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Winter health & safety tips from OCSWA

Winter’s various dangers to people can occur suddenly, like a heart attack while shoveling snow, or slow and stealthily like carbon monoxide poisoning. Hypothermia and frostbite are always a concern, especially for the elderly and for people with chronic health conditions. The Ohio Department of Health and the Ohio Department of Aging offer these safety tips to help keep you and your family safe this winter season.

Snow Shoveling Safety

Keep walkways around the home clear of snow and ice. Snow shoveling can cause serious injuries or death to people who are elderly, have chronic health problems or are not used to strenuous activity. If you are in one of these categories, you may want to use a snow blower or hire a snow removal service.

If you choose to do this heavy work yourself, remember that your body may tire quicker in the cold. Do not overextend yourself. Take short breaks in between shoveling. Exhaustion can make the body more susceptible to cold injuries.

Tips:

  • Wear sturdy shoes with rugged soles to help prevent slips and falls.
  • Never smoke while shoveling. Tobacco smoke constricts blood vessels just as cold air does; the combination could be dangerous.
  • If you become short of breath while shoveling, stop and rest. If you feel pain or tightness in your chest, become dizzy, faint or start sweating heavily, stop immediately and call for help.
  • Have a partner monitor your progress and share the workload. If you have a heart attack, your partner can call for help and if trained, perform cardiopulmonary resuscitation (CPR) until help arrives.
  • Use a sturdy, lightweight shovel to push the snow out of the way. If you must lift the snow, take small scoops. A shovel-full of dry snow can weigh about four pounds; wet snow can weigh significantly more.
  • Warm up before shoveling by walking and stretching your arms and legs for a few minutes. Warm muscles are less likely to be injured and work more efficiently.
  • If you use a snow blower, keep in mind that pushing a snow blower through heavy, packed snow can present a health risk.

Avoiding Slips and Falls

Winter in Ohio can be unpredictable. Snow, sleet and icy roads and walkways can make getting around not only inconvenient, but dangerous. Use these simple precautions to decrease your risk of falling:

  • Take it slow. Allow extra time to get places in the winter. Try to avoid carrying heavy packages while walking on ice or snow – it can leave you feeling unbalanced.
  • Keep rock salt, sand and a shovel available. Rock salt is a chemical de-icing compound that reduces the risk of slipping.
  • Wear appropriate footgear. Winter boots provide more traction than tennis or dress shoes. Carry a cell phone when walking in inclement weather.
  • Ask for help. If you have to walk across an icy sidewalk or parking lot, try to find a steady arm to lean on. Most people will gladly help an older person navigate a slippery walkway.
  • Continue your exercise regimen indoors, if possible.

For additional information on preventing falls, visit the CDC website: www.cdc.gov/features/fallrisks/

Hypothermia

When exposed to cold temperatures, the body begins to lose heat faster than it can be produced. Prolonged exposure to cold will eventually use up your body’s stored energy. The result is hypothermia, or abnormally low body temperature. Body temperature that is too low affects the brain, making the victim unable to think clearly or move well. This makes hypothermia particularly dangerous because a person may not know it is happening and won’t be able to do anything about it.

Hypothermia is most likely at very cold temperatures, but can occur even at cool temperatures (above 40o F) if a person becomes chilled from rain, sweat or submersion in cold water. Hypothermia can also occur inside a building. The thermostat should be set no lower than 65-70 degrees if the occupants are 75 years or older.

Signs of Hypothermia

  • Confusion or memory loss
  • Sleepiness
  • Slowed, slurred speech or shallow breathing
  • Weak pulse or low blood pressure
  • Exhaustion
  • A change in behavior during cold weather or a change in the way a person normally looks
  • A lot of shivering or no shivering; stiffness in the arms or legs
  • Poor control over body movements or slow reactions
  • Chilly rooms or other signs that a person has been in a cold place

Who is at risk of hypothermia and how can it be prevented?

  • Infants younger than one year of age are at risk. They should never sleep in a cold room and should wear warm clothing or a snug-fitting sleeper to prevent loss of body heat. Do not place blankets in the crib. Instead use a sleep sack to keep infants warm. Pre-warm vehicles before taking infants out into extreme cold weather.
  • Children lose heat faster than adults do. They have a larger head-to-body ratio than adults do, making them more prone to heat loss through the head. Ensure children playing outside cover their heads (with hats or hoods) and come inside periodically to warm up.
  • If you don’t eat well, you might have less fat under your skin. Fat can protect your body. It keeps heat in your body. Make sure you are eating enough food to keep up your weight.
  • People with serious mental illnesses, developmental or cognitive disabilities who may not hear temperature or weather advisory warnings broadcast on TV or radio or may not fully recognize the significance of the cold weather warnings.
  • Some medicines can increase the risk of accidental hypothermia. These include drugs used to treat anxiety, depression, or nausea. Some over-the-counter cold remedies can also cause problems.

Some illnesses may make it harder for your body to stay warm. They include:

  • Disorders of the body’s hormone system such as low thyroid (hypothyroidism)
  • Any condition that interferes with the normal flow of blood such as diabetes
  • Skin problems, such as psoriasis, cause your body to lose more heat than normal. Visit your doctor regularly to help keep any illness under control, and try to stay away from cold places.

Other health conditions might hinder the ability for people to either move to a warmer place, or put on additional clothing, or wrap up in a blanket. For example:

  • Severe arthritis, Parkinson’s disease, or other illnesses can physically make it harder to move around.
  • A debilitating illness such as a stroke can leave a person paralyzed and impair the ability to think clearly.
  • Memory disorders or dementia can impair the ability to think clearly and make simple decisions.
  • A fall or other injury can hinder movement or judgment.

Alcoholic drinks can also make a person lose body heat faster. People at risk of hypothermia should use alcohol moderately, if at all. They should not drink alcohol before bedtime when the temperatures become colder.

What can you do if you think someone might have hypothermia?

First, take his or her temperature. If the temperature does not rise above 96 degrees, call for help. This person must be seen by a physician.

While waiting for help to arrive, keep the person warm and dry. Wrap the person in extra blankets, coats, towels. Use whatever you may have available. Your own body can serve as warmth. Lie close, but be gentle. Rubbing the skin of an older adult can make problems worse because his/her skin is thinner and could easily be torn or injured by vigorous rubbing. Set the thermostat for at least 68 to 70 degrees.

Remember to check the forecast for very cold or very windy weather. On these days, it might be best to remain indoors.

Hypothermia-associated deaths occurring in Ohio

Ohio Deaths From Hypothermia 2005 - 2010

Year

Primary Underlying Cause

Other Deaths with mention of hypothermia

Total deaths associated with hypothermia

2008

20

27

47

2009

24

34

58

2010

27

33

60

2011*

13

21

34

2012*

6

11

17

Source: Ohio Department of Health's Center for Public Health Statistics and Informatics, Oct 2012

Note: Each death is assigned a primary underlying cause of death for purposes of public health reporting. Those numbers are provided in the second column. The “other” deaths are cases where hypothermia was mentioned as an additional cause of death, but another reason was the primary underlying cause. For example, some deaths were given the primary underlying cause of death as “drug overdose” or “fall,” but hypothermia was mentioned as an additional cause.

*Data for 2011 and 2012 are preliminary and subject to change.

Frostbite

Frostbite is the most common cold-related injury. Frostbite is an injury to the body caused by freezing of skin tissue. Frostbite causes loss of feeling and color in the affected areas. It most often affects the nose, ears, cheeks, chin, fingers or toes. Frostbite can permanently damage the body and severe cases can lead to amputation. The risk of frostbite is increased in people with reduced blood circulation, those who drink alcoholic beverages, the elderly and people who are not dressed properly for extremely cold temperatures.

At the first signs of redness or pain in any skin area, get out of the cold or protect any exposed skin – frostbite may be beginning. The following signs may indicate frostbite: a white or grayish-yellow skin area; skin that feels usually firm or waxy; numbness. A victim is often unaware of frostbite until someone else points it out because the frozen tissues are numb.

What to do

If you detect symptoms of frostbite, seek medical care. Because both frostbite and hypothermia result from exposure, first determine whether the victim also shows signs of hypothermia, as described above. Hypothermia is a more serious medical condition and requires emergency medical assistance.

If there is frostbite but no sign of hypothermia, and immediate medical care is not available, proceed as follows:

  • Get into a warm room as soon as possible.
  • Unless absolutely necessary, do not walk on frostbitten feet or toes. This can increase the damage.
  • Immerse the affected area in warm – not hot – water (the temperature should be comfortable to the touch of unaffected parts of the body).
  • Or, warm the affected area using body heat. For example, the heat of an armpit can be used to warm frostbitten fingers.
  • Do not rub the frostbitten area with snow or massage it, at all. This can cause more damage.
  • Do not use a heating pad, heat lamp or the heat of a stove, fireplace or radiator for warming. Affected areas are numb and can be easily burned.

These steps are not substitutes for proper medical care. Hypothermia is a medical emergency and frostbite should be evaluated by a healthcare provider. It is a good idea to take a first aid and emergency resuscitation (CPR) course to prepare for cold-weather health problems.

Taking preventative action is your best defense against having to deal with extreme cold-weather conditions. By preparing your home and car in advance for winter emergencies, and by observing safety precautions during times of extremely cold weather, you can reduce the risk of weather-related health problems.

Carbon Monoxide Poisoning and Fire Prevention

As the weather turns cold, Ohioans look for ways to save on heating costs during these tough economic times. The use of alternative heating sources such as portable heaters, fireplaces and wood stoves increases. Fire deaths and carbon monoxide poisoning are increased risks from using alternate heating sources. Home heating equipment is among the top causes of fires and CO poisoning. The Ohio Departments of Health and Aging suggest the following safety tips to prevent injury from carbon monoxide poisoning and fire.

  • Install a battery-operated carbon monoxide detector and smoke alarms throughout the home, and check or replace the batteries twice a year, when you change the time on the clocks every spring and fall. If the CO detector or smoke alarm sounds, leave the building immediately and call 911.
  • Have a fire safety escape plan. Keep escape routes clear and free of clutter and trip hazards. Keep a robe, slippers, eye glasses and keys close to the bed.
  • Have your heating system, water heater, and any other gas, oil or coal-burning appliance serviced by a qualified technician every year.
  • Seek prompt medical attention if you suspect CO poisoning, or are feeling dizzy, light-headed or nauseous.
  • Do not heat your house by using a gas oven.
  • Do not run or warm a vehicle inside a garage that is attached to the home, even if the garage door is open.

If using a fireplace or wood stove:

  • Have your chimney or wood stove inspected and cleaned annually by a certified chimney specialist.
  • Keep the hearth area clear of debris, decorations and flammable material.
  • Do not burn anything in a stove or fireplace that is not vented.
  • Do not leave fires burning unattended.

If using a portable heater:

  • Keep the heater at least one foot away from people, pets and objects.
  • Do not leave portable heaters on when no one is home.
  • Turn the heater down or off when you are sleeping.
  • Unplug electrical appliances/heaters when not in use.
  • Never hang damp clothes near a heater to dry them.

For additional information on winter health and safety, visit the following:

Centers for Disease Control and Prevention (CDC) http://emergency.cdc.gov/disasters/winter/
Ohio Department of Health http://www.odh.ohio.gov/features/odhfeatures/winterweather.aspx
Ohio Department of Aging http://www.aging.ohio.gov/information/emergencypreparedness/

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