Frostbite of the face and ears: epidemiological study of risk factors in Finnish conscriptsBMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7021.1661 (Published 23 December 1995) Cite this as: BMJ 1995;311:1661
- E Lehmuskallio, medical chief Institute of Military Medicine, Finnish Defence Forces, Mannerheimintie 164, 00300 Helsinki, Finlanda,
- H Lindholm, research fellowa,
- K Koskenvuo, surgeon generalb,
- S Sarna, associate professor in statisticsc,
- O Friberg, senior researchera,
- A Viljanen, head of army departmenta
- aSantahamina Military Health Centre, POB 6, 00861 Helsinki, Finland
- b Medical Section, Finnish Defence Staff, POB 919, 00101 Helsinki, Finland
- c Department of Public Health, University of Helsinki, POB 21, 00014 Helsinki, Finland
- Correspondence to: Dr Lehmuskallio
Objective:To determine the incidence of and the risk factors for local cold injuries of the face and ears in peacetime military service
Design:Prospective, controlled epidemiological study using a questionnaire
Setting:Finnish defence forces, 1976-89
Subjects:913 young male conscripts with local frostbite of the head that needed medical attention and 2478 uninjured control conscripts
Main outcome measures:Type of activity, clothing, and other risk factors at the time of cold injury. Odds ratios were used to calculate risk. Controls were handled as one group.
Results:The mean annual incidence of frostbite was 1.8 per 1000 conscripts. Frostbite of the ear was most common (533 conscripts (58%)), followed by frostbite of the nose (197 (22%)) and of the cheeks and other regions of the face (183 (20%)). Most conscripts (803 (88%)) had mild or superficial frostbite. Risk factors included not wearing a hat with earflaps (odds ratio 18.5 for frostbite of the ear); not wearing a scarf (odds ratio 2.1 and 3.8 for frostbite of the ear and cheeks respectively); using protective ointments (odds ratio 3.3, 4.5, and 5.6 for frostbite of the cheeks, ear, and nose respectively); being extremely sensitive to cold and having hands and feet that sweat profusely (odds ratio 3.5 for frostbite of the nose); and being transported in the open or in open vehicles under windy conditions (odds ratio 2.2 for frostbite of the cheek).
Conclusion: Wearing warm clothing, including a scarf and a hat with earflaps, helps to prevent frostbite. Each person's sensitivity to cold may also be important. The routine use of protective ointments should not be recommended.
Funding Scientific Committee of National Defence, Finland.
Conflict of interest None.