to keep you dry.
• Wool or synthetic (not cotton) socks and waterproof boots that fit well. Socks, boots, and shoes must fit closely but not be tight or have any pressure areas. Smooth out all wrinkles in your socks when you put them on.
• Mittens rather than gloves so your fingers are together and can be rolled into a fist.

Drinking alcohol may increase the risk of injury from cold exposure. Alcohol:

• Changes your body's ability to regulate body temperature.
• Changes your judgment. For example, a person may not put on more clothing when it is needed if their judgment is changed by alcohol.
• Can cause blood vessels in the skin to get bigger (dilate). This increases heat loss.