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Water and hydration in the workplace *
Published in Jamie Bartram, Rachel Baum, Peter A. Coclanis, David M. Gute, David Kay, Stéphanie McFadyen, Katherine Pond, William Robertson, Michael J. Rouse, Routledge Handbook of Water and Health, 2015
Besides hypothermia, workers exposed to high winds and cold temperatures can suffer from frostbite and trench foot which are exacerbated by wet conditions (National Institute for Occupational Safety and Health 2014a). Frostbite develops when ice crystals form in the fluids and underlying soft tissues of the skin, causing tissue destruction. Exposed areas, such as ears, nose, mouth, cheeks, fingers, and toes, are most commonly affected. Frostbitten skin is hard, pale, cold, and lacks feeling. When the affected area thaws, it becomes red and painful and may cause permanent damage to body tissues. Symptoms of frost bite are reduced blood flow to hands and feet, numbness, tingling, throbbing sensation, and bluish or pale waxy skin. Trench foot or immersion foot is an injury to the feet caused by prolonged exposure to wet and cold conditions. Skin tissue will die because of a lack of oxygen and nutrients to the feet, and buildup of toxic products. Symptoms include reddened skin, numbness, leg cramps, edema, tingling pain, blisters, bleeding under the skin, and gangrene.
The management of major injuries
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Localized cold injury is seen in three forms: Frostnip – the mildest form, which is reversible on warming.Frostbite – due to freezing of tissue and resultant damage from intracellular ice crystals and micro-vascular occlusion. This can be classified as two types and four degrees: Superficial frostbite: – First-degree – hyperaemia and oedema without skin necrosis.– Second-degree – vesicle formation with partial-thickness skin necrosis.Deep frostbite: – Third-degree – full-thickness and subcutaneous tissue necrosis, with haemorrhagic vesicle formation.– Fourth-degree – full-thickness necrosis, including muscle and bone gangrene.Non-freezing injury – trench foot or immersion foot, with microvascular endothelial damage, stasis and vascular occlusion.
A review of construction workforce health challenges and strategies in extreme weather conditions
Published in International Journal of Occupational Safety and Ergonomics, 2023
Sanjgna Karthick, Sharareh Kermanshachi, Apurva Pamidimukkala, Mostafa Namian
A major increase (15%) in emergency room visits by workers for cold-related injuries such as slips and falls (CP11) has been observed with every degree that the temperature falls during cold weather, and an increase in wind speed further increases the number of visits by 6% [49,50,51]. The rising number of slips, trips and fall-related accidents is attributed to ice, snow, limited visibility and cooling of the body [37,49]. Two-thirds of all fall events in cold weather occur on ice that is coated with snow [60]. Trench foot or immersion foot are also the result of working in cold environments [62,63]. Trench foot (CP12) is a condition in which blood vessels are inflamed to the extent that they damage organs and tissues; it is common among those who work for prolonged periods of time in temperatures that are above 0° C (32 °F). Immersion foot develops when workers stand in the same position for long periods of time, especially in cold, wet environments [61]. The terms trench foot and immersion foot are often used interchangeably; immersion foot, formerly known as trench foot, is considered a non-freezing cold injury. It is experienced by many outdoor workers, and often occurs when construction workers perform jobs, such as excavating a hole for a foundation, in cold, muddy water [63]. The symptoms of immersion foot begin with numbness and white or pale skin that changes to a shade of blue. It is often characterized by numbness and severe pain, even after heat has been restored [64,65]. Table 5 presents the physical challenges and health issues that workers encounter in extremely cold temperatures.