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Extreme Weather – Cold

Whenever temperatures drop significantly below normal and as wind speed increases, your body can lose heat more quickly. These weather-related conditions may lead to serious health problems, especially for vulnerable people. Cold weather injuries, such as frostbite and hypothermia, are preventable. Most healthy people can tolerate a short period of cold weather if they remain dry and properly dressed.  However, the most vulnerable and at-risk groups for cold-related health impacts include: 

  • Infants and children 
  • Older adults 
  • People with medical or mental health conditions 
  • People taking certain medications 
  • People who work or engage in physical activity outdoors 
  • People who use substances  
  • People who are homeless or marginally housed 

Please note the content of this page is largely adapted from Health Canada: It’s Your Health – Extreme Cold. 

Signs of Cold-Related Illness

Cold weather can negatively impact health by increasing the risk of heart attacks, strokes, respiratory diseases, and falls and injuries. Exposure to cold can cause freezing injuries such as windburn, frostbite, and hypothermia. Wind chill can exacerbate cold injuries by accelerating the rate at which your body loses heat. 

What is Windburn

Windburn occurs when cold wind removes the top layer of oil from the skin, causing: 

  • excessive dryness 
  • redness 
  • soreness 
  • itchiness 

Although windburn is different than sunburn, people often confuse the two because the symptoms are similar. 

What is Frostbite

When the temperature drops below 0ºC, blood vessels close to the skin constrict to protect the core body temperature. When your body is exposed to the cold for a long period of time, blood flow to your hands, feet, nose, and ears can be severely restricted. The combination of poor circulation and extreme cold can lead to frostbite. 

Frostbite generally occurs in body parts furthest from the heart: 

  • hands 
  • feet 
  • nose 
  • ears 

Mild frostbite (frostnip) makes your skin look yellowish or white but it is still soft to the touch. Your skin might turn red during the warming process, but normal colour returns once the area is warmed. 

Severe frostbite can cause permanent damage to body tissue if it is not treated immediately. Nerve damage occurs and frostbitten skin becomes discoloured and turns black. After some time, nerve damage becomes so severe that you will lose feeling in the affected area and blisters will occur. If the skin is broken and becomes infected, gangrene can set in which can result in loss of limbs. 

What is Hypothermia

There are three stages of hypothermia: 

  • Stage 1 – When your body temperature drops by 1 or 2ºC, you start shivering, get goose bumps on your skin, and your hands become numb. Your breath can become quick and shallow, and you may feel tired and/or sick to your stomach. You may also experience a warm sensation, which means your body is entering stage 2 of hypothermia. 
  • Stage 2 – Your body temperature has dropped by 2 – 4ºC  and your shivering is strong. Muscles are uncoordinated and movements are slow and laboured. You may suffer mild confusion, become pale, and your lips, ears, fingers, and toes may turn blue. 
    • Check yourself! Try touching your thumb to your little finger. If you can’t, your muscles are not working properly and you’re experiencing stage 2 hypothermia
  • Stage 3 – If your body temperature drops below 32ºC (89.6ºF), the shivering will stop but you’ll have trouble speaking, thinking, and walking. You may even develop amnesia. When your body temperature drops below 30ºC (86.0ºF), exposed skin becomes blue and puffy, it will be hard to move muscles and behaviour becomes irrational. Your heart may be beating quickly but your pulse and breathing will decrease. At this stage you are at risk of dying. 

Treatments for Extreme Cold Conditions

Windburn

Do not scratch or rub the affected area–it can damage the skin. 

  • Apply a protective skin care product (e.g. therapeutic moisturizers) to the affected area(s) as needed. 
  • Use a protective lip balm. 

Frostbite

Mild frostbite (frostnip) can be treated in two ways (can be done together): 

  • Passive warming – move to a warm room, wrap yourself in blankets or reheat your body by skin-to-skin contact with another person. 
  • Active warming – add heat directly to the frostbitten area to thaw the injured skin as quickly as possible without burning yourself. Thawing frostbitten skin is very painful so the injured skin should be placed in water that is just above body temperature. Do not rub, massage or shake the injured skin: that can cause more damage. 

Severe frostbite requires immediate medical attention. While you are waiting for help to arrive, begin passive and active warming. 

Hypothermia

Severe cases of hypothermia (such as stages 2 and 3) require immediate medical attention. Call 9-1-1. 

For stage 1 hypothermia or while waiting for help to arrive: 

  • find shelter 
  • keep your muscles moving 
  • dry and (gradually) warm your body 
  • wrap yourself in blankets/dry clothing or reheat your body by skin-to-skin contact with another person 
  • drink warm, sweet liquids 
  • don’t fight shivering, this is one of the ways your body increases its core temperature 
  • if the person is unconscious lay them down and avoid shaking them or handling them roughly as they may have an arrhythmia (irregular heartbeat) 

After an extreme cold event watch for signs of illness, Health effects can take up to a few weeks to occur. 

Preventing Cold-Related Illnesses

Wear appropriate clothing 

  • Always wear clothing appropriate for the weather. Synthetic and wool fabrics provide better insulation. Some synthetic fabrics are designed to keep perspiration away from your body which keeps you dry and further reduces your risk. 
  • Dress in layers with a wind resistant outer layer.  
  • Wear warm socks, gloves, a hat and a scarf in cold weather. Be sure to put a scarf over your nose. 
  • If you get wet, change into dry clothing as soon as possible. You lose heat faster when you’re wet. 

Protect yourself 

  • On sunny days wear sunglasses, lip balm and sunscreen to protect your skin from UV rays and keep it moisturized to help prevent windburn. 
  • Wear a face mask and goggles if you are participating in winter activities such as skiing, snowmobiling, or skating, to protect your face from frostbite and windburn. 
  • Keep moving (especially hands and feet) to keep blood flowing and maintain body heat. 

Know the weather conditions 

  • Pay attention to weather alerts in your area.  
  • Environment Canada issues wind chill alerts to warn you of conditions that will cause frostbite to exposed skin. 

Find shelter and keep moving 

  • If you are caught in a severe snowstorm, or outside in extreme cold conditions, look for shelter. If there are no buildings around, a small cave, ditch, hollow tree or a vehicle can help reduce your chances of frostbite or hypothermia. 
  • Even if you find shelter, keep moving to maintain your body heat. 
  • People who are homeless are encouraged to seek emergency shelter until the period of extreme cold has passed.  

Avoid alcohol 

  • Consuming alcohol before you go out in the cold may increase your risk of hypothermia because it increases blood flow to the extremities of the body. You may actually feel warm even though you are losing heat. 

Know your health risks 

  • Talk to your health care professional to see if you are at an increased risk from extreme cold due to a medical condition. 
  • If you have health problems such as a heart condition you may wish to avoid strenuous activities like shoveling snow.  

Preparing for Extreme Cold

Extreme Cold – Get Prepared

How to prepare before an extreme cold event 

  • Prepare your emergency kits.  
  • Make a household emergency plan. Consider the specific needs of all members of your household, including older adults, children, pets, and anyone with special health needs 
  • Some municipalities may offer warming centers during extreme cold events. Check with your city or municipality to learn more. 
  • Make sure that you have appropriate winter clothing for all members of your household, especially infants, young children, and older adults. Recommended items include insulated winter jackets, waterproof footwear, warm socks, gloves or mittens, a toque, and a scarf or face covering 

Where to get information 

Prepare your home 

  • Do regular maintenance before cold weather starts. Make sure your heating system is working efficiently, that your chimney is clean and ready for use, and that any cracks and drafts are sealed to keep the heat inside 
  • Check on older adult relatives and neighbours to ensure they are warm enough and have sufficient supplies, particularly when the weather is cold or snowy. 
  • Consider installing a backup heat source that can be used in case of a power outage, such as a fireplace (that does not require power to operate the exhaust system) or a generator to power an electric space heater or run existing electric heating appliances? 
  • Install certified carbon monoxide alarms with battery backup in hallways, outside of sleeping areas (learn more about carbon monoxide). 

Prepare your vehicle 

During an extreme cold event 

Take shelter, don’t delay! Extreme cold can quickly become life threatening. If you head outdoors remember to dress for the weather including the wind chill – bright, sunny days can appear deceptively mild. Go to the nearest heated location at the first signs of exposure to extreme cold (numb extremities). On a cold day, dress for the weather and don’t leave home without your toque! 

  • Protect your indoor air quality in the event of a power outage 
  • Consider delaying travel or outdoor activities until conditions improve 
  • Never operate a fuel-burning generator or use fuel burning cooking equipment such as BBQs or camping stoves inside a home, garage, basement, crawlspace or shed, or under a covered area outside the house (such as under an awning or gazebo) 
  • Operate portable generators at least 6 metres (20 feet) from all homes or buildings 
  • Direct the exhaust away from open windows and doors. Close all windows and doors on the side of the home closest to or downwind from the generator 
  • Run a trickle of water to prevent pipes from freezing if the pipes cannot be kept at a temperature above freezing 

Extreme Cold Warning System

Peterborough Public Health (PPH) has adopted a series of cold weather thresholds designed to advise the general public, healthcare providers and community service providers of appropriate measures they can take to reduce the risk of cold weather injuries and illness. 

PPH monitors the forecasted weather conditions from December 1 to April 1. Notifications of extreme cold will be issued when the forecasted temperature or wind chill may result in an increased risk of frostbite. Upon learning that a potential cold threshold may be reached, PPH will activate the Extreme Cold Response Plan (ECRP). A key objective of the ECRP is to provide health information and education concerning extreme cold weather to both the general public and community partners serving people most vulnerable to the health impacts of extreme cold. 

Level 1: Frostbite Alert 

Issued when temperatures are forecasted to be from -27ºC to -38ºC or a wind chill of -27 to -38. 

Exposed Skin can freeze in as little as 10 to 30 minutes 

Level 2: Frostbite Warning 

Issued when temperatures are forecasted to be from -39ºC to -47ºC or a wind chill of -39 to -47 

Exposed Skin can freeze in as little as 5 to 10 minutes 

Level 3: Cold Weather Emergency 

Issued when temperatures are forecasted to be -48ºC or colder or a wind chill of -48 or colder OR when the temperature is below -27ºC or a wind chill below -27 accompanied by a contributing risk factor such as a power outage, or critical infrastructure failure. 

Exposed Skin can freeze in as little as 5 minutes 

Resources

Cold/Health-related Posters:

Resources for specific populations or settings

Parents & Caregivers

Older Adults  

Active Individuals

Outdoor Workers  

Pets 

Additional Winter Safety Resources 

 

 

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