Frostbite: The Icy Truth

By Kim Fulford, CHST
Safety Management Group

frostbiteMost of the hazards associated with working in winter weather conditions are fairly obvious. We know that we can slip and fall on ice, and that snow and ice can fall off of roofs and overhanging structures. We bundle up and bring portable space heaters to work areas to prevent against hypothermia. When we need to drive or move vehicles around a worksite, we exercise extra caution to avoid skidding or sliding.

But one of the most dangerous winter hazards is also one of the least-understood. It’s the skin injury known as frostbite. Beyond the discomfort associated with suffering frostbite, it can cause permanent damage to skin, and in the most severe cases, can even lead to the loss of limbs and appendages.

Growing up in northern Minnesota gave me a practical education in avoiding frostbite, but I became even more acutely aware of it earlier in my career, when I performed construction work at the National Science Foundation’s research station at the South Pole. The station’s aluminum dome had to be replaced because years of accumulating ice crystals. Summertime at the Pole offers weather that would be called a vicious winter on most of the planet, with constant winds creating average wind chills of 70 degrees below zero. Under those conditions, exposed skin can develop frostbite in less than two minutes.

In its simplest terms, frostbite is the destruction of tissue caused by exposure to extreme cold. The epidermis, which is the layer directly beneath the exposed skin, is mostly water, so it is easily affected by extremely cold temperatures.

As frostbite begins, you’ll notice small patches of white on the skin. That’s because the moisture directly under that part of the skin has already frozen. Once that happens, it’s important to take immediate action before the effects become any worse. You need to move to a warmer area and allow the skin to come back to its normal temperature gradually.

Some people believe that rubbing frostbitten skin, putting hot compresses on the affected area, or running warm water on it are helpful, but they can actually make the damage worse. The affected skin layer will die and peel off like a scab, leaving a pockmark. The only safe solution is to allow the skin temperature to rise gradually.

Frostbite tends to attack the extremities, because the body’s response to extreme cold is to concentrate heat in its inner core. It starts to shut down capillaries. Areas such as your ears, your nose, and your cheek are extremely susceptible. Should you fail to respond to those early warnings, the frostbite can become significantly worse. If you reach the point where you can no longer feel your fingers or your toes, you need to obtain immediate medical attention. If your finger or toe starts to turn black, you’ll probably lose it.

Proper prevention is the best way to avoid frostbite. If you can’t avoid being out in the cold, the time-honored advice about covering exposed skin and dressing in layers is both accurate and critical. At the South Pole, there were times I would wear two or three layers on my head and face, as well as hand warmers inside my gloves. And even with my knowledge of frostbite, I wasn’t immune. I suffered a small streak on my cheek and another on one of my ears. While the damage isn’t visible, the streaks remind me of their presence during cold weather with a strong burning sensation.

Don’t fall for the myth that you can avoid frostbite by building up a tolerance to the cold or avoiding certain weather conditions. Humidity and wind play key roles in the likelihood of developing frostbite, and what may not seem like dangerous conditions could fool you.

The best advice is to be like a kid. When kids playing in the snow become uncomfortably cold, they head inside to warm up before going back out. Hardworking adults would be wise to follow their lead, instead of convincing themselves that they can manage to work for 15 or 30 more minutes. Maybe kids are actually smarter than we are!

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