@article{ref1,
title="Frostbite of the face and ears: epidemiological study of risk factors in Finnish conscripts",
journal="British medical journal: BMJ",
year="1995",
author="Lehmuskallio, E. and Lindholm, H. and Koskenvuo, K. and Sarna, S. and Friberg, O. and Viljanen, A.",
volume="311",
number="7021",
pages="1661-1663",
abstract="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). CONCLUSIONS: 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.<p /><p>Language: en</p>",
language="en",
issn="0959-8138",
doi="",
url="http://dx.doi.org/"
}