Lee, Renee, Features Editor has reference to this Academic Journal, PHwiki organized this Journal Working in Cold Environments Preventing Cold-related Injuries in addition to Illnesses January, 2011 What This Presentation Covers How the body maintains thermal (heat) balance, constant internal temperature How the body reacts to cold conditions Injuries in addition to illnesses caused by exposure to cold Preventive measures to minimize the hazards from cold exposure See the module Cold-related Injuries in addition to Illnesses as long as more detailed descriptions of hypothermia, frostbite, in addition to other cold injuries. Introduction Exposure to cold can occur when working outdoors or in artificial cold environments. Working as long as prolonged periods or in extreme cold conditions can lead to cold-related injuries in addition to illnesses, permanent tissue damage, in addition to death. Examples of artificial cold environments: Cold storage rooms, refrigerated warehouses Freezers Refrigerated tractor trailers
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Workers at Risk of Cold Exposure Building, road, in addition to other construction, repair Airport ground personnel/ support Ski resorts in addition to other outdoor recreation Ferries; Longshore/dock work Fishing, crabbing, diving Logging Trucking, other transport Agriculture in addition to dairy Food processing, packing, storage Cold storage, warehousing Ice making Window cleaning Police, fire, in addition to emergency response Postal, delivery services Sanitation/trash collecting Utilities, communications Examples of industries/jobs at risk of exposure to cold: Maintaining Temperature: Balancing Heat Loss in addition to Heat Production Most of the bodys energy is used to maintain an internal (core) body temperature of approximately 98.6°F (37°C). Normal core body temperature: 98.6°F (37°C) The body does this through balancing heat loss in addition to heat production. In cold conditions, the body reduces heat loss in addition to increases heat production. Maintaining Temperature: Balancing Heat Loss in addition to Heat Production Over time, your body will decrease blood flow to your extremities in addition to outer skin in addition to shift it to the body core to keep the internal organs warm. However, this allows exposed skin in addition to the extremities to cool rapidly in addition to increases the risk of cold-related injuries, such as frostbite in addition to hypothermia.
Challenges from Cold Conditions Cold conditions as long as ce your body to work harder to maintain its temperature. The challenges you face from a cold environment include: Air temperature Wetness: rain, snow, ice, humidity; sweat; wet clothes; water Air movement: wind speed (5 miles per hour in addition to higher); blown air from fan in cold rooms, etc. Wind Chill Effect Wind chill is the perceived temperature (what it feels like) resulting from the effect of wind (wind speed) in combination with cold air (air temperature). The combined effect increases the rate of heat loss from exposed skin. The stronger the wind at a given temperature, the cooler the wind chill will be. (Refer to Wind Chill Chart on next slide) Example: When the air temperature is -15°F in addition to wind speed is 10 mph, your exposed skin receives conditions equivalent to the air temperature being -35°F. Frostbite will develop in 30 min. If the wind speed doubles to 20 mph, it will feel like its -42°F in addition to frostbite will occur in only 10 minutes. Source: National Oceanic in addition to Atmospheric Administration (NOAA), National Weather Service Example: If the temperature is -15°F in addition to wind speed is 10 mph, it will feel like its -35°F, in addition to frostbite will develop in 30 minutes. If the wind speed doubles to 20 mph, the time as long as frostbite to occur drops to only 10 minutes. Wind Chill Chart
How the Body Loses Heat CONDUCTION: Heat loss through contact with a cooler object in addition to transfer of heat to the cooler object; increases when in contact with cold wet objects (generally, conduction accounts as long as 2-3% of total heat loss in dry conditions; with wet clothes the loss is increased 5x, in addition to rate of heat loss is 25x faster when a person is immersed in cold water) EVAPORATION: Heat loss in the as long as m of vapor when body uses heat to evaporate moisture from skin surface (perspiration or sweat) CONVECTION: Heat loss from wind (blown air from fan, etc.) removing the layer of warm air next to the skin; rate of heat loss depends on wind/air speed RADIATION: Heat loss from exposed body areas to the environment due to the difference between the temperature of the body in addition to that of the cooler air (when air is <98.6°F) RESPIRATION: Heat loss from lungs warming inhaled cold air, which is then exhaled How the Body Loses Heat Factors in heat loss: Air temperature, wind speed, wetness Area of skin surface exposed to cold (particularly in radiation) Contact with cold water or surfaces Each of these means of heat loss can play a large or small role in the development of a cold-related injury. In addition to air temperature, air movement (wind speed), in addition to wetness, the skin surface area that is exposed to the cold is a factor in the amount of heat lost from the body. How the Body Produces Heat Metabolism: Biochemical reactions in the body which produce heat as a by-product Physical Activity (exercise/work): Muscles produce most of the heat during physical work Shivering: Inefficient quivering of the muscles that increases the bodys heat production; limited to a few hours because of depletion of muscle fuel stores in addition to the onset of fatigue Your body must produce an equal amount of heat to counter-balance the heat loss in order to survive in addition to stay active in the cold. Heat is produced in the following ways: How the Body Produces Heat Food intake "Fuel" (glycogen) store Fluid balance Size in addition to shape of the body (surface to volume ratio) Layer of fat under the skin Decreased blood flow through the skin in addition to extremities Insulation (clothing) Factors important in heat production: Factors influencing heat retention in addition to tolerance to cold: Cold Stress If your body begins to lose heat faster than it is produced, your core body temperature drops below normal, in addition to cold stress may result. Cold stress doesnt only happen when conditions are below freezing; it can also be brought about by temperatures in the 50's coupled with some rain in addition to wind. How does cold affect work per as long as mance Lower work efficiency Higher accident rates Uncom as long as tably cold working conditions (combination of temperature, wetness, wind) Immediate signs: Decreased alertness Restlessness, lack of concentration Impaired per as long as mance of complex mental tasks Impaired ability to per as long as m manual tasks Numbness, muscle weakness, stiffened joints Factors Increasing Risk of Cold Injuries/Illnesses Previous cold-related injury Predisposing health conditions:: Cardiovascular disease, Diabetes, Anemia, Sickle cell disease, Vibration/White finger disease, other conditions associated with poor circulation, Hypertension, Asthma Fatigue, poor physical condition Poor nutrition Medication: Anti-depressants, Sedatives, Tranquilizers, Others Alcohol: Decreases awareness; impairs the bodys ability to regulate temperature in addition to increases risk as long as hypothermia In general, people in good physical health are less susceptible to cold injury. In addition to weather conditions, the following factors may increase the risk of developing a cold injury: Caffeine: Increases urine production, contributes to dehydration Nicotine (Smoking): Increases risk as long as cold-induced skin injury (such as frostbite, immersion foot); promotes development of peripheral vascular disease Wearing tight clothing: Restricts circulation Under-activity: Can lead to decreased body heat production Over-activity: Can lead to wet skin, clothing, or shoes from sweating Under-dressing: Exposed fingers, nose, ears; uncovered head Over-dressing: Can result in wet skin in addition to clothing from sweating Length of exposure Age: Older adults may be at more risk than younger Dehydration: Causes bodys natural defense mechanisms to fail in addition to person becomes more susceptible to cold injuries Factors Increasing Risk of Cold Injuries/Illnesses (Cont.) Injuries/Illnesses from Cold Exposure Hypothermia is a serious medical emergency Frostbite, frostnip, chilblains, in addition to immersion injury most commonly affect the extremities - toes, fingers, ears, nose Working in freezing conditions or under prolonged exposures to temperatures above freezing, along with other factors, can cause cold-related injuries in addition to illnesses, tissue damage, possible amputation, or death. Injuries/Illnesses from Cold Exposure The module Cold-related Injuries in addition to Illnesses covers these topics at greater depth. Preventive Measures Planning: Plan as long as work in cold weather in addition to implement controls to reduce in addition to minimize exposure in addition to the risk of cold stress. Planning as long as the conditions Engineering controls Work practices Appropriate clothing Personal protective equipment Training: Provide training in the recognition in addition to treatment of cold-related injuries in addition to illnesses. Supervisors, workers, in addition to co-workers should watch as long as signs of cold stress in addition to allow workers to interrupt their work if they are extremely uncom as long as table. Awareness: Being aware of how your body is reacting to the cold is important in preventing cold stress. Planning Indoors: Take readings of temperature in addition to air movement in all cold work areas at the start, middle, in addition to end of each shift, at least every four hours. Outdoors: The weather report can be used. Postpone work to a warmer day. Schedule heavy work during the warmer parts of the day if possible. Where there is air movement from wind, ventilation, or travel in an open vehicle like a as long as klift, use the wind chill index to evaluate the hazard rather than the air temperature. The wind chill index takes into account the wind blowing the heat away from the body. If you know the temperature in addition to speed of air movement, the wind chill can be looked up in the wind chill chart. Monitor temperatures in addition to air movement Engineering Controls Use radiant heaters, warm air jets, in addition to contact warm plates to warm workers. Shield work areas from drafts or wind to reduce wind chill. Provide heated warming shelters, e.g., tents, cabins, or rest rooms, as long as continuous work in temperatures below freezing. Cover equipment h in addition to les, especially metal h in addition to les in addition to bars, with thermal insulating material when temperatures drop below freezing (steel conducts heat away even faster than water). Design machines in addition to tools so that they can be operated without having to remove gloves or mittens. In refrigerated rooms, minimize air speed as much as possible with properly designed air distribution systems. If workers are simultaneously exposed to vibration in addition to /or toxic substances, reduced limits as long as cold exposure may be necessary. Clothing The following are recommendations to protect your body, h in addition to s, feet, in addition to head when working in cold environments: Body: Wear at least three layers of loose-fitting clothing to trap air in addition to provide insulation, in addition to allow better ventilation. Inner wicking layer made from polyester, polypropylene, or other synthetic material that draws moisture away from the skin in addition to helps keep it dry. Middle insulating layer made of wool, down, fleece, or other material with loft that will hold the bodys heat. Outer layer as long as wind in addition to water protection, made of breathable waterproof fabric that allows some ventilation (like Gortex® or nylon) in addition to is windproof, in addition to that may also need to be resistant to oil, fire, chemicals, or abrasion. Any additional layer(s) of clothing should be large enough not to compress the inner layers in addition to decrease the insulation properties. Head: Wear a wool knit cap or a liner under a hard hat to reduce excessive heat loss. A mask also helps protect the cheeks in addition to nose. Up to 40% of body heat can be lost when the head is left exposed. Clothing (Cont.)
The American Conference of Governmental Industrial Hygienists H in addition to s: Wear gloves in addition to mittens to prevent cold-related injuries as well as prevent accidents in addition to maintain dexterity. The ACGIH recommends wearing gloves when the air temperature is: below 60.8°F as long as sedentary work below 39.2°F as long as light work below 19.4°F as long as moderate work below 0°F, wear mittens, which protect better than gloves Use glove/mitten liners as long as extra protection. Use fingerless gloves with mittens as long as work requiring dexterity. Clothing (Cont.) Feet: Wear insulated boots with removable felt liners; remove liners daily as long as complete drying. Leather mukluk or pack type boots are porous, allowing the boots to “breathe” in addition to letting perspiration evaporate. If work involves st in addition to ing in water or slush (e.g., fire fighting, farming), boots must be waterproof. If there are crushing hazards, boots must be steel-toed. Wear warm thick socks. If you wear two pairs of socks, inner liner socks made of polypropylene will help keep feet dry in addition to warmer (silk, nylon, or thin wool will work also). Outer thicker socks should be larger so inner socks are not compressed. Clothing (Cont.) Keep clothing dry. Remove snow in addition to moisture from clothes prior to entering heated shelters. While resting in a heated area, remove outerwear to allow perspiration to evaporate. Keep extra complete change of dry clothing, shoes, hat, gloves, etc., available in case work clothes become wet. The body loses heat faster if skin is in contact with wet clothing, in addition to will chill rapidly. Excess perspiration will increase heat loss, so remove extra layers of clothing whenever you feel too warm. (Socks, continued) Make sure socks are not too thick; this may result in tightness in addition to loss of insulating properties, in addition to increase the risk as long as cold injuries. If the socks are too thin, the boots will fit loosely in addition to may lead to blisters. Change socks if they get wet or damp General Guidelines Clothing (Cont.)
Personal Protective Equipment Face in addition to Eye Protection In extremely cold conditions where face protection is needed, use eye protection that is separate from the nose in addition to mouth to prevent fogging in addition to frosting eye shields or glasses Wear eye protection appropriate as long as the work Wear eye protection that protects against: ultraviolet light from the sun glare from the snow blowing snow/ice crystals high wind chill conditions to protect the corneas of the eyes from potentially freezing Work Practices Work Practices are important preventive measures. Pace the work to avoid excessive sweating. Change into dry clothes if clothes become wet. New employees should be given enough time to get acclimatized to cold in addition to protective clothing be as long as e assuming a full work load. Avoid sitting or st in addition to ing still as long as prolonged periods. Take frequent breaks, in shielded areas out of the cold, to avoid fatigue since energy is needed to keep muscles warm. Work in pairs to keep an eye on each other in addition to watch as long as signs of cold stress. Consume warm, high calorie food such as pasta to maintain energy reserves. Working in the cold requires more energy to maintain body heat. Work Practices Drink plenty of warm liquids often, especially when doing strenuous work, to prevent dehydration. Avoid caffeine, which increases urine production in addition to contributes to dehydration. Avoid alcohol. When it is cold, do not brush up against metal surfaces with bare skin. The skin may stick to it in addition to get immediate frostbite. Greases in addition to oils get thick in addition to hard which makes equipment difficult to use. Follow the proper procedures in addition to use the right tools. Tools also get brittle in the cold, so use caution when working with them. Avoid skin contact when h in addition to ling evaporative liquids (gasoline, alcohol, cleaning fluids) while de-icing in addition to fueling below 40°F. These materials in contact with the skin greatly increase heat loss from the body.
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