New study highlights lack of cold exposure guidelines for vulnerable outdoor workers

Cold exposure is a common feature of outdoor work in many parts of the world, occurring not only in Arctic regions but also in temperate climates where working temperatures frequently fall below 10–15°C. Despite its widespread nature and well-documented health impacts, cold exposure remains insufficiently addressed within occupational health and safety frameworks.

A newly published paper in the International Journal of Circumpolar Health highlights a critical gap in occupational health and safety policies: the lack of clear guidelines to protect outdoor workers with climate-sensitive health conditions from cold exposure. The paper is authored by Mojdeh Rafieian and colleagues from UiT The Arctic University of Norway, Umeå University, and the University of Oulu.

The paper focuses on workers with conditions such as diabetes, cardiovascular disease, and chronic respiratory disorders. These conditions can compromise thermoregulation and physiological responses to cold, increasing susceptibility to cardiovascular strain, respiratory symptoms, reduced work performance, and cold-related injuries. Although cold exposure has been associated with increased morbidity and mortality globally, occupational health and safety guidance remains largely oriented toward heat stress. Through a critical review of existing standards, policies, and scientific evidence, the authors identify substantial gaps in current approaches to cold risk management, particularly for medically vulnerable worker groups.

Key highlights

• Cold exposure is a global occupational issue: Working in cold conditions is common worldwide, not only in Arctic or extreme climates.
• Workers with chronic diseases are more vulnerable: Diabetes, cardiovascular disease, and chronic respiratory conditions can increase susceptibility to cold-related health risks.

• Occupational guidance is limited: Existing standards rarely provide disease-specific or practical recommendations for managing cold exposure in outdoor work.
• Health impacts are multifaceted: Cold exposure affects cardiovascular, respiratory, and musculoskeletal systems and increases the risk of occupational accidents.
• Development of targeted guidelines is needed: The authors call for evidence-based occupational health guidelines that explicitly address cold exposure among vulnerable outdoor workers.

The authors conclude that strengthening occupational health and safety guidance for cold environments is essential for protecting worker health, supporting sustainable working practices, and improving resilience to climate-related variability.

Original publication

Rafieian, M., Höper, A. C., Stjernbrandt, A., Tapper, R., & Ikäheimo, T. M. (2026). Lack of guidelines for cold exposure among vulnerable outdoor workers. International Journal of Circumpolar Health, 85(1). https://doi.org/10.1080/22423982.2026.2619359