How to Work in Extreme Cold: Safety Precautions to Take

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Medically Reviewed By:
Mark Arredondo, M.D.

Some jobs require working out in the elements, and that can pose dangers to workers.

Having to perform job duties in extremely cold conditions can lead to a number of injuries and illnesses, according to the U.S. Occupational Health and Safety Administration (OSHA). People working in the following jobs may be susceptible:

  • Snow removal crews

  • Firefighters

  • Emergency medical technicians

  • Law enforcement officers

  • Sanitation workers

Here, experts discuss the health effects of working in extreme cold and offer the best ways to protect yourself in winter weather.

What happens to the body under extreme cold conditions?

“[In extreme cold], your body loses heat and blood flow to hands, feet, ears and the nose become restricted,” said Mathew MacLeod, senior technical specialist at the Canadian Centre for Occupational Health and Safety (CCOHS).

“Also, mental alertness can be reduced with prolonged exposure to the cold,” he added.

According to OSHA, blood flows away from the hands and feet in extreme cold to keep vital organs warm. This causes the skin and the extremities to become cold very quickly.

The U.S. Centers for Disease Control and Prevention says severe cold weather can trigger a variety of symptoms, such as:

  • Skin reddening

  • Shivering initially and no shivering as hypothermia progresses

  • Numbness

  • Blue-colored skin

  • Slow, shallow breathing

  • Dilated pupils

  • Cramping legs

  • Blisters

  • Swelling

  • Tingling and aching limbs, hands and feet

  • Blue, purple or gray feet (gangrene)

  • A loss of consciousness

What are the health problems associated with working in an extremely cold environment?

Let’s explore four cold weather injuries that OSHA says you should watch out for.


Chilblains occur when small blood vessels in your skin become inflamed. You might notice your skin turning red, itching and swelling. Sometimes chilblains leads to blisters and ulcers.


When your skin and the tissues below it freezes, they can become damaged. This is called frostbite, and the CDC says it usually happens to the fingers, toes, chin, cheeks, ears and nose.

According to OSHA, you may experience numbness, aching, tingling, blisters and blue or pale, waxy skin in the areas where frostbite occurs.


When your body temperature falls below 95° Fahrenheit, it’s considered hypothermia. Symptoms include shivering in the initial stages, which stops as your body temperature plummets. Confusion, lack of coordination, slower breathing, dilated pupils, a slow pulse and an inability to stand or walk are additional signs of hypothermia, according to OSHA.

Trench foot

When the feet are both cold and wet (or even consistently wet) your body sends signals to narrow your blood vessels. This causes the skin in your feet to lose oxygen and nutrients and start dying. This condition is known as trench foot.

Signs of trench foot include skin redness, swelling and numbness; leg cramps; bleeding beneath the skin; blisters or ulcers, and gangrene.

Who shouldn’t work under extreme cold conditions?

Here are seven health conditions and substances that may make it dangerous to work in extremely cold conditions.

Circulatory issues

Blood vessels constrict in the cold, and the heart has to work harder to keep you warm. The Inspira Health Network (IHN) says this can put a strain on heart muscles for those with heart disease.

Constriction also increases blood pressure, according to the Cleveland Clinic, which is why people with hypertension should avoid working in extremely cold temperatures.

Breathing issues

The IHN notes that airways can also become constricted in chilly weather, making it difficult to get enough oxygen if you have a condition that already affects your breathing, such as COPD.

Raynaud’s phenomenon

Raynaud’s phenomenon is a temporary condition that causes blood vessels to spasm, according to the U.K.’s National Health Service. This blocks blood flow to the extremities. The condition affects about 20% of adults around the world, and one of its triggers is cold weather.


The British Thyroid Foundation explains that cold intolerance is one of the main symptoms of hypothyroidism (underactive thyroid). This is because the thyroid gland is one of the key regulators of heat production.


Some research shows the body temperature of older people is lower because of reduced heat regulation, according to Life Enriching Communities. Circulation may also become poorer as people age, and the layer of protective fat beneath the skin can become thinner.


Diabetes UK notes that heart disease and neuropathy (nerve pain) are common complications of diabetes. In addition to the cold’s impact on the heart, it can also worsen that nerve pain.


Consuming alcohol causes your skin blood vessels to widen, which the CCOHS says can reduce your ability to shiver -- a vital natural response to the cold that helps keep you warm.

How can you protect yourself?

Dress for warmth and dryness

“Remember to dress in multiple layers of loose, dry, protective clothing when temperatures are at or below 4°C [39°F],” MacLeod advised. “Layers of warm clothing should include a wind-resistant outer layer, a hat, mittens or insulated gloves, a scarf, neck tube or face mask, and insulated, waterproof footwear.”

Take breaks from the outdoor air

MacLeod recommended taking “regular breaks from the cold in warm places.”

The Saskatchewan Occupational Health and Safety Division offers a warm-up work schedule based on the temperature and wind chill.

Eat and hydrate often

The CCOHS notes that working in colder weather burns more energy, which is why it’s important to eat and drink more frequently.

Monitor your body

According to the Canadian government’s Get Prepared Campaign, you should familiarize yourself with the common symptoms of cold weather injuries and illnesses and monitor yourself regularly for them. If you notice symptoms, get indoors to warmer temperatures, remove any wet clothing and seek immediate medical attention.

“Most importantly, encourage the use of a buddy system to watch for symptoms in others,” MacLeod emphasized.


Mathew MacLeod, senior technical specialist, Occupational Health and Safety, Canadian Centre for Occupational Health and Safety

Occupational Health and Safety Administration: Cold Stress Guide

U.S. Centers for Disease Control and Prevention: Cold Stress -- Cold Related Illnesses

Inspira Health Network: 5 Cold Weather Health Risks to Watch Out For

Cleveland Clinic: Vasoconstriction

U.K. National Health Service: Raynaud’s phenomenon

The British Thyroid Foundation: Myths and misunderstandings about thyroid disease

Life Enriching Communities: Are You Feeling Colder As You Get Older?

Diabetes UK: Cold Weather and Diabetes

Canadian Centre for Occupational Health and Safety: Cold Environments

Saskatchewan Occupational Health and Safety Division: Workplace Injury Prevention: Working in Cold Places

Government of Canada Get Prepared Campaign: Seven steps to cold weather safety

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