Cold related injuries

Most individuals have the luxury of working in an office or some other type of edifice, so cold related injuries wouldcold rarely, if ever, be a concern. However, there are organizations and industries in which people work outside on a frequent or regular basis. Parks employees, road workers, construction, military, for example, have duties that involve braving the elements to earn a paycheck. While working outdoors, especially during winter weather, it’s important to take precautions to avoid injuries related to the cold.

Though apathy and lack of awareness may contribute to risk, there are other contributing factors to cold related injuries.

  • Inadequate or wet clothing
  • Consuming substances that inhibit the body’s response to cold, or that impair judgment.
  • Poor physical fitness
  • Illness, such as a cold or the flu
  • Becoming fatigued, restrained, injured, lost or entrapped out in the elements
  • Also, men have a notable higher rate of cold related injury than do women.

Damage can occur through the following conditions:

Cold stress: When the body struggles to maintain its normal temperature, the body will begin to shift blood flow from the extremities and outer skin to the chest and abdomen. Exposed skin and the extremities will cool more rapidly and increase the risk of more serious cold related injuries, such as frostbite and hypothermia. First indication is shivering.

Rewarm an individual suffering from cold stress by wrapping their body in blankets, finding shelter, and providing a radiant heat source. Encourage him or her to stay in motion to generate body heat.

Hypothermia: When the body is unable to replace heat lost to the elements, body temperature will become abnormally low.

Symptoms include:

  • Shivering
  • Fatigue
  • Loss of coordination
  • Slurred speech
  • Disorientation

More advanced indicators may involve:

  • The lack of shivering
  • Blue skin
  • Dilated pupils
  • Shallow breathing
  • Irregular heartbeat

In the late stages, the victim might feel so hot they may want to remove clothing. If left untreated hypothermia can result in unconsciousness and eventually death.

Helping someone with hypothermia:

  • Request immediate medical assistance.
  • Move the person to a warm, dry room or shelter
  • Remove wet clothing, including shoes and socks
  • Keep the person in a horizontal position.
  • Cover him or her with layers of blankets or towels and a vapor barrier for example a tarp or garbage bag.
  • Cover the head and neck but not the face
  • If alert, offer a warm, sweetened, nonalcoholic beverage.
  • Place warm bottles or hot packs in armpits, the groin area and along sides of the chest.
  • Ask emergency technicians for additional rewarming instructions.

 

A person in late stage hypothermia and unconscious is in a lethal situation. Wrap him or her in blankets and quickly transport them to where they can receive medical attention. Do not attempt to rewarm them.  If they stop breathing or don’t have a pulse for the period of one minute, CPR should be started. However, don’t apply chest compressions without the direction of an emergency medical technician (EMT).

Immersion Hypothermia: This condition is when exposure to cold water results in hypothermia. Damage occurs more quickly when a person is wet as water conducts heat away from the body 25 times faster than air. Don’t let warmer water fool you. Immersion hypothermia can occur in water temperatures below 70°F.

Helping someone with this type of hypothermia is similar to nonimmersion hypothermia.

 Frostnip and Frostbite:  Frostnip is a mild freezing of the top layers of skin tissue and is reversible. Frostbite is irreversible and occurs when the skin freezes, causing ice crystals to form between cells. Toes, fingers, ears, cheeks and the nose are particularly prone to frostbite. In serious cases, tissue, muscle and bone may be affected and amputation may be required.

Symptoms of Frostbite:

  • Numbness, tingling, stinging or aching,
  • Bluish or pale, waxy skin.

If caught early, recovery from frostbite is possible.  If there is no danger of freezing, mildly frozen tissue may be rewarmed and insulated until medical attention is received.

In case of frostbite:

  • Get indoors immediately.
  • Seek medical attention.
  • Remove constrictive clothing and jewelry that could impair circulation.
  • Place dry, sterile gauze between toes and fingers to absorb moisture and keep them from sticking together
  • Elevate the affected area to reduce pain and swelling

Immediate care recommendations for deep frostbite:

  • Follow guidelines for the treatment of hypothermia.
  • Do not rub or massage the affected area to warm it.
  • Do not apply snow or water, or break blisters.
  • Loosely cover and protect the area from contact.
  • Do not try to rewarm the frostbitten area without professional medical assistance. For example, do not place in warm water. Rewarmed tissue sustains further damage if it refreezes.
  • Warm with radiant heat. Do not use a heating pad, heat lamp or the heat of a stove, fireplace or radiator. Numb extremities can be easily burned.

Trench/Immersion Foot:  This happens when the body, to reduce heat loss, constricts blood vessels to cut down circulation in the feet. Without circulation, the skin tissue will die. This can occur in temperatures as high as 60°F if the feet are constantly wet.

Symptoms include:

  • Numbness, a tingling and/or itching sensation accompanied by,
  • Redness, swelling, leg cramps, blisters or ulcers, and bleeding under the skin.
  • In some cases, gangrene may turn feet dark purple, blue or gray.

 For immediate care:

  • Avoid walking
  • Remove footwear and socks, and dry the feet.
  • Moving to a warm, dry area and using rewarming techniques is usually only minimally effective.
  • Seek medical treatment.

Chilblains: These are damaged capillary beds (groups of small blood vessels) in the skin. They are caused by repeated exposure to temperatures just above freezing and up to as high as 60°F. Damage is permanent.

Symptoms:

  • Redness and itching—usually on cheeks, ears, fingers and toes
  • Blistering, inflammation and, in severe cases, ulceration.

Caring of chilblains:

  • Avoid scratching.
  • Slowly warm the skin.
  • Use corticosteroid creams to relieve itching and swelling.working outdoors
  • Keep blisters and ulcers clean and covered.
  • Seek medical advice.

 How to prevent these cold related injuries:

  • Use your head:
    • Check the weather forecast and be prepared for changing conditions.
    • If working on ice, be sure it’s thick enough to safely support applied weight.
    • Take extra precautions if you are unaccustomed to the cold or exerting yourself at higher elevations.
  • Clothing:
    • Wear layers of cold weather clothing retain body heat and repel water.
    • Wool, silk and most synthetics retain their insulating properties when they are wet.
    • Pack extra clothing in case you get wet.
    • Wear goggles or sunglasses to protect your eyes and sunscreen to protect your skin, even when it’s overcast.
    • The Army Medical Department website states to remember the acronym COLD.
      • C: Keep it Clean; O: Avoid Overheating; L: Wear clothing Loose and in layers; D: Keep clothing Dry
    • Follow the rules:
      • Stay on paths and trails and out of restricted areas.
      • Use your phones for emergencies and do not use it while engaging in a work or recreation activity.
    • Avoid fatigue:
      • Staying fit year-round is one of the best ways to manage fatigue and prevent serious injuries.
      • Follow an exercise regimen that helps build strength, stamina and flexibility.
      • Always stretch before and after your activity.
      • Take a break in a warm place if you are in pain or feel exhausted.
      • Keep your body fueled and well-hydrated. Drink plenty of water, eat nutritious meals and carry snacks to boost your energy.
      • Cold-weather workers who wear heavy, protective clothing require 10-15 percent more calories a day compared to those working in temperate climates.

Much of this advice is common sense. Don’t put yourself in peril by not being prepared for being in cold weather. This information isn’t only for those who work in the cold, but those who play in it as well – skiers, snowboarders, snowmobilers, etc. Whether at work or play, use your head, wear appropriate clothing and bring extra, and stay out of restricted areas and you should be able to avoid cold related injuries.

10 Common Causes of Workplace Injuries

Many of the cases I handle result from injuries sustained at the workplace. Much of the time, work injuries are Work injury
preventable. Every year, Liberty Mutual puts out a Workplace Safety Index which outlines the top ten causes of serious, nonfatal workplace injuries. Here is what they came up with:

2016 Workplace Safety Index (based on 2013 injury data)

 

10. Repetitive Motion Injuries – Engaging in some type of repetitive motion during the day, such as typing or styling hair can put pressure on the median nerve and cause muscle and tendon strain. This can result in numbness and pain in the fingers, wrists and hands, back pain, vision problems, and carpal tunnel syndrome. Using ergonomic equipment can help decrease instances of this kind of injury.

9. Struck Against Object or Equipment — When a person accidentally runs into a physical object such as a wall, door, or cabinet for example, injury may occur. Head, knee, neck, and foot injuries are most common with this type of incident. Keeping work areas free of hazards and employees being aware of their surroundings can help prevent these types of injuries.

8. Machine Entanglement – Entanglement usually occurs when heavy equipment and machinery are operated. If safety measures are not properly exercised when using heavy machinery, clothing, shoes, fingers and hair could become trapped. Protective equipment and again, employee diligence can help avoid these types of injuries.

7. Slip or Trip Without Fall — Break rooms and kitchens are common places for slips to occur because of the number of liquids that get splashed and spilled then are not cleaned up. Mopped and waxed linoleum, hardwood or tile floors are especially perilous. Footwear without nonskid soles may also contribute to slipping at work.

Obstacles in high traffic areas, extension cords not properly taped down and loose carpeting can all contribute to tripping up employees. Hallways without proper lighting and stairways are hazardous as well.

6. Roadway Incidents Involving Motorized Land Vehicles – This is not limited to car accidents, though vehicle collisions do occur when driving is part of an employee’s job. These types of incidents also include pedestrian workers struck by a vehicle in the work zone. Drivers should be mindful when passing through road construction sites. Keeping speed low and watching for road workers may prevent an avoidable injury or death.

5. Reaction Injuries and Other Exertions– Much of the time this happens while slipping or tripping. For instance, if an individual slips or trips, jerking actions as they try to regain their balance may cause pulled muscles or broken bones. Sometimes it’s just better to fall. Exertions include bending, crawling, reaching, twisting, climbing, stepping, kneeling, sitting, standing or walking.

4. Struck by Object – Equipment and furniture not properly anchored, or boxes inadequately stored on shelves can be falling hazards. If they become dislodged or loose, they could topple down on an employee and cause serious injuries. Head injuries are the most common result of this type of occurrence. Personal protection gear, such as a hard hat, may keep workers safe from harm.slippery when wet

3. Falls to Lower Level – If a worker falls from an elevated area, like a roof or ladder, serious injury may occur. Falls to lower levels can also include slipping or falling due to faulty equipment or gear. Always inspect equipment for defects and ensure it is properly assembled. Also make a habit of wearing all personal protection gear required for a job.

2. Falls on Same Level – This refers to slipping and tripping that results in a fall. Icy walkways into work and wet floors can result in slipping. Electrical cords, area rugs, and other hazards may cause an employee to trip. Common falling injuries include muscle injury, sprained or torn ligaments, bone fractures, and head injuries.

1. Overexertion – The leading cause of workplace injuries consist of actions that lead to fatigue such as lifting, pushing, pulling, holding, carrying, and throwing. Mental and physical exhaustion can occur when someone pushes themselves too hard. This leads to impaired judgment and slower reflexes. Those deficiencies can be lethal if operating heavy equipment, industrial machinery, or motor vehicles.

Workplace injuries put employees at risk of a visit to the ER or even death. Other considerations for employers are higher insurance rates, a decrease in worker productivity and diminished employee morale. For the worker it could mean a loss of wages, medical bills, change in routine and/or lifestyle, and stress on family and friendships.

Employers and laborers alike should make safety at work a top priority. Business owners should provide competent training and education to ensure the proficiency of their employees. They should devote time and money to ensure proper maintenance of all equipment and gear, to keeping the workplace free of hazards, and to confirm their employees are following protocol. Workers should check their own equipment for defects, make certain they’re using the right gear for the right job, be cognizant of their surroundings, and err on the side of caution.

What is your take on workplace injuries? Should the responsibility fall more on the shoulder of the employer or worker? Or should it be an even split.

Keeping the workplace safe

Safety measures at work are vital to keeping employees protected from harm. All workplaces, from small offices to large factories, can be vulnerable to worker injuries. Ensuringhard hat
hazards are cleared promptly, machinery is operating properly, and that workers keep themselves healthy and safe is an ongoing process and the responsibility of all employees, from top level to new hires.

According to the Bureau of Labor Statistics 2014 Census:
  • More than 13 workers per day died while doing their jobs.
  • 4,454 of those were men and 367 were women.
  • The majority were between 45 and 64 years old
  • The most affected industries were:
  • Construction, (899 deaths)
  • Transportation and warehousing (766)
  • Agriculture (584)
  • Government (435)
  • Professional and business services (425) and
  • Manufacturing (349)
Most of them, 1,984 died in transportation incidents, followed by:
  • Slips, trips and falls: 818
  • Injuries by people or animals: 765 (409 of these were homicides)
  • Contact with objects and equipment: 715
  • Exposure to harmful substances or environments: 390
  • Other events or exposures: 149
How can workplaces stay safe? Here are some ideas:

 

Preventing trips, slips and falls:
  • Report and/or clean up spills and leaks.Work injury
  • Keep hallways, aisles and exits clear of obstacles.
  • Install mirrors and warning signs to help with blind spots.
  • Replace dilapidated, torn or damaged flooring.
  • Anti-slip flooring is available and could be used in areas that can’t always be cleaned immediately.
  • Don’t be complacent, check work areas for protruding nails, holes or loose boards.
  • Make sure cords, wires, etc., are not out where people could stumble over them. Or cover them with a mat or tape to keep them from being a tripping hazard.
Eradicating fire hazards:
  • Keep combustible materials in a safe storage area unless they are needed for a job. Then only keep amounts needed in the work area.
  • Store quick-burning, flammable materials in designated locations away from ignition sources.
  • Change clothes if they are contaminated with flammable materials.
  • Keep passageways and fire doors free of obstructions and stairwell doors closed. Do not use the stairwell for storage.
  • Automatic sprinklers, fire extinguishers and sprinkler controls need at least an 18 inch clearance, thought 24 to 36 inches is recommended. Also, there needs to be a 3 foot clearance between any stacked materials and the ceiling. If stock is piled more than 15 feet high, double the clearance size.
  • Always report hazards in electrical areas and ensure work orders are turned in for repair.
Avoid falling objects:
  • Defenses such as a toe board, net, etc., can help prevent objects from falling and injuring workers.
  • Ensure any stacked materials are straight up and down to keep them from falling or toppling over.
  • Place heavy objects on lower shelves.
  • Keep items away from desk and table edges.
  • Don’t stack objects in workers walking paths.
Use safety gear when needed:
  • Know what equipment, tools and gear is essential to stay safe at work.safety goggles
  • Ensure knowledge of how to properly put on, adjust, wear, remove and store safety gear.
  • Understand how to properly use equipment and tools.
  • Types of safety gear include, but are not limited to:
    • Eye and ear protection
    • Respirators
    • Head protection
    • Foot and leg protection
  • Do Maintenance checks on tools and equipment regularly.
  • Immediately repair or properly remove any equipment that is broken or damaged.

It’s up to employers and workers alike to maintain a safe workplace. Most workplace injuries and deaths are preventable. Working together and being diligent, responsible and knowledgeable can and will save lives. You can find safety training courses at The National Safety Council. Need more info? The best resource is the Occupational Safety and Health Administration.