Daniel Weinstein, MD, is Medical Director of the Walk-In Care Clinic at the University of Vermont Medical Center. He is also a Family Medicine Physician and Assistant Professor at the University of Vermont College of Medicine.

Daniel Weinstein, MD, is Medical Director of the Walk-In Care Clinic at the University of Vermont Medical Center. He is also a Family Medicine Physician and Assistant Professor at the University of Vermont College of Medicine.

Now that we are in the midst of winter weather, it is important that we all take precautions to stay safe and healthy while enjoying the great outdoors. We spoke to Daniel Weinstein, MD, family medicine physician and medical director of Urgent Care at the UVM Medical Center, about how to do just that.

What are some ways cold weather affects health that people may not be aware of? 

Some risks of cold weather include hypothermia, frostnip and frostbite, heart and breathing risks and ice-related risks of falling, which I see much more commonly than any of the others.

For some people with asthma cold weather may trigger symptoms of difficulty with breathing.

If you have heart disease, cold weather may put more stress on your heart. Your body is smart, and when it senses cold it protects your core by decreasing blood flow to your extremities. This is called peripheral vasoconstriction, and may increase your blood pressure and the work that your heart needs to do to pump blood. If you add physical exertion such as shoveling into the mix that can cause additional work for the heart.

Ice that forms along with cold, and especially with cycles of thawing, followed by cold outside often lead to unexpected falls. Often the ice is particularly difficult to see because it is covered in snow, or it is a type of ice that is very clear and is difficult to see that it is coating a surface (known as “black ice” in Vermont).

The cold can also indirectly affect our health. Often, we spend more time indoors around others, and this can lead to the spreading of colds and the flu.

What populations are most at risk for problems related to cold weather?

The very young and the elderly are often most at risk in temperature extremes. The very young have increased surface area compared to their overall volume and this can lead to increased heat loss. Elderly people often have decreased reserves to adapt to the cold. 

Those who may have trouble with balance, including the elderly and those with certain neurologic conditions, may be at increased risk for falling on the ice and should take extra precautions.

If you have decreased sensation in your feet from diabetes or other conditions, you may be at increased risk for frostbite as you may not notice the cold.

Those with underlying heart or circulatory disease are at increased risk as well.

If you have certain autoimmune diseases, such as Reynaud’s, you may be at increased risk from the cold.

Are there a few basic tips you think people should keep in mind to avoid common cold-weather-related health problems? 

Absolutely! If it is extremely cold or windy out try to stay indoors! If you must go out, minimize the amount of time you spend outdoors if possible.

If you do go out, dress warmly in layers, including an inner layer that helps wick moisture away from the body, followed by insulating layers, and then an outer shell that protects against wind and moisture. Cotton is not a good insulator when wet and does not wick moisture away from the body and should be avoided. Many of the insulating synthetic fabrics are excellent, as is wool. Hats and protection for your fingers are a must, as is good footwear that is preferably waterproof and with good treads.  Mittens are warmer than gloves. Always cover exposed areas that can be susceptible to frostbite, including your ears, nose and cheeks.  

Stay well hydrated, and avoid alcohol. 

If you have cold-induced asthma, be sure to bring your rescue inhaler. Breathing through a fleece neck gator or balaclava may help. 

Be cautious and aware of the risk of ice! Use footwear with good textured soles, and consider add-on products to your shoes and boots that increase traction, and keep your center of gravity over your feet.

Fortunately, with the right precautions you can still enjoy the outdoors in the cold weather! I still like to ski in the single digits. I just add a layer so my core stays warm and can share blood with my extremities, and I cover all my exposed skin with a hat/helmet and a balaclava. I drink plenty of non-alcoholic fluids and hope for snow!

Learn more about Urgent Care at the University of Vermont Medical Center. 

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