Cold Injury Prevention

Last Updated: October 14, 2022
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Soldier in snow storm

​​Cold weather injuries (CWIs) include hypothermia, frostbite, chilblains and trench foot (prolonged wet skin), when heat loss is greater than heat production in an area of the body or body core. But cold temperatures, snow, or ice conditions are also associated with dehydration, snow blindness, slips or falls, and burns, electric shock, or carbon monoxide poisoning from heaters. Other injuries may occur when cold stress impacts physical or mental functioning. 

​Soldiers have an increased likelihood of exposure to cold weather during various training and operational activities in colder and/or wet climates. Military surveillance data finds that rates of cold injuries are higher among African Americans, women, Service members under 20 years, and the enlisted population, especially those recently acclimated to warmer climates. However, anyone can become a CWI casualty in the right conditions. 

Additional risk factors are discussed below and detailed in this FACTSHEET



Prior Cold Injury or Certain Medical Conditions: 

Persons who have had a cold injury in the past, or who have certain existing medical conditions, are much more likely to develop a CWI within a shorter period of time or more severe CWIs. For example, Raynaud’s Disease is a disorder that causes blood vessel constriction in cold temperatures, resulting in reduced blood flow to the extremities (e.g., fingers and toes). Anemia, diabetes, sickle cell disease, hypotension, and atherosclerosis may also increase susceptibility to frostbite and other CWIs. Leaders and Soldiers need to be aware of persons with these conditions. 

Medications: 

Some medications impair blood vessel constriction increasing risk of CWI. These include but are not limited to benzodiazepines, tricyclic antidepressants, barbiturates, and general anesthetics. Soldiers on these medications should let leaders and battle-buddies know if their medication puts them at increased risk.


Alcohol and Nicotine: 

Alcohol imparts a sense of warmth, causes dilation of skin blood vessels, and increases heat loss to the environment. It may also impair the senses and judgment, making it difficult for a Soldier to detect signs and symptoms of a CWI. Tobacco use (through smoking or chewing) causes increased constriction of skin blood vessels, which increases the risk for frostbite. 

 

Over- and Under-Activity: 

Vigorous exercise/activity induces sweating, which leads to wet clothing and subsequent increased heat loss. Conversely, under-activity results in low heat production, which may lower the body’s core temperature. 


Clothing: 

Close-fitting clothing reduces insulation and may restrict movement, resulting in heat loss. Clothing should be worn loosely and layered to allow adjustments as physical activity levels and environmental conditions change. 


Dehydration: 

Inadequate fluid intake affects the body’s ability to sustain physical activity, which affects thermoregulation (i.e., the balance between heat production and loss). In cold environments, sensitivity to thirst declines, which can increase the risk of dehydration during strenuous activity, where fluid loss often exceeds intake. 


Inadequate Nutrition: 

Underfeeding can cause low blood sugar (hypoglycemia), which impairs shivering; thus making it difficult to generate body heat. Low carbohydrates stores also limit the ability to maintain physical activity. 



General Prevention Tactics Include: 

  • Increase resilience to cold weather by consuming a healthy diet, drinking plenty of fluids, maintaining fitness levels, and getting quality sleep each night. 
  • Dress properly in a way to easily adjust (loose layers). 
  • Ensure skin is kept dry (trench foot, from prolonged wet skin can occur in any temperature).
  • Balance the time spent in cold weather conditions - especially if you are at-risk with prior CWI, medical condition, or medication.
  • Wear dark UV protective glasses, sunscreen and lip balm.
  • Use gloves to handle all equipment and fuel products.
  • Do not use face camouflage at temperatures below 32°F.
  • Stay hydrated - drink warm liquids.