OCC/Welfare/TBT-OCC-013

Hypothermia and Cold Stress

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Hypothermia and Cold Stress

Toolbox Talk Record

Ref: TBT-OCC-013  |  Issue: 1  |  Date: March 2026
PresenterProject
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What?

  • Hypothermia occurs when the body loses heat faster than it can produce it, dropping core temperature below 35°C.
  • Construction workers are at high risk during winter months, especially in exposed and elevated locations.
  • Wind chill dramatically increases heat loss — a 10 mph wind at 5°C feels like minus 1°C on exposed skin.
  • Early symptoms include shivering, confusion, slurred speech, and loss of coordination.
  • Severe hypothermia can cause unconsciousness, cardiac arrest, and death if untreated.
  • Wet clothing accelerates heat loss — workers caught in rain or working near water are especially vulnerable.
  • Cold stress also includes frostbite to extremities and non-freezing cold injury to hands and feet.
  • Workers taking certain medications or with circulatory conditions face increased risk.
  • Night shift workers and lone workers in remote locations are particularly exposed to cold stress.
  • The Management of Health and Safety at Work Regulations 1999 require employers to assess cold weather risks.

Why?

Prevent fatalitiesUntreated hypothermia progresses rapidly from confusion to unconsciousness and death, particularly outdoors.
Worker fitnessCold stress reduces manual dexterity, concentration, and reaction times, increasing the risk of accidents.
Employer dutyMHSWR 1999 requires employers to assess and control risks from cold working environments on site.
Do Don't
  • Provide warm welfare facilities with hot drinks available during cold weather
  • Wear multiple layers of clothing including a moisture-wicking base layer
  • Schedule regular warm-up breaks, especially for workers in exposed locations
  • Monitor colleagues for early signs of hypothermia such as shivering and confusion
  • Change out of wet clothing as soon as possible to prevent further heat loss
  • Eat regular meals — the body needs energy to generate heat in cold conditions
  • Plan work to reduce exposure time in the coldest and most windswept areas
  • Ensure lone workers in remote locations have communication and check-in procedures
  • Provide appropriate cold weather PPE including insulated gloves and thermal hats
  • Call emergency services immediately if someone shows signs of severe hypothermia
  • DON'T ignore shivering, confusion, or slurred speech — these are warning signs
  • DON'T continue working in wet clothing during cold weather conditions
  • DON'T skip meals or rely on caffeine alone to stay warm on site
  • DON'T allow workers to remain in exposed elevated positions for long periods
  • DON'T rub or massage frostbitten skin — this causes further tissue damage
  • DON'T give alcohol to a person with suspected hypothermia
  • DON'T immerse a hypothermic casualty in hot water — rewarm them gradually
  • DON'T dismiss cold stress complaints as workers just being uncomfortable
  • DON'T send lone workers to remote locations without cold weather risk assessment
  • DON'T assume thermal PPE alone is sufficient without scheduled warm-up breaks

See also: Winter Working Safety | Cold Weather PPE

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