Cold weather injuries among U.S. soldiers in Alaska: a five-year review.

Cold weather injury (CWI) reports covering 272 U.S. Army soldiers from September 1990 to May 1995 were reviewed. First- and second-degree frostbite accounted for 99.3% of all injuries. Although some soldiers had extensive lost duty time from their injuries, no one suffered tissue loss during the 5-year period. Fifty-one percent of injuries occurred during field training. Thirty-six percent occurred while engaging in garrison activities, including physical training, which accounted for 15% of all CWIs. Twelve percent of all injuries occurred during off-duty time. Seventy-one percent of CWIs occurred when the wind-chill factor was at or below -20 degrees F (-29 degrees C). Male African-American soldiers appear to be significantly more susceptible to frostbite than male Caucasian soldiers, especially with regard to frostbite of the distal extremities (relative risk = 3.94; 95% confidence interval = 2.77-5.59). Other identified risk factors include inadequate clothing, wet clothing, dehydration, inactivity, fatigue, and previous CWIs.