Warding Off the Cold Shoulder
October 11, 2006
A: The principles of remediation are the same regardless of the climate that you may be working. I would recommend that you follow the IICRC S500 "Standard and Reference Guide for Professional Water Damage Restoration" for sewage damage remediation and the S520 "Standard and Reference Guide for Professional Mold Remediation" for mold remediation.
The major physical concern when working in cold environments is to maintain the body's core temperature. When the body's temperature starts to drop below what is normal, hypothermia can result. Hypothermia means "low heat." Hypothermia results in the impairment of the body's normal muscular and cerebral functions. Frostbite is another possible consequence that can occur independent of hypothermia.
The human body is designed to function at an internal (core) temperature of approximately 37 degrees C (98.6 degrees F). In cold environments, the body temperature is maintained by gaining heat from food and muscular activity, and by reducing heat loss by inhibiting the sweat glands. The latter is accomplished by the constriction of the blood vessels in the skin, arms and legs. At this point the body's shell becomes an insulator, keeping the interior organs warm. It is partially for this reason that frostbite occurs to the extremities of the body. Frostbite occurs when there is a freezing of the fluids around the cells of the body tissue. The freezing point of the skin is reported to be at about -1 C (30 F). The face, ears, fingers, and toes are most commonly affected by frostbite. The symptoms may vary from not painful to a sharp, prickling sensation. The first indication of mild frostbite is numbness with the possibility that the skin appears waxy. If the tissue hardens or is blistered, seek emergency medical treatment.
When the body can no longer maintain its core temperature, it begins to shiver. Severe shivering can occur when the body temperature drops to around 35 C (95 F). It has been reported that most cases of hypothermia occur in air temperatures between 2-10 C (30-50 F). This might have resulted from workers not realizing that hypothermia could happen when temperatures are in this range. If clothing becomes wet or damp, hypothermia can occur when the air temperature is 65 F. One source recommends that when working in "air temperatures of 2 C (35.6 F) or less, workers whose clothing gets wet for any reason must be immediately given a change of clothing".
Uncontrollable shivering is one of the first symptoms. Drowsiness, slow or slurred speech, memory lapses, slow or irregular breathing, exhaustion and fatigue are other symptoms. When someone is fatigued by physical activity, they are more susceptible to heat loss. Individuals at higher risk of cold stress include the very young; the elderly; those with cardiovascular or circulatory difficulties; those who are drug or alcohol impaired; and those who are inactive
The early signs of mild hypothermia include shivering, confusion, poor coordination and possibly blue lips or fingers. Moderate hypothermia is evidenced, in addition to the conditions listed for a mild condition, by slow breathing, disorientation and mental impairment. In the severe stage of hypothermia, the individual might be unconscious and not shivering. Their heartbeat may be irregular or difficult to detect. OSHA makes the following recommendations:
"Treatment depends on the severity of the hypothermia. For cases of mild hypothermia move to warm area and stay active. Remove wet clothes and replace with dry clothes or blankets, cover the head. To promote metabolism and assist in raising internal core temperature drink a warm (not hot) sugary drink. Avoid drinks with caffeine. For more severe cases do all the above, plus contact emergency medical personnel (Call 911 for an ambulance), cover all extremities completely, place very warm objects, such as hot packs or water bottles on the victim's head, neck, chest and groin. Arms and legs should be warmed last. In cases of severe hypothermia treat the worker very gently and do not apply external heat to re-warm. Hospital treatment is required."
How to Protect 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 environmental temperatures. Wear a hat and gloves, in addition to undergarments that will keep water away from the skin (polypropylene).
- 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, sports-type drinks). Avoid drinks with caffeine (coffee, tea, or hot chocolate) or alcohol.
- Eat warm, high-calorie foods like hot pasta dishes.
In performing remediation services, you are generally working indoors with a climate-controlled environment that will provide you with protection from the elements. In some cases, it is necessary to shut down the HVAC system due to contamination. If that is the case, then it will be necessary to provide supplemental heat to minimize the potential for cold stress.