When one thinks about protecting workers above the neck thoughts inevitably jump to hard hats, noise protection and safety glasses. Barrels of ink have been exhausted on the writing of the ins and outs of these forms of personal protective equipment, yet protecting the body from the neck up is far less intuitive or effective when one considers temperature extremes. And irrespective of how infrequently you use your body parts from the neck up I think we can all agree that they are worth protecting.
While many believe that 40–50% of our body heat is lost through our heads, modern science has found that number to be considerably less – around 10%, or roughly akin to the percentage of our total body mass. Of course, that assumes that the person is naked or at the very least that all body surfaces are equally covered. Scarce few jobs require workers to actually perform their jobs naked, so for the purposes of this article, we will focus on those workers who remain at least partially clothed and whose duties require them to work outside in temperature extremes.
I live in Michigan and as I write this it is dark and it is a balmy -13° C degrees outside; today’s low is -18°C. I used to tell people I lived here because I like the close proximity to water, but this time of year I have to admit that the real reason I live here is because I am a stupid, STUPID man. For me staying warm in the frigid months to come is more than an academic exercise; it’s a necessity. Fortunately, I carry 15 stone of blubbery layers on my 1.7 metre frame to keep me warm (I throw so much heat that homeless people forgo the usual ritual of asking me for spare change in exchange for standing in a circle around me warming themselves like I am a human trashcan fire.)
“if the temperature outside is 1.7° C and the wind is blowing at 8 kph it would take less than 30 minutes to contract frostbite on exposed skin”
Beyond my walrus-like build and ability to keep warm, there are important considerations for keeping our face and heads warm (at least for the less… prosperously statured than I).
According to the UK’s National Health Service (NHS) “Frostbite is damage to skin and tissue caused by exposure to freezing temperatures – typically any temperature below -0.55C (31F). Frostbite can affect any part of your body, but the extremities, such as the hands, feet, ears, nose, and lips, are most likely to be affected.”
The NHS paints an even grimmer picture when it comes to severe cases of frostbite, “In severe cases of frostbite, the loss of blood supply to the tissue may cause it to die (gangrene). A type of surgery called debridement may be needed to remove the dead tissue. Amputation may be needed in very severe cases.” It takes surprisingly little time to develop frostbite. In fact, according to the US National Weather Service if the temperature outside is 1.7° C and the wind is blowing at 8 kph it would take less than 30 minutes to contract frostbite on exposed skin. These temperatures aren’t really that cold and the colder and windier it gets the less time it takes to develop frostbite. And it gets worse: according to the NHS the long-term health effects of frostbite can be severe: “After having frostbite, some people are left with permanent problems, such as increased sensitivity to cold, numbness, stiffness and pain in the affected area.” So when we talk about protecting the body from the neck up, we have to consider frostbite as a real threat.
The threat of frostbite is a continual issue for those who work on North Sea oil rigs, or outside in countries where winter temperatures dip to unholy levels. So here’s what can be done.
Know the conditions
Understanding the duration one can be exposed to the specific weather conditions without risking frostbite before work begins is key. Recognise that winter weather is a fickle beast and can change rapidly with little notice. Monitor the weather to ensure you are able to modify your safety strategy as needed.
Limit workers’ duration of exposure
As noted, it takes scarce little time to be seriously afflicted with frostbite, so after calculating the time it takes to suffer frostbite (there are many charts and graphs available on the web) allow a cushion of time between the rate of exposure and the workers’ coming into a shelter to warm themselves. Remember to allow time for the workers to safely shut down their work and walk to a shelter when you calculate the duration of cold weather works. A great way to limit workers’ exposure to the elements is to work in smaller, rotating work teams; this way while one team is warming the other is working and so on. This may seem unnecessarily cumbersome, but I would contend that it is not nearly as cumbersome as having someone contract frostbite and be unable to work or someone dying of hypothermia.
Create warming stations
Strategically placed warming stations can help prevent frostbite. Warming stations needn’t be as warm as your living room, but they should be warm enough so that workers can gradually raise the temperature of their skin. Note, having a warming station that is too warm will raise the skin temperature too quickly and cause the workers discomfort or even pain. Many workers would rather brave the cold than feel as if they have been put into a microwave oven.
Provide hot drinks and even a hot snack
Drinking coffee, hot tea, or even cocoa helps to raise the body temperature organically while keeping the worker hydrated. A good source of hot water is soup, as it fights both hunger and dehydration. Factors such as exhaustion, hunger, and dehydration further lower the body’s defences against frostbite.
Cover the body parts that can be covered
A loose-fitting, preferably wool scarf should be used to cover the workers’ mouths and nose. Note: tight fitting garments actually increase the danger of frostbite while wool has excellent insulating properties. A wool cap with earflaps should be worn by workers to protect the head and ears.
“all too often the hoods of non-FRC layers underneath PPE become reservoirs where flaming liquids collect and horribly injure workers; in cold weather make sure fire retardant clothing remains the outermost layer”
Know the symptoms of frostbite
Knowing the symptoms of frostbite and intervening before it occurs is your best defence against serious injuries related to it.
According to the Mayo Clinic, signs and symptoms of frostbite include:
- At first, cold skin and a prickling feeling
- Red, white, bluish-white or grayishyellow skin
- Hard or waxy-looking skin
- Clumsiness due to joint and muscle stiffness
- Blistering after rewarming, in severe cases
- Frostbite is most common on the fingers, toes, nose, ears, cheeks, and chin. Because of skin numbness, you may not realise you have frostbite until someone else points it out
Stages of frostbite
Frostbite occurs in several stages: frostnip, superficial frostbite, and severe (deep) frostbite.
The first stage of frostbite is frostnip. With this mild form of frostbite, your skin pales or turns red and feels very cold. Continued exposure leads to prickling and numbness in the affected area. As your skin warms, you may feel pain and tingling. Frostnip doesn’t permanently damage the skin.
The second stage of frostbite is superficial frostbite, which appears as reddened skin that turns white or pale. The skin may remain soft, but some ice crystals may form in the tissue. Your skin may begin to feel warm – a sign of serious skin involvement. If you treat frostbite with rewarming at this stage, the surface of your skin may appear mottled, blue or purple. And you may notice stinging, burning and swelling. A fluid-filled blister may appear 24 to 36 hours after rewarming the skin.
As frostbite progresses to severe levels it affects all layers of the skin, including the tissues that lie below. You may experience numbness, losing all sensation of cold, pain or discomfort in the affected area. Joints or muscles may no longer work. Large blisters form 24 to 48 hours after rewarming. Afterward, the area turns black and hard as the tissue dies.
Fire retardant clothing
If the workers are required to wear fire retardant clothing (FRC), such as those working in oil and gas exploration, for example, make sure that the fire retardant clothing is on the outermost layer. This may be more difficult than it seems. Many oil and gas workers will gladly don their FRC only to have a non-FRC hood sticking out of their jackets. Too often these hoods become reservoirs where flaming liquids collect and horribly injure workers. There are FRC sweatshirts that do come with a hood. If one of these types of sweatshirts is worn the hood must always be worn on the head when working outdoors to prevent flammable materials collecting in it.
A perilous commute
Perhaps some of you reading this don’t work in weather extremes and therefore don’t give much thought to protecting yourself against frostbite, but consider your commute to work. How well are you prepared should the car, bus, train, or hot air balloon breakdown? You may reason that since you won’t be standing in the cold for long you needn’t protect yourself from the elements, yet many a commuter has found themselves in real peril because they failed to consider the possibility of an unplanned excursion into severe weather.
“too many people see staying warm while working outdoors in arctic temperatures as a mere luxury, but it really is as important as wearing a hard hat in areas where falling objects may injure a worker”
Falls on the ice
Another thing to consider in protecting oneself from the neck up in weather extremes is to wear appropriate footwear. Slipping on the ice and losing consciousness is a real and often life-threatening possibility. I have a friend who, while working at a car dealership, exited his vehicle, slipped on the ice and was knocked unconscious. He lay unconscious for around 45 minutes unnoticed in the line of cars. Fortunately, he suffered no long-term ill effects, but between the blow to the head, the loss of consciousness and the threat of hypothermia (he wasn’t bundled up to protect his face and head from frostbite) his fate could have been far worse. On the other hand, he still works at an automobile dealership and to hear him tell it, death may have been preferable. One simple bit of PPE could likely have prevented his ordeal: ice cleats.
Ice cleats are relatively inexpensive and effective protection from falls on the ice. They come in a range of styles and are easy to put on and take off. I use them when I walk my imbecilic Labradors in subarctic temperatures each morning and they greatly increase my safety. It’s worth noting that some workers complain that wearing ice cleats makes it feel that they are walking on an uneven surface all day and may be reluctant to wear them. Personally, I would rather feel as if I were walking on an uneven surface or even through quicksand than take a spill on the ice and suffer a closed head injury, but I guess to each his or her own.
First aid for frostbite
If despite our best efforts we fail to prevent frostbite, it is of paramount importance to get medical attention as soon as possible. If you are in a remote area and are unable to get medical attention quickly, there are some things you can and should do while you are waiting for medical attention.
Warm the afflicted area
Warming a frostbitten body part is a nuanced process. Contrary to what you may have heard from movies, television or a sleazy lothario, fleshto- flesh contact is not the preferred method of warming frostbitten flesh. Experts warn that this method should only be used as a last resort.
The best way, according to WebMD, to warm an afflicted area is to:
- Get the person to a warm place and remove their wet clothing
- Unless absolutely necessary, the person should not walk on frostbitten toes or feet
- Do not rewarm the skin until you can keep it warm – warming and then re-exposing the frostbitten area to cold air can worsen damage
- Gently warm the area in warm water (not hot) or with wet heat until the skin appears red and warm, using a compress to gently warm the frostbitten areas above the neck
- If no water is nearby, breathe on the area through cupped hands and hold it next to your body
- Do not use direct heat from heating pads, radiators, or fires – heating a frostbitten area creates a kind of thermal shock that damages the tissue of the afflicted area and actually does more injury than good
- Do not rub or massage the skin or break blisters – while this may seem obvious many people will rub or massage the skin in an effort to get the blood circulating, but all it does is further injure the affected area
While it is similar to a sunburn, the red and sore skin that frequently occurs in cold and blustery weather is neither caused by the sun’s harmful rays nor is it, in fact, a burn. Windburn occurs when low temperatures and low humidity combine to dry out exposed skin. Unlike frostbite, windburn isn’t serious but can be very painful. To treat windburn apply unscented moisturising cream to the affected area.
As any avid skier can tell you, it doesn’t have to be warm and sunny to cause you to get a nasty sunburn. Despite the fact that most of us consider sunburn a summer problem, the sun’s ultraviolet rays can penetrate cloud cover and cause sunburn. Wearing a sunscreen will protect us from both sunburn and windburn (as it moisturises our skin.) If the weather is sunny but frigid, a cruel trick mother nature frequently plays, workers should wear appropriately tinted sunglasses because the ultraviolet rays not only beam down at them from above but are also reflected by any snow on the ground.
Keeping the body warm is hard work and as our bodies work hard proper hydration becomes key. Symptoms of dehydration include:
- Inability to concentrate – an inability to concentrate increases the likelihood that a worker will commit errors, which in cold weather could be deadly
- Fatigue – dehydrated individuals also become easily fatigued, which is another performance inhibitor that leads to increased error making
- Dry skin – as discussed, dehydration plays a major role in windburn which can be painful
Keep plenty of warm beverages on hand and ensure that workers drink them when they come in to warm themselves. Explaining why drinking plenty of water – or eating soup – is important will help with those workers who refuse to drink because they don’t believe they are thirsty.
Protecting oneself from the neck up may seem like an easy thing to do, but as you can now see it is not nearly so cut and dry as you may have once believed. Too many people see staying warm while working outdoors in arctic temperatures as a mere luxury, but it really is as important as wearing a hard hat in areas where falling objects may injure a worker or where gloves are used to protect workers from cutting their hands or getting splinters. Keeping workers warm not only protects them from injuries and illnesses, it decreases the human errors they might otherwise commit that could lead to devastating consequences.