OCCUPATIONAL COLD STRESS

Considerable clinical evidence exists for the incidence of occupational cold stress among workers in indoor cold-storage rooms and other indoor occupations, as well as among workers in outdoor occupations during severe winter weather. Frederick (1992) has included cold as one of the risk factors for occupational 'cumulative trauma disorders.' Reviews of the Code of Federal Regulations performed here, however, have revealed no in-place standards, criteria, or regulations for either specific clothing or specific working-environment temperatures promulgated or overseen by any agency to assure worker safety from cold-stress related injuries or to prevent exposures or exposure-durations in temperature regimes that promote cold stress. Medical studies of the phenomenon nonetheless span an enormous gamut of occupations, workers, laboratory animals, climes, and regions of the world.

The following review is outlined to cover the topic with examinations of American (federal) cold stress standards, guidelines, or criteria in place, if any; medical studies of cold stress cases and treatments that have been reported in the scientific literature, and discussion and conclusions from the literature about the incidence, treatment, and prevention of cold stress, principally in an occupational setting.

OCCUPATIONAL COLD STRESS--STANDARDS AND STUDIES

Cold stress is not listed as an indexed t

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s Table 1 above) is identical to the Saskatchewan table, which the Canadian Centre (1987, p. 12) reproduced in 1987. MEDICAL STUDIES OF OCCUPATIONAL OR OTHER COLD STRESS Ingvar Holmér works for the National Institute of Occupational Health in Solna, Sweden--another cold place; so it is not surprising that Holmér and the Swedish Institute have presented a fairly recent and comprehensive overview of "Work in the Cold" and methods for cold-exposure assessment (Holmér, 1993, p. 147). The hazard faced during exposure to either natural or artificial conditions of cold is tissue cooling, although there is an associated sequel of less harmful effects, ranging from simple discomfort to cold injuries (Holmér, 1993). Holmér (1993) summarizes the nature, risk, and magnitude of the effects from cold as being dependent on a mixture of environmental and behavioral patterns: climatic factors (air temperature, mean radiant temperature, humidity, and wind speed), protection used (gloves; clothing types and layers), and metabolic heat production (activity level of the worker). Holmér (1993) is the only author reviewed who presented five different ways that cooling effects can be manifested. These are whole-body cooling, extremity cooling (whi
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