Frostbite: Serious Cold Weather Risk for All Ages

Cold weather conditions are the most common cause of frostbite, although direct contact with ice, frozen metal or very cold liquids can also lead to frostbite.

Chilblains are the painful inflammation of small blood vessels in the skin that occur in response to repeated exposure to cold but not freezing air. Also referred to as pernio, chilblains can cause itching, red patches, swelling and blistering on hands and feet.

Aaron Yoder, Environmental, Associate Professor for Agricultural and Occupational Health at the University of Nebraska Medical Center, says farmers and ranchers can avoid these serious cold weather illnesses by recognizing their symptoms and understanding how to respond if either frostbite, trench foot or chilblains occur.

“Fingers, toes, cheeks, nose and ears are the areas where frostbite typically occurs,” Yoder says. “Once skin has been frostbitten, it may look white or grayish yellow. It may feel cold,

hard, and maybe waxy to the touch.”

Persons with frostbitten skin will experience numbness of the area, aching, tingling and stinging. Appropriate first aid response includes finding a warm room or shelter (i.e. a vehicle) as soon as possible. If your feet or toes are frostbitten, avoid walking, which can lead to further tissue damage.

“Soak the affected area(s) in warm but not hot water,” Yoder says. “Avoid rubbing the affected area because that could cause tissue damage. Use a soft cloth the wrap the affected area, but don’t use a heating pad, fireplace or radiator for warming the frostbitten area. If there’s a chance the area could be refrozen, don’t warm it.”

Minor frostbite can be treated at home. Serious frostbite may involve rewarming, medications, wound care, surgery and other various therapies.

If frostbite is severe enough to warrant a physician’s care, provide the doctor with the following information to assist in developing a treatment plan:

1. List all signs and symptoms you’re experiencing.

2. Document the length of time you have experienced the symptoms.

3. List key medical information, including all other medical conditions, prescribed medications, OTC medications and supplements.

4. Document the date of your last tetanus shot. Frostbite increases the risk of tetanus. If it’s been more than 10 years since your last tetanus vaccination, your doctor may recommend a tetanus vaccination.

In addition to rewarming, a physician may use oral pain medicine to ease the pain of rewarming a frostbitten area.

To properly heal, a frostbitten area must be free of damaged, dead or infected tissue. It’s possible that damaged tissue cannot be removed for one to three months.

Following frostbite, both prescribed and over-the-counter (OTC) drugs should be used to help combat pain. Some people may find it helpful to apply aloe vera gel or lotion several times per day to the affected area.

Areas most susceptible to chilblains are the toes, fingers, ears, and nose. When chilblains occur, symptoms include redness, blistering, itching, inflammation and (in severe cases) ulceration.

To treat chilblains, avoid scratching the affected area. Slowly warm the skin and use corticosteroid creams to relieve itching and swelling. If blisters and ulcers are present, they should be kept clean and covered.

The most effective treatment for these coldrelated illnesses is prevention, beginning with appropriate dress.

“When you’re working outdoors, wear a minimum of three layers of clothing,” Yoder says. “An outer layer to break the wind, a middle layer to retain insulation and an inner layer that allows for ventilation. Have a change of clothes available in case your garments become wet.”

Since alcohol and drugs can increase heat loss and impair judgment, never use these substances when working in a cold environment. Know the signs and symptoms of coldinduced conditions and know the appropriate first-aid response to them.

Warm, caffeine and alcohol-free beverages can be used to help maintain energy and body heat. Staying in good physical condition also helps prevent coldrelated illness.

“Farm and ranch managers need to take precautions to keep workers safe during cold and/or wet weather, too,” Yoder says. “Allow them to complete their work at a comfortable pace, taking extra breaks if necessary. Always have workers doing jobs in teams during cold weather to help keep an eye on one another.”

When possible, farm managers should schedule outdoor work during the warmest part of the day, or move a job to an enclose area. Workers should be discouraged from sitting or standing in prolonged periods during cold weather.