Cold-related injury is a relatively common cause for hospitalization in Alaskan workers. the cold continues to be a tangible and potentially serious hazard, particularly for military and outdoor workers and Alaska Natives. The apparent higher relative risk for these injuries experienced by African American workers also requires further investigation. Careful attention to wearing proper clothing, particularly gloves or mittens and boots or mukluks, as well as limiting sustained exposure times, should be encouraged. Specialized training in cold preparedness and injury prevention should be considered for all workers and persons conducting subsistence activities in cold environments. Planning for work regimes to include persistent or frequent physical activity while working out of doors in the cold is important. Sir William Osler noted that lumber jacks could work protractedly in cold, wet conditions for weeks at a time without cold injury, which he attributed to their high activity level. In this century's two World Wars and the Korean conflict, the troops suffering the most cold injuries were those experiencing general body chilling during bivouacs and while confined to unheated vehicles, trenches or foxholes (Burtan in Zenz et al., 1994). Even the modern vapor-barrier boots and high-tech mittens may not be sufficient to overcome the combined insults of deep cold and enforced inactivity. The placement of infrared heaters in strategic locations to heat workers and sensitive machinery has also been proposed and evaluated (Anttonen, 1995). A systematic and comprehensive approach, such as that taken by the Oulu Regional Institute of the Finnish Institute of Occupational Health, to studying, designing clothing and equipment, and organizing worktasks for prevention of cold injury (well-documented in the literature) is needed for other areas and occupations.
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