Cold injuries occur as a result of exposure of the body to cold weather, in either wet or dry conditions. The cold may affect:
- the whole body by decreasing the core body temperature – generalised cold injury (hypothermia)
- a specific part of the body – localised cold injury (1).
Cold weather injuries is a significant issue in the Armed forces:
- 488 UK Armed Forces personnel who were identified as having a cold injury during the period Oct 2015 – Sep 2016
- rates are higher in the untrained and the young (16–19 years).
Cold weather injuries have also been reported in occupations associated with harsh weather conditions such as fishermen and cold storage workers (butchers, meat processors).
- However over the last decade civilians have also been affected by these injuries due to the increase in popularity of activities with a high risk of cold weather injuries such as skiing and winter mountaineering (2).
Localised cold injuries may be further divided into:
- freezing cold injuries (FCI)
- parts of the body freeze due to exposure to cold resulting in significant disability – the extremities (face, fingers, toes, heels and soles of the feet) are most prone
- tissue freezing is present
- two types of FCI:
- frost nip – superficial tissue injury with recovery of the injured part within 30 minutes of re-warming
- frost bite – deeper tissue injury that may result in lasting damage
- non freezing cold injuries (NFCI)
- injury, often to feet or hands, caused by allowing the body part to remain cold or wet for long periods
- does not involve tissue freezing
- NFCI can be
- trench or immersion foot
- pernio/chilblains (1,2).
Note:
- FCI and NFCI may coexist in a single individual or in the same limb. However the dominant form is usually evident (2).
Reference:
- Government of UK. Ministry of defence. Joint Service Publication (JSP). Heat illness and cold injury: prevention and management (JSP 539) 2017.
- Heil K et al. Freezing and non-freezing cold weather injuries: a systematic review. Br Med Bull. 2016;117(1):79-93.