Bureau of Workers Comp PA Training for Health amp Safety PATHS Who is at Risk Anyone who works outside is subject to cold weather injuries 2 PPT08401 Who is at Risk Whether during their regular shift or during extended shifts due to emergencies ID: 911216
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Slide1
Cold Weather Injuries
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Bureau of Workers CompPA Training for Health & Safety(PATHS)
Slide2Who is at Risk?
Anyone who works outside is subject to cold weather injuries!
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Slide3Who is at Risk?
Whether during their regular shift or during extended shifts due to emergencies.
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Slide4Who is at Risk?
Others at risk:
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Slide5Who is at Risk?
Those using extremely cold liquefied gases in industry such as:Liquid Nitrogen
and
Liquid Helium5
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Slide6Types of Cold Weather Injuries
Hypothermia
ChilblainsFrostbiteTrench Foot or Immersion Foot
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Slide7Hypothermia
Hypothermia is a Medical Emergency
Normal body temperature (98.6
oF) drops to or below 95oF.
Fatigue
or drowsiness; uncontrolled shivering; cool bluish skin; slurred speech; clumsy movements; irritable, irrational or confused behavior.
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Slide8Hypothermia
Symptoms
Mild
Moderate to SevereShivering Shivering will stopDizziness Lack of CoordinationHunger Clumsiness
Nausea Loss of Consciousness
Breathing/heart rate Shallow breathing/weak
increase pulse
Difficulty speaking Slurred speech/mumbling
Slight confusion Poor decision making
Fatigue Drowsiness, low energy
lack of concern
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Slide9Causes of Hypothermia
Wearing unsuitable clothing
Working or recreation outdoors too long
Exertion leading to wet clothingFalls into water
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Slide10Causes of Hypothermia
Risk Factors:
Elderly or very youngMental problems interfering with judgment; dementia or mental illness.
Alcohol and drug use causing blood vessels to dilateMedical conditions; poor nutrition, stroke, severe arthritis, Parkinson’s, diabetes; conditions affecting blood flow.
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Slide11Other Conditions
Freezing body tissues-frostbiteTissue death and decay-gangrene
Diagnosis is apparent by physical signsDon’t drink alcohol
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Slide12Hypothermia
What Should be Done? (land temperatures
)Call for emergency help (e.g. Ambulance or Call 911
).Move the person to a warm dry area.
Don’t
leave the person alone.
Remove
any wet clothing and replace with warm, dry clothing or wrap the person in blankets
.
Have the person drink warm, sweet drinks (sugar water or sports type drinks) if they are alert.
Avoid drinks with caffeine
(coffee, tea, or hot chocolate) or alcohol.
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Slide13Hypothermia
What Should be Done? (
land temperatures)
Have the person move their arms and legs to create muscle heat. If they are unable to do this, place warm bottles or hot packs in the arm pits, groin, neck and head areas.
Do
NOT
place them in warm water bath. This may stop their heart
.
DO NOT
rub the affected area, because rubbing causes damage to the skin and tissue.
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Slide14Hypothermia
What Should be Done? (water temperatures)
Call for emergency help (e.g. Ambulance or Call 911). Body heat is lost up to 25 times faster in water.
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Slide15Hypothermia
What Should be Done? (water temperatures)
DO NOT remove any clothing.
Button, buckle, zip and tighten any collars, cuffs, shoes and hoods because the layer of trapped water closest to the body provides a layer of insulation that slows the loss of heat.
Keep
the head out of water and put on a hat or hood.
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Slide16Hypothermia
What Should be Done? (Person not breathing)
If a person is not breathing or has no pulse: Call
911 for emergency medical assistance immediately.Treat the worker as per instructions for hypothermia, but be very careful and do not try to give an unconscious person fluids.
Check him/her for signs of breathing and for a pulse. Check for 60 seconds.
If after 60 seconds the affected worker is not breathing and does not have a pulse, trained workers may start rescue breaths for 3 minutes.
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Slide17Hypothermia
What Should be Done? (Person not breathing)
Recheck
for breathing and pulse, check for 60 seconds.If the worker is still not breathing and has no pulse, continue rescue breathing.
Only start chest compressions per the direction of the 911 operator or emergency medical services
*
Reassess patient’s physical status periodically
.
*
Chest compression are recommended only if the patient will not receive medical care within 3 hours.
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Slide18Hypothermia (water)
Get out of the water
quickly or climb on anything floating.
DO NOT attempt to swim unless a floating object or another person can be
reached.
S
wimming
or other
activity
uses the body’s heat and reduces survival time by about 50%.
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Slide19Hypothermia (water)
Can’t get out of the water: Wait quietly, conserve
body heat. Fold
arms across the chest, keep thighs together, bend knees, and cross
ankles.
If
another person is in the water, huddle together with chests held closely.
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Slide20Infants and Hypothermia
Visual cues:Skin-bright
red and coldLow energyWeak cry
Precautions:Dress infants and young in one more layer than adults for same conditions.
If shivering-bring indoors
and rewarm
.
Babies should not sleep in a cold room.
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Slide21Winter Driving Tips
Let your destination contact know when you’re leaving and estimated time of arrival.Keep emergency kit in car:
Blankets Matches
Clean can to melt ice for drinking First aid kit
Food
Jumper cables
Cellphone
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Slide22If Stranded on the Road
Bring everything you’ll need from trunk
to car
Stay covered and huddleRun
car for 10 minutes hourly to warm
up
Ensure
window is down a bit and exhaust pipe is
unobstructed.
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Slide23Chilblains
Painful inflammation of small blood vessels due
to sudden warming from cold temperatures. Symptoms:
Itching, red patches, swelling and blistering on extremities, such as on your toes, fingers, ears and nose.
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Slide24Chilblains
In one to three weeks, condition may
clear as weather warms.
Treatments typically consist of lotions and medication. Limit
your exposure to
cold
and dress warmly.
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Slide25Chilblains Risk Factors
Skin exposed to cold
Being female and underweight
Where DomiciledTime of year
Poor circulation
Diagnosed with Raynaud’s Phenomenon
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Raynaud’s Phenomenon
Slide26Frostbite Hazards
Temperature + Wind Speed=Frostbite
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Slide27Frostbite
Signs & Symptoms
At first, cold skin and a prickling feelingNumbness
Red, white, bluish-white or grayish-yellow skinHard or waxy-looking skinClumsiness due to joint and muscle stiffness
Blistering after rewarming, in severe cases
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Slide28Frostbite Stages
Frostnip: First stage
A mild form of frostbite.
Pale or red skin and feels very cold.
This
can lead to prickling and numbness.
As skin warms, pain
and
tingling
No permanent skin damage.
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Slide29Frostbite Stages
Superficial Frostbite: Second Stage
Reddened skin turns white or pale.
Some ice crystals may form in the tissue.
If your skin feels
warm
it is a
sign of serious skin
involvement
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Slide30Severe Frostbite
Severe (or deep) Frostbite: Third Stage
All skin layers and underlying
tissues involved.
Numbness
, loss of all
cold
, pain or discomfort
sensation in
the affected area.
Joints or muscles may no longer work.
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Slide31Frostbite Risk Factors
Medical conditions: dehydration
, exhaustion, diabetes and poor blood flow Alcohol or drug abuse
SmokingFear, panic or mental illness, inhibiting your ability to respond to cold
Previous frostbite or cold injury
I
nfant
or older
adult: difficulty in producing body heat
H
igh altitudes, reduce oxygen supply to your skin
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Slide32Frostbite
Seek medical attention for frostbite if you experience:
Signs and symptoms of superficial or deep frostbite — such as white or pale skin, numbness, or blisters
Increased pain, swelling, redness or discharge in the area that was frostbitten
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Slide33Frostbite
Seek Medical Attention if:
FeverNew, unexplained
symptoms Get emergency medical help
if
you suspect hypothermia,
a
condition in which your
body
loses heat faster than it
can be produced.
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Slide34Frostbite
What Happens to the Body:
Freezing in deep layers of skin and tissue. Pale waxy-white skin colors. Skin becomes hard and numb; usually affects the fingers, hands, toes, feet, ears and nose.
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Slide35Frostbite
What Should be Done?
Move the person to a warm dry area. Don’t leave the person alone.
Remove any wet or tight clothing that may cut off the blood flow to the affected areas.
DO NOT
rub the affected area, because rubbing causes damage to the skin and tissue.
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Slide36Frostbite
What Should be Done?
Gently place the affected area in a warm (105o
F) water bath and monitor the water temperature to slowly warm the tissue. Don’t
pour warm water directly on the affected area because it will warm the tissue too fast causing tissue damage. Warming takes about 25-40 minutes.
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Slide37Frostbite
After the affected area has been warmed, it may become puffy and blister.
The affected area may have a burning feeling or numbness.
When normal feeling, movement and skin color have returned, the affected area should be dried and wrapped to keep it warm.
NOTE
:
If there is a change the area may get cold again, do not warm the skin. If the skin is warmed and then becomes cold again, it will cause severe tissue damage
.
Seek medical attention as soon as possible.
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Slide38Frostbite Treatment
Medical treatment may involve:
Rewarming of skinPain medicine
Protection of injury locationDebridement of damaged tissueWhirlpool and wound therapy
Anti-infection and
clot-
removing drugs
Surgery or amputation
Hyperbaric oxygen therapy in a pressurized room
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Slide39Frostbite Complications
Increased sensitivity to cold
Risk of recurring frostbite
Long-term numbness in the affected areaChanges in the cartilage between the joints (frostbite arthritis)Growth defects in children, if frostbite damages a bone's growth
plate
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Slide40Frostbite Complications
Infection
Tetanus
Gangrene — decay and death of tissue resulting from an interruption of blood flow to the affected area — which can result in amputation
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Slide41Trench Foot or Immersion Foot
First noted in the trench warfare where soldiers suffer from this disease after having their feet exposed to prolonged moisture.
This disease is most prevalent during rainy days especially in places where
flooding is usual.
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Slide42Trench Foot or Immersion Foot
Characterized by
irritation, rash formation, and foot ulceration.
It results from a prolonged exposure of the feet to damp, wet, unsanitary and cold
conditions.
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Slide43Trench Foot
Usually evidenced with a tingling or itching sensation then pain, swelling and numbness usually felt right after removing the foot from being soaked for a very long time.
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Slide44Trench Foot Cause
While encountered during World War I, this was also an issue during subsequent wars; World War II, Korea and Viet Nam.
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Slide45Trench Foot Treatment
Prevention first!
Constant change to dry socks.
Keep feet dry and clean.
Do not wear
constrictive
footwear.
C
lean
the foot using mild cleansers.
Dry carefully using a clean towel.
After drying the feet, keep them elevated and gently warm them.
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Slide46Trench Foot Treatment
Elevating the affected area promotes increased blood circulation which reduces inflammation.
After elevating the feet, carefully warm them by immersing in warm circulating water, about 104F to 107
F, for 15 to 30 minutes.
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Slide47Trench Foot
See a physician:
Contact your podiatrist regarding the cure of the disease.
Cover the foot with adequate amounts of clean
cloth
to prevent
the
recurring of cold injury.
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Slide48Other Conditions
Other conditions due to cold environments would also include:
Dehydration
Cold DiuresisConstipation
Sunburn
Snow Blindness
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Slide49Dehydration
When you’re wearing multiple layers of clothing, you may not be aware of body moisture loss.You must drink water to replace fluid loss.
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Slide50Cold Diuresis & Constipation
Cold Diuresis is the increased output of urine during cold weather. Replace fluids.
Constipation may result due to putting off relieving yourself in the cold.
Eating dehydrated foods.Drinking too little liquid.
Irregular eating habits may contribute.
Eat fruits and increase fluid intake to at least 2 quarts a day.
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Slide51Sunburn
This is due to the sun’s reflection off many surfaces and striking sensitive skin:
SnowIce
WaterThe application of sunburncream and lip salve willh
elp.
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Slide52Snow Blindness
Sun’s ultraviolet rays are reflected off snow.Symptoms may include:
Feeling of grit in eyes,Pain in and over eyes which may increase with eyeball movement,
Watering eyes; becoming redA headache which intensifies
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Slide53Snow Blindness
Treatment is required since prolonged exposure may result in permanent eye damage.Bandage eyes until symptoms disappear.
Wear sunglasses.You can improvise sunglasses by cutting slits in cardboard.
Put soot on cheeks under eyes to reduce glare.
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Slide54MSD Risk Factors
Cold Temperatures
Cold environments compromise muscle efficiency.
Possible vascular and neurological damage.
Workers with cold-desensitized fingers may grasp loads with more force than necessary: exposes muscles, soft tissues, and joints to increased force.
Alcohol, nicotine, caffeine, and some medication increases MSD risks from cold temperatures.
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Slide55Preventive Hygiene
Washing areas where moisture develops can help prevent rashes to preclude more severe problems.
Wash where moisture and sweat accumulate:
Under armsBetween legs
Wipe dry and then periodically wipe in the same areas to remove moisture
Wash feet daily and put on dry socks.
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Slide56Protecting Workers
Recognize the environmental and workplace conditions that lead to potential cold-induced illnesses and injuries
.Learn the signs and symptoms of cold-induced illnesses/injuries and what to do to help the worker
.Train the workforce about cold-induced illnesses and injuries.
Select proper clothing for cold, wet and windy conditions. Layer clothing to adjust to changing temperatures. Wear a hat and gloves, in addition to underwear that will keep water away from the skin (polypropylene).
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Slide57Protecting Workers
Take frequent short breaks in warm dry shelters to allow the body to warm up.
Perform work during the warmest part of the day
.
Avoid exhaustion or fatigue because energy is needed to keep muscles warm
.
Use the buddy system (work in pairs
).
Drink warm, sweet beverages (sugar water or sports type drinks).
Avoid drinks with caffeine
(coffee, tea, or hot chocolate) or alcohol
.
Eat warm, high-calorie foods like hot pasta dishes.
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Slide58Protecting Workers
Workers Are at Increased Risk When…
They have predisposing health condition such as cardiovascular disease, diabetes, and hypertension.
They take certain medication (check with your doctor, nurse, or pharmacy and ask if any medicines you are taking affect you while working in cold environments).
They are in poor physical condition, have a poor diet, or are older.
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Slide59Protective Measures
The National Safety Council recommends:
General Controls to promote personal protection:
TrainingHygiene practices
Medical Surveillance
Specific Controls
advanced:
Engineering controls
Administrative measures
Person Protection (PPE)
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Slide60Wear Proper Clothing
Clothing should protect you from cold, wind, and precipitation and should also provide ventilation—be "breathable
".
Protect head, feet, hands, and face.
Keep
dry
.
Cover your head.
Up
to 40 percent of body heat can be
lost when the head is exposed
.Footgear should be insulated to protect against cold and dampness.
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Slide61Wear Proper Clothing
Dress in layers, wearing warm, waterproof/resistant clothing.
An outer layer to break the wind and allow some ventilation (like Gore-Tex® or nylon).
A middle layer of wool or synthetic fabric (Qualofil or Pile) to absorb sweat and retain insulation in a damp environment. Down is a useful lightweight insulator; however, it is ineffective once it becomes wet.
An inner layer of synthetic weave to allow ventilation. Synthetic materials such as
supplex
and
coolmax
are ideal because they keep you warm and dry.
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Slide62Employee’s Responsibilities
Dress for conditions
RehydrateKnow signs and symptoms of exposure
Keep clothing dryRewarm at station when requiredMaintain periodic communications with supervisor to apprise of team’s condition
Have an additional set of dry clothing on-hand
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Slide63Supervisor’s Responsibility
Brief all teams of their job duties and precautions for cold weather injuries
Check on team’s condition on periodic basis (by radio or field observations)Inform team of anticipated weather changes and impact
Provide periodic rest breaks in a warm shelterProvide hot beverages
Know signs and symptoms of exposure
Have provisions for First Aid and Advanced Care if required
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Slide64With Cold - Take No Chances
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Slide65Bibliography
Fundamentals of Industrial Hygiene, Barbara A. Plog, MPH, CIH, CSP, Editor in Chief, National Safety Council, Itasca, IL, 2012
FM 21-76, US Army Survival Manual, Headquarters, Department of the Army
www.mayoclinic.org/diseases-conditions/chilblains/basics/...
http://www.safetybok.org/osha_quick_card__cold_stress/
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Slide66Bibliography
http://www.mayoclinic.org/diseases-conditions/hypothermia/basics/prevention/con-20020453
http://www.mayoclinic.org/diseases-conditions/frostbite/basics/complications/con-20034608
http://gudhealth.com/trench-foot.htmlhttps://www.osha.gov/SLTC/emergencypreparedness/guides/cold.html
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Slide67Contact Information
Health & Safety Training Specialists1171 South Cameron Street, Room 324
Harrisburg, PA 17104-2501(717) 772-1635RA-LI-BWC-PATHS@pa.gov
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Slide68Questions
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