Water and hydration in the workplace *
Jamie Bartram, Rachel Baum, Peter A. Coclanis, David M. Gute, David Kay, Stéphanie McFadyen, Katherine Pond, William Robertson, Michael J. Rouse in 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
Ashley W. Blom, David Warwick, Michael R. Whitehouse in Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Localized cold injury is initially managed in the field. The hypothermia and dehydration associated with frostbite should be addressed. Wet and constrictive clothing should be removed, the involved extremities should be elevated and wrapped carefully in dry sterile gauze, and affected fingers and toes should be separated. Further cold injury should be avoided. Rapid rewarming is the single most effective therapy for frostbite. As soon as possible, the injured extremity should be placed in gently circulating water at a temperature of 40–42 °C (104–107.6 °F) for approximately 10–30 minutes, until the distal extremity is pliable and erythematous. The current consensus is that clear blisters are aspirated or debrided and dressed. Early surgical intervention in the form of tissue debridement and amputation is not indicated; full demarcation of dead tissue can take 3–4 weeks to occur, and debridement at this point will avoid unnecessary tissue loss.
Applied exercise physiology and the environment
Nick Draper, Helen Marshall in Exercise Physiology, 2014
Exposure to cold environments can lead to hypothermia and frostbite. Hypothermia is most commonly diagnosed at a core temperature of 35°C or below. It can be triggered by a sudden water immersion, such as the result of a kayak or canoe capsize, or a slower onset such as might occur during a mountain marathon, adventure/multisport race. The symptoms of hypothermia include shivering, a change to a greyish colour for those with lighter skin colouring, slurred speech, irritability, clumsiness and drowsiness. When the core temperature drops to 31°C shivering will cease, representing a significant point in hypothermia. At this point, an individual is unable to re-warm themself without external heating. In cases of mild hypothermia, removing the person from the wind (an emergency shelter is excellent for this purpose), replacing wet clothing, increasing insulation and providing food and drink can help the person to recover quite quickly. As the person begins to recover, decisions can be made about how best to evacuate. In cases of severe hypothermia, the above measures should be completed where possible but medical assistance should be sought as quickly as circumstances allow. A further problem of exercise in cold environments is frostbite which can occur in skin exposed to sub-zero temperatures. In mild cases, limbs can be rewarmed in body temperature (37°C) water, or in the case of a hand, by placing it under the armpit. In severe cases of frostbite, especially if there is a danger of the limb refreezing if warmed, medical assistance should be sought for treatment.
Human vulnerability and variability in the cold: Establishing individual risks for cold weather injuries
Published in Temperature, 2022
François Haman, Sara C. S. Souza, John W. Castellani, Maria-P. Dupuis, Karl E. Friedl, Wendy Sullivan-Kwantes, Boris R. M. Kingma
The main causes of NFCI are the sustained exposure to cooling temperatures between 25°C and 10°C and/or wet conditions. The feet are the most at risk; however, NFCI can affect any body part. Overall, NFCI diagnosis is based on comprehensive history, general examination, and injury classification. NFCI are classified in four different stages according to the exposure duration to cold temperatures, skin color, and other specific symptoms. In case of suspected NFCI, the patient should be first evacuated from the cold and/or wet environment if possible and subsequently receive immediate and additional management. Prevention is still the major way of avoiding long-term consequences such as cold sensitivity. Frostbite is mainly related to the exposure to temperatures close to tissue freezing point (−0.55°C). The diagnosis of frostbite starts with a clinical approach and is followed by the injury classification. Frostbite can be clinically differentiated into superficial (first and second levels.) and deep (third and fourth levels). Imaging exams to evaluate the level of tissue damage should be performed in deep cases of frostbite. Although there are different treatments available (e.g. iloprost and tPA), the first management is highly determinant of prognosis. Clearly, preventing and mitigating risks of CWI is key when exposed to cold conditions. Much work remains to clearly understand how individual morphological, physiological, and psychological differences can modulate cold responses and the risk of developing cold weather injuries.
Exploring the frostbite healing potential of hyaluronic acid based hydrogel of Manuka honey through in-silico antithrombotic and anti-platelet studies of major phytoconstituents and in-vivo evaluation in Wistar rat model
Published in Drug Development and Industrial Pharmacy, 2021
Kumud Joshi, Bhaskar Mazumder, Pronobesh Chattopadhyay, Danswrang Goyary, Madhubanti Das, Sanjai Kumar Dwivedi
HA possess a significant antiplatelet activity and MH is rich in polyphenols and flavonoids and both of them possess significant wound healing activity. Polyphenols and flavonoids are natural compounds with significant antioxidant activity and are used in wound healing. Frostbite is a wound associated with ischemic injury and is associated with significant thrombosis. The resolution of thrombosis is very important for the treatment of frostbite. The in-silico docking study was performed which focused on investigating the anti-thrombotic and anti-platelet activity of some major phyto-compounds of MH from natural sources. The results reveal that leptosin of MH forms a stable protein-ligand complex with the target proteins as compared to the drug aspirin. Thus, the comparative in-silico molecular docking analysis of the phytochemicals and drug aspirin against the target proteins proves that leptosin can be a good drug candidate having anti-thrombotic and anti-platelet activity. These studies suggest that the major constituents of MH possess a significant antithrombotic activity and can be useful in countering microvascular thrombosis in frostbite.
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
International standards for workers define ‘cold’ as temperatures at or below 10–15 °C [48]. The physical challenges experienced by those who work in cold temperatures were identified through the literature review, are presented in Table 5 and are expanded upon in this paragraph. When the human body is exposed to cold, its internal temperature automatically falls, resulting in exposed parts becoming numb (CP1) and an increased number of accidents (CP2) [31,42]. To prevent this, workers need to wear well-fitted personal protective clothing (PPC) that can entrap and retain heat. A proper fit is key to success, as clothing that is too loose does not retain warmth, and clothing that is too tight causes discomfort and a hobbling effect (CP3) [5,49,50]. When an individual’s body is unable to thermoregulate because of exposure to extreme cold, its internal temperature falls and it exhibits cold-related illnesses that result in cold stress, slowed actions and reactions, and an inability to perform tasks at the normal level of competence, causing physical fatigue (CP4) [36]. Hypothermia (CP5), which can decrease job performance by as much as 70% [43,44] and increases an individual’s vulnerability to frostbite, necrosis and respiratory problems, also occurs when the CBT falls significantly. Shivering from the cold causes vasoconstriction of blood vessels (CP6) [36] and exposure to cold air also causes cold injuries such as frostbite (CP7) are due to tissue freezing as ice crystals form on exposed body parts [42,45,46,47]. Frostbite and skin problems like dryness, pain, itching, and swelling are outcomes of exposure to cold dry air [36]. Workers exposed to rapid cooling are at risk of necrosis (CP8) [46,47].
Related Knowledge Centers
- Cheek
- Hypothermia
- Skin
- Injury
- Freezing
- Finger
- Toe
- Nose
- Ear
- Chin