How to Prevent Cold Stress in the Workplace? Complete Safety Guide

Key Takeaways

• Cold stress does not require extreme or subzero temperatures to become dangerous.

• Cold stress risk increases significantly when temperatures drop below 40°F (4.4°C), especially with wind or moisture.

• Hypothermia occurs when the body’s core temperature drops below 95°F (35°C).

• Employers have a duty to recognize cold stress risks, train employees properly, and put controls in place before injuries occur. 

What Is Cold Stress?

Cold stress is a condition that occurs when the body loses heat faster than it can produce it. Prolonged exposure to extremely cold temperatures can overwhelm the body’s ability to maintain a normal body temperature. When this happens, workers are at risk of serious medical conditions that can escalate quickly if not addressed.

But how cold is too cold? There is no single temperature that is “too cold” for all workers, and cold stress does not only occur in extreme Arctic conditions. Risk depends on several factors:

• • Air temperature

  • Wind speed (wind chill)

  • Wetness from rain, snow, or sweat

  • Work intensity and duration

  • Clothing and protective equipment

Many safety organizations, like the Occupational Safety and Health Administration (OSHA), note that cold stress risk increases significantly when temperatures drop below 40°F (4.4°C), especially with wind or moisture. Below 32°F (0°C), the danger rises sharply, and additional controls are often required.

What Are the Types of Cold Stress and Their Early Symptoms?

What Is Hypothermia?

Hypothermia occurs when the internal body temperature drops below 95°F (35°C) and the body can no longer maintain normal heat balance. It can occur during prolonged exposure to cold air, wind, or wet conditions, and it can develop faster when clothing is damp, workers are exhausted, or warm-up breaks are missed. 

What Are the Symptoms of Hypothermia?

• • Shivering (often intense at first)

  • Fatigue or unusual sleepiness

  • Confusion, irritability, or poor judgment

  • Slurred speech

  • Clumsiness, loss of coordination, or stumbling

  • Slow or shallow breathing in severe cases

  • Shivering that slows or stops (a serious warning sign)

What to Do When Hypothermia Occurs?

• • Move the worker to a warm, dry area and shield them from wind and moisture.

  • Replace wet clothing with dry layers and cover the worker with blankets or insulated coats.

  • Warm the core first (torso, neck, head) and use warm packs on the armpits and groin if needed.

  • Provide warm, sweetened drinks only if the worker is fully alert and able to swallow.

  • Call for emergency medical care if the worker is confused, drowsy, losing coordination, or if symptoms are worsening.

Early signs include intense shivering, fatigue, confusion, and loss of coordination. As the condition worsens, shivering may stop, speech becomes slurred, and the individual can show signs of drowsiness, shallow breathing, and a weak pulse.

What Is Frostbite?

Frostbite is the freezing of skin and underlying tissues, most often affecting fingers, toes, ears, nose, and cheeks. It progresses from frostnip to superficial frostbite to deep frostbite, and causes loss of sensation in severe cases. Frostbite occurs during exposure to freezing temperatures or direct contact with cold metal accelerate heat loss.

What Are the Symptoms of Frostbite?

• • Frostnip: Cold, tingling, or numb skin that usually improves with rewarming.

  • Superficial frostbite: Numb, pale, or grayish skin with possible blistering after rewarming.

  • Deep frostbite: Affects deeper tissues, with skin becoming hard and waxy and later turning blue or black.

What to Do When Frostbite Occurs?

• • Move the worker to a warm, dry location immediately.

  • Protect the affected area from further cold and remove tight jewelry or clothing.

  • Rewarm gently using body heat or warm (not hot) water between 98–104°F if refreezing is not possible.

  • Do not rub, massage, or apply direct high heat to the affected area.

  • Seek medical evaluation promptly, especially if skin is hard, blistered, or discolored.

💡Expert Insights

“Curtis Chambers, CSP, a Board-Certified Safety Professional and court-recognized expert in OSHA compliance, notes that cold stress hazards like hypothermia and frostbite are still widely underestimated on job sites. He cautions that this lack of awareness often leads to serious injuries, avoidable downtime, and increased regulatory exposure when basic controls are not in place.”

What Is Trench Foot?

Trench foot, or immersion foot, results from prolonged exposure to wet and cold conditions. Unlike frostbite, it can develop in temperatures above freezing when feet remain damp for hours, especially in tight or non-breathable boots.

What Are the Symptoms of Trench Foot?

• • Tingling, itching, or numbness in the feet

  • Swelling and redness or blotchy skin

  • Pain when warming or walking

  • Blisters or open sores in more advanced cases

What to Do When Trench Foot Occurs?

• • Remove wet boots and socks and gently dry the feet.

  • Elevate the feet and allow them to air dry in a warm area.

  • Avoid walking on injured feet unless necessary.

  • Keep feet clean and monitor for signs of infection.

  • Seek medical attention if swelling, severe pain, or skin breakdown occurs.

What Are Chilblains?

Chilblains are painful inflammations of small blood vessels in the skin caused by repeated exposure to cold but non‑freezing temperatures. They often affect fingers, toes, ears, and the nose when skin is repeatedly chilled and rewarmed. While usually not permanent, these cold-related illnesses can be debilitating and increase infection risk.

What Are the Symptoms of Chilblains?

• • Red or purple patches on the skin

  • Itching or burning sensation

  • Swelling and tenderness

  • Blistering in some cases

What to Do When Chilblains Occur?

• • Move to a warm, dry environment and warm the skin gradually.

  • Avoid direct heat sources or rapid rewarming.

  • Keep the affected area clean and protected from further exposure.

  • Do not scratch or break blisters.

  • Consult a healthcare provider if symptoms are severe or persistent.

Why Employers Must Address Cold Stress?

Employers must address cold stress because it is a recognized workplace hazard that can cause serious injury, illness, or death if not properly managed. Under the OSHA General Duty Clause, employers must provide a workplace free from recognized hazards likely to cause serious harm. Failure to manage cold stress can lead to injuries, which in turn can result in workers’ compensation claims, OSHA citations, higher insurance costs, and reputational damage. 

I remember in 2004, OSHA documented a fatal incident at a gas drilling site in Niles, Ohio, where a rig hand working alone in very cold temperatures and poor lighting fell into a mud pit and died. The coroner listed hypothermia and drowning as the causes of death, and OSHA later issued the employer three serious citations, including one for failure to protect workers from hazards such as cold exposure, totaling $2,750 in penalties. 

Preventing cold stress is, simply put, both a crucial safety responsibility and a smart risk-management choice.

How Can Employers Prevent Cold Stress in the Workplace?

Conduct a Cold‑Stress Risk Assessment

Assess job tasks, exposure duration, weather conditions, and work locations. Identify who is most at risk, including new workers, those with medical conditions, and employees working alone. Engage with employees for their insights on cold weather challenges and potential safety improvements.

Implement the ACGIH Work/Warm Schedule

Where possible, adjust work schedules to minimize exposure to the coldest parts of the day. ACGIH, or the American Conference of Governmental Industrial Hygienists, develops guidelines to assist employers in determining how long workers can safely remain in cold environments and how frequently they need warm-up breaks to prevent serious cold related illnesses.

A typical ACGIH Work/Warm Schedule would look like this:

The colder and windier it gets, the less continuous exposure is allowed, regardless of clothing. Where possible, consider rotating employees through tasks that allow for periods of warming up.

Provide Heat Sources & Shelters

To make those warm-up breaks effective, employers should provide dedicated break areas: warming tents, trailers, or vehicles with reliable heat. These warm areas, like the one pictured above, must be shielded from the cold and wind, and equipped with means to warm up, such as heaters, dry clothes, blankets, or warm sweetened fluids. The shelters should be close enough to the work area that people will actually use them on schedule.

Insulate Materials & Equipment

Prioritize insulating contact points that rapidly draw heat away, such as metal tool handles, levers, steering wheels, railings, and control surfaces. A bare metal handle at 20°F can pull heat from skin faster than standing in winter weather. Keep spare batteries and critical parts warm because cold temperatures can reduce performance and increase failure risk.

Provide Warm Liquids

Offer warm, non-caffeinated drinks so workers can hydrate without cooling down. Hydration matters in the cold because people often drink less, and dehydration can make it harder for the body to regulate heat. Keep water and drink stations easy to access so workers do not skip them to stay on task.

Provide Cold Stress Training

Train workers before the season starts and refresh the basics during cold snaps with short toolbox talks. Cover symptom recognition, proper clothing, the buddy system, and what to do when someone is showing warning signs. Make it job-specific by using your site conditions, your equipment, and your actual warm-up plan.

Monitor the Weather

Track temperature, wind chill, and wet conditions throughout the shift, not just at the start of the day. Set clear triggers for adding breaks, switching tasks, or stopping work when conditions worsen. Document these decisions so supervisors follow the same playbook and workers know what to expect.

Cold Stress Training and Education Topics for Employees

At a minimum, training should cover the following topics so employees understand the risks and know how to protect themselves:

1. 1. Environmental conditions leading to cold stress: Cover how temperature, wind chill, moisture, and prolonged exposure increase heat loss, even when conditions do not seem extreme. Emphasize that wet and windy weather can be just as dangerous as very low temperatures.

   2. Proper Clothing and PPE: Train workers on layering, fabric selection, and appropriate clothing that supports warmth without restricting movement. Review when additional PPE is required.

   3. Causes and limiting risks: Explain how work intensity, fatigue, dehydration, and skipped warm-up breaks raise cold stress risk. Reinforce practical controls like task rotation, scheduled breaks, and using shelters as planned.

   4. Symptom recognition: Teach workers to spot early warning signs such as shivering, numbness, confusion, and changes in speech or coordination. Stress the importance of watching coworkers, since people often miss symptoms in themselves.

   5. First aid and emergency response: Review immediate steps to take when cold stress is suspected and when emergency medical care is needed. Make clear what actions to avoid, including alcohol, caffeine, and rapid rewarming of frostbitten skin.

💡 Did You Know?

“NIOSH published a systematic review of occupational safety and health training research and found that training can improve worker knowledge and safer behaviors. The review also noted that in some settings, training is associated with better safety outcomes, including reduced injuries and illness.”

What clothing and PPE should workers wear to prevent cold stress?

Workers should wear personal protective equipment and layered clothing that allows insulation, moisture control, and flexibility as conditions change. A practical three-layer system includes:

• • Inner layer: Moisture‑wicking fabric to keep sweat off the skin

  • Middle layer: Insulating material to retain body heat

  • Outer layer: Wind‑ and water‑resistant protection

OSHA, a primary U.S. workplace safety authority, suggests an inner layer made of wool, silk, or modern synthetic fabrics, as these materials insulate even when damp. Cotton should be avoided, however, because it traps moisture and speeds up heat loss. Clothing must fit correctly to allow circulation without restricting movement. 

When conditions require it, employers should provide cold-weather PPE such as thermal hats or knit masks, mittens (often warmer than gloves) when temperatures drop below −7°C, and insulated waterproof boots with removable insoles. Protective eyewear can also help by reducing wind exposure and improving visibility in glare from snow or ice.

What Should You Do if Someone Shows Signs of Cold Stress?

Move the Worker to a Warm, Dry Location

Stop work immediately and remove the worker from exposure. Move the person out of wind, moisture, and cold as quickly as possible, even if symptoms seem mild. Do not allow them to “finish the task” or walk it off.

Use a heated shelter, vehicle, or indoor space whenever available. Shield them from drafts and wet conditions while warming begins.

Replace Wet Clothes and Keep Them Warm

Wet clothing pulls heat away fast, so remove it carefully and add dry, loose-fitting clothing. Focus first on the torso, hands, feet, and head. Cover the worker with blankets or insulated coats and apply warm packs to the armpits and groin if medical help is not immediately available. 

❗What NOT to Do

“Don’t use direct high heat (heating pads on bare skin, open flames, exhaust heat). Burns happen easily when skin is numb. At the same time, avoid aggressively rubbing hands, feet, or frostbitten skin, which can cause tissue damage.”

Provide Warm Drinks if Alert

Use water or non-caffeinated beverages to support hydration and energy. Do not give alcohol or caffeine, as they interfere with the body heat regulation. Never force liquids, and stop if there is any choking risk.

Monitor and Keep Them Still

Watch for confusion, slurred speech, drowsiness, or changes in consciousness, which may signal worsening hypothermia. Keep the worker lying down and as still as possible if symptoms are moderate to severe. Do not send them back to work “after they feel better.”

Seek Immediate Medical Care

Call emergency services right away for uncontrolled shivering, loss of coordination, altered mental status, suspected frostbite, or if the worker’s condition is worsening. Severe cold illness can escalate quickly, and delaying care is a common factor in serious outcomes.

These response steps are based on input commonly taught by experts who routinely advise employers on OSHA compliance and incident response. These actions focus on stabilizing the worker, preventing further heat loss, and avoiding mistakes that can make injuries worse.

Cold Stress FAQs

What temperature is freezing?

Freezing is 32°F (0°C). Even above freezing, workers can still develop cold stress when wind, wet clothing, or long exposure pulls heat away faster than the body can replace it. Wind chill can make skin cool rapidly, so supervisors should base decisions on conditions, not just the thermometer.

Can you get sick from being cold?

Cold air does not directly cause viral illness, but cold exposure can make it easier to get sick in practical ways. People often spend more time in enclosed spaces during cold weather, which increases exposure to germs. Cold stress and fatigue can also weaken the body’s defenses, making it harder to fight infections.

What are the early signs of hypothermia and frostbite?

Early hypothermia often shows up as shivering, fatigue, and confusion. Frostbite typically starts with numbness, tingling, or pale skin on fingers, toes, ears, or the face. Because workers may not notice symptoms in themselves, buddy checks and supervisor observation matter in cold conditions.

What is a dangerously low body temperature?

A core body temperature below 95°F (35°C) is considered hypothermia and needs medical evaluation. At that point, thinking and coordination can be impaired, which raises the risk of falls, vehicle incidents, and delayed reporting. Severe hypothermia can become life-threatening quickly, so do not wait for symptoms to “pass.”

Can too much cold cause a stroke?

Cold exposure can increase strain on the heart and blood vessels, which may raise risk for some people, especially those with existing cardiovascular conditions. Cold can also increase blood pressure and make sudden heavy exertion more taxing, such as shoveling or lifting in low temperatures. The safest approach is to manage exposure with warm-up breaks, proper PPE, and avoiding sudden overexertion in extreme cold.

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