• 07Jan

    Can exposure to cold be dangerous?

    Human beings are homeothermic, which means we maintain a narrow range of normal body temperature, irrespective of the environmental temperature. This also means that human body is incapable of adapting to cold. Exposure to cold results in a spectrum of injuries depending on the temperature and duration of exposure.

    These injuries can be restricted to a part of the body which is exposed, generalized effects or a combination of both types. The peripheral cold injuries are usually mild in severity whereas generalized exposure results in hypothermia or fall of body temperature below normal which may be life threatening. These injuries are commonly seen in cold areas or snow bound areas. They are more common in soldiers who perform duty in high altitude areas, though they may also be seen in the civilian population. 


    Peripheral cold injuries

    Peripheral cold injuries occur due to exposure of hands, feet, ears and nose to extreme cold as it results in freezing of tissue. Freezing of water outside the cells causes cellular dehydration. The concentration of intracellular electrolytes reaches toxic levels, resulting in cell death and loss of tissue. When the cold part is thawed, the injured capillaries leak fluid, causing edema of tissues and further reducing blood flow. This results in lack of oxygen delivery and tissue death. Depending on the severity, the peripheral cold injuries are known as frostnip, chilblains, immersion foot and frostbite.

    Frostnip

    This is the mildest form of cold induced injury. This is usually seen over the tip of nose, ears, fingers and toes. These areas are most peripheral in the sense that the blood flow is lesser, making them more prone to cold. This is usually seen on exposure to cold wind, during winter sports, skiing or ice hockey. The duration of exposure to freezing temperature is short and results in pain and loss of manual dexterity. Local application of warmth and hot drinks are sufficient for relief.

    Exposure to cold can result in a spectrum of injuries depending on the temperature and duration of exposure.

    Exposure to cold can result in a spectrum of injuries depending on the temperature and duration of exposure.

    Chilblains

    Chilblains occur due to exposure to non-freezing temperature in presence of dampness. It manifests with skin rashes over face, hands and feet which appear about 12 hours after exposure. This occurs due to cold induced inflammation of blood vessels called vasculitis. The rashes are red to violet in color. Later on blisters and ulcers may appear. Treatment is done by providing warmth, pain relief and local application of moisturizers. These lesions usually resolve spontaneously within a few weeks.

    Immersion foot

    This injury occurs on prolonged exposure to cold under damp conditions and may be seen in shipwrecked survivors or in soldiers exposed to above conditions. This type of injury also affects nerves and blood vessels in the feet. The patient develops tingling sensation, numbness, itching and cramps. The skin becomes congested initially and later it appears pale or mottled due to swelling.

    Treatment requires rewarming of the affected part and as a whole, keeping the feet dry and dressing in case of ulceration. Foot elevation is done for the swelling to subside. The condition resolves in a few weeks.

    Frostbite

    This is the most severe form of peripheral cold injury and it may be accompanied with fall of body temperature below normal called hypothermia. This occurs on exposure to freezing temperature. Usually feet, legs or hands are affected. The other areas which may be involved include ears, nose, cheek and penis. People with substance abuse are especially prone. The affected area turns black after few days. This occurs due to irreversible damage to the blood supply of the affected part.

     These patients require hospital admission and treatment involves rewarming of the patient including the affected part, pain relief, antibiotics in presence of infection and splinting of the part of body affected. After a few weeks a line of demarcation appears when the black or gangrenous part is removed surgically. Many patients require rehabilitation.

    Cold injuries can be serious and can result in loss of limb or even life. Adequate precautions should be taken when visiting cold areas which include protective clothing and other gear. In case of any cold induced injury, prompt medical consult should be taken.

    Anna L.

    It’s all about health!
    I have academic background in drugs related Chemical Technology, as well as extensive professional experience in pharma and medical companies. My main area of interest is everyday life medicine. The goal of my articles is to give people informative answers to the questions that bother them, to dispel doubts and some common misbeliefs and also to inspire everyone to keep healthy lifestyle.

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