Do the Prep Work

Smart work practices, proper clothing, first aid awareness, and vigilance should ward off the season's illness and injuries.

• By Fred Elliott
• Nov 01, 2005

ADEQUATE preparation surely is the answer to many of life's challenges and dangers. It is well established that prevention's value outweighs the cost of incidents themselves (for example, the UK Department for Transport has calculated that the total value of preventing the 229,014 highway accidents in Great Britain in 2001, of which 3,176 were fatal accidents and 31,588 were serious accidents, would have been roughly $31 billion, or about $135,000 per accident).

Preparing for winter hazards is a perfect example. Intelligent work practices, proper clothing, first aid awareness, and vigilance should ward off the illness and injuries that are more common in winter--as well as those that are less common.

Poisonings
Wind chills and hypothermia spring to safety managers' minds when winter approaches. Few would think immediately of poisons, but in fact, a leading cause of poisoning deaths is exposure to carbon monoxide, especially during colder winter months. Faulty gas furnaces and automobiles are the most common sources of carbon monoxide poisoning.

Poison control experts also warn of ethylene glycol, a sweetish ingredient in automobile radiator antifreeze that is sometimes ingested by children or pets.

Hypothermia and Frostbite
Hypothermia is a dangerously low body temperature (one that is below 95 degrees F). People who are considered at highest risk of hypothermia include those who are very young or very old; the chronically ill; people who are overtired, and those who are under the influence of alcohol or drugs. Heart failure can occur when the body's temperature drops below 90 degrees F.

Hypothermia occurs when a person's body loses more heat than it can generate. It is usually caused by extended exposure to the cold. It is commonly caused by being outside in cold temperatures without enough protective clothing; falling overboard from a boat into cold water; wearing wet clothes in windy or cold weather; or heavy exertion during cold weather while not drinking enough fluids. Symptoms include drowsiness, confusion, loss of coordination, uncontrollable shivering, and slowed breathing or heart rate.

Frostbite is a risk for someone who is experiencing hypothermia. It usually occurs in exposed areas or extremities, which can be numbed because of slowed blood flow. When frostbite starts, the worker will lose feeling in the affected area. The frozen tissues will appear whitish or pale. If frostbite is suspected, have the worker hold the frostbitten area closely against warm skin to return blood flow and warmth to that area.

For a wind chill chart, a handy wind chill calculator, and answers to typical questions about wind chill and cold, visit www.nws.noaa.gov/om/windchill. That's the address of the Wind Chill Temperature Index from the Office of Climate, Water, and Weather Services inside the NOAA National Weather Service.

Apparel for Cold Temperatures
Workers who are about to spend time outside in the cold should not smoke or drink alcohol or smoke. They should drink plenty of fluids, eat and rest properly, and wear appropriate clothing:

• Mittens or gloves
• Windproof, water-resistant clothing, in multiple layers
• Two pairs of socks (have them wear cotton next to skin, then wool)
• A scarf and hat that cover the ears

In extremely cold temperatures, especially with high winds, workers should not be outside in wet clothes. They should be cautioned about poor circulation, which is more likely because of age, tight clothing or boots, cramped positions, fatigue, certain medications, smoking, alcohol, and diseases such as diabetes that affect circulation.

First Aid
1. Call 911 if symptoms of hypothermia are observed.

2. If the person is unconscious, CPR may be necessary; check airway, breathing, and circulation.

3. Take the victim inside to room temperature if possible and cover him with warm blankets. If going indoors is not possible, get the person out of the wind and use a blanket to provide insulation from the cold ground. Cover the person's head and neck to help retain body heat.

4. Once inside, remove the person's wet or constricting clothes and replace them with dry clothing.

5. Warm the person with warm compresses or your own body heat if necessary. If the person is alert, give warm, sweetened, non-alcoholic fluids.

6. Don't use direct heat (such as hot water, a heating pad, or a heat lamp). Don't give the victim alcohol.

Slips and Falls
Walking on snow or ice is treacherous. OSHA advises that it is essential to wear proper footwear in those conditions. Recommended PPE includes well-insulated boots with good rubber treads and also rubber overshoes or ice cleats.

An OSHA advisory about winter storms suggests walking slowly with short steps when traversing an icy or snow-covered walkway; workers should be on the lookout for vehicles that lose traction and should be aware that approaching vehicles may not be able to stop at crosswalks or traffic signals.

"At night, wear bright clothing or reflective gear, as dark clothing will make it difficult for motorists to see you," the advisory page says. "During the daytime, wear sunglasses to help you see better and avoid hazards."

Cold Stress Checklist
OSHA advises workers in construction, commercial fishing, maritime, and agriculture to take precautions against the effects of prolonged exposure to freezing or cold temperatures. Serious health problems can result. Danger signs include uncontrolled shivering, slurred speech, clumsy movements, fatigue, and confused behavior. If you observe these signs, call for emergency help.

Other tips:

• Learn the signs and symptoms of cold-induced illnesses/injuries.
• Train all exposed workers about cold-induced illnesses and injuries.
• Encourage workers to wear proper clothing for cold, wet, and windy conditions, including layers so they can adjust to changing conditions.
• Be sure workers take frequent, short breaks in warm, dry shelters to allow them to warm up.
• Try to schedule work for the warmest part of the day.
• Use the buddy system: Make sure work is done in pairs so one worker can recognize another's danger signs.
• Provide and encourage consumption of warm, sweet beverages. Avoid drinks with caffeine or alcohol.
• Eat warm, high-calorie foods, such as hot pasta dishes.
• Keep in mind that workers are at increased risk when they take certain medications, are in poor physical condition, or suffer from illnesses such as diabetes, hypertension, or cardiovascular disease.

This article appeared in the November 2005 issue of Occupational Health & Safety.

This article originally appeared in the November 2005 issue of Occupational Health & Safety.