Prevent Cold Weather Illnesses This Winter

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January 11, 2017

By Mackenzie Simmons, ATC

Throughout winter, it is important to be aware of the signs and symptoms of cold weather illnesses, as well as the risk factors and preventative methods. While heat illness usually seems to be on the forefront of environmental issues, cold weather illnesses can cause the same catastrophic results. Athletic Trainers (ATs) and other healthcare professionals need to be knowledgeable in differentiating and diagnosing hypothermia, frostbite, chilblains and trench foot in athletes. A short summary of these cold weather illnesses are listed below.

Hypothermia (mild, moderate or severe) is caused by prolonged exposure to cold, wet or windy conditions, usually during endurance events or outdoor games.

Mild

- Core temperature 98.6F to

- Cold extremities

- Shivering

- Pallor

Moderate

- Core temperature 94F to 90F

- Slowed respiration and pulse

- Cessation of shivering

- Dilated pupils

- Impaired mental function and motor control

Severe

- Core temperature below 90F

- Rigidity

- Severely depressed respirations

- Bradycardia

- Usually has fallen into a coma

Frostbite (mild or superficial) occurs when there is an exposure to cold temperatures, often in conjunction with wind or touching cold surfaces

Mild

- Area is firm or cold to the touch

- Limited movement

- White or blue-gray colored patches in skin

- Tingling or burning sensation

Superficial

- Area is hard or cold

- Burning, aching, throbbing or shooting pain

- White, gray, black or purple skin

- Tissue necrosis

Chilblain (or pernio) is caused when the body has prolonged exposure to cold, wet conditions.

- Red or cyanotic lesions

- Tissue necrosis

- Skin sloughing

- Swelling

Trench foot comes from prolonged exposure to cold, wet conditions; it usually occurs with the continued wearing of wet socks, wet shoes or both.

- Burning, tingling or itching

- Loss of sensation

- Cyanotic or blotchy skin

- Blisters or skin fissures

Sometimes, cold weather illnesses cannot be prevented in athletes, but there are risk factors that can predispose an athlete to getting hypothermia, frostbite, chilblain or trench foot. Listed below are a few of the risk factors for cold weather illnesses:

- Lean body composition

- Lower fitness level

- Females

- Older age

- Issues such as cardiac disease, Raynaud’s phenomenon and anorexia

- Previous cold injuries

- Low caloric intake

- Dehydration

- Fatigue

While most risk factors are genetic, there are a few that can be controlled. An AT can encourage athletes to stay properly hydrated and nourished before activity to ensure the body has enough nutrients to efficiently function. Also, make sure the athletes are at the necessary fitness level to perform the event in the cold weather. It is important to encourage the athletes to get a full night of rest leading up to the event so the body is not fatigued.

In addition to controlling the risk factors, the AT can also provide guidance on the proper clothing to wear to the event. When possible, the athlete should keep their hands, feet, toes and ears covered. Also, dressing in layers is essential to keeping warm—the first layer of clothes should allow sweat evaporation, the middle layer for insulation and then the outer layer being water and wind resistant. The AT should also monitor the wind chill before and during the event to make sure the weather is safe for activity.

Resources

Cappaert, Thomas A., et al. "National Athletic Trainers'' Association position statement: environmental cold injuries." Journal of athletic training 43.6 (2008): 640-658.