{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:25Z","timestamp":1787016985366,"version":"build-2736575974"},"reference-count":13,"publisher":"BMJ","issue":"7021","license":[{"start":{"date-parts":[[1995,12,23]],"date-time":"1995-12-23T00:00:00Z","timestamp":819676800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1995,12,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    To determine the incidence of and the risk factors for local cold injuries of the face and ears in peacetime military service\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design:<\/jats:bold>\n                    Prospective, controlled epidemiological study using a questionnaire\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting:<\/jats:bold>\n                    Finnish defence forces, 1976-89\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Subjects:<\/jats:bold>\n                    913 young male conscripts with local frostbite of the head that needed medical attention and 2478 uninjured control conscripts\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Main outcome measures:<\/jats:bold>\n                    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.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    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).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    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.\n                  <\/jats:p>","DOI":"10.1136\/bmj.311.7021.1661","type":"journal-article","created":{"date-parts":[[2011,10,27]],"date-time":"2011-10-27T19:38:44Z","timestamp":1319744324000},"page":"1661-1663","source":"Crossref","is-referenced-by-count":53,"title":["Frostbite of the face and ears: epidemiological study of risk factors in Finnish conscripts"],"prefix":"10.1136","volume":"311","author":[{"given":"E","family":"Lehmuskallio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Lindholm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Koskenvuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Sarna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O","family":"Friberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Viljanen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1995,12,23]]},"reference":[{"key":"2025122209281571000_311.7021.1661.1","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1093\/milmed\/152.8.393","article-title":"An overview of medically related problems in the cold environment.","volume":"152","author":"Hamlet","year":"1987","journal-title":"Mil Med"},{"key":"2025122209281571000_311.7021.1661.2","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1093\/milmed\/134.11.1307","article-title":"Cold injury in man: a review of its etiology and discussion of its prediction.","volume":"134","author":"Hanson","year":"1969","journal-title":"Mil Med"},{"key":"2025122209281571000_311.7021.1661.3","unstructured":"Lindholm H Koskenvuo K Sarna S Friberg O .Frostbites of conscripts in 1976\u20131989. (In Finnish.). Helsinki: Scientific Committee of National Defence,1993. (Report A 1993\/1.)"},{"key":"2025122209281571000_311.7021.1661.4","first-page":"177","article-title":"Measurements of dry atmospheric cooling in subfreezing temperatures.","volume":"89","author":"Siple","year":"1945","journal-title":"Proceedings of the American Philosophical Society"},{"key":"2025122209281571000_311.7021.1661.5","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1152\/jappl.1970.29.5.658","article-title":"Role of air temperature and wind in the time necessary for a finger to freeze.","volume":"29","author":"Wilson","year":"1970","journal-title":"J Appl Physiol"},{"key":"2025122209281571000_311.7021.1661.6","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1093\/milmed\/152.8.389","article-title":"Adverse effects of heat and cold on military operations: history and current solutions.","volume":"152","author":"Steinman","year":"1987","journal-title":"Milit Med"},{"key":"2025122209281571000_311.7021.1661.7","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1093\/milmed\/145.5.305","article-title":"Local cold injury\u2013menace to military operations: a review.","volume":"145","author":"Vaughn","year":"1980","journal-title":"Mil Med"},{"key":"2025122209281571000_311.7021.1661.8","first-page":"41","article-title":"Prevention of cold injury on exercises with the allied military force (land) in north Norway.","volume":"4","author":"Dick","year":"1989","journal-title":"Medical Corps International"},{"key":"2025122209281571000_311.7021.1661.9","unstructured":"Lehmuskallio E Rintamdki H Anttonen H .The protective effect of facial ointments in acute cold exposure. In: Jemec GBE ed.Proceedings of the third congress of the European Academy of Dermatology and Venereology. Copenhagen: Kandrup,1993:10."},{"key":"2025122209281571000_311.7021.1661.10","first-page":"9","article-title":"The frostbites of conscripts in early winter 1976. (In Finnish.)","volume":"52","author":"Koskenvuo","year":"1977","journal-title":"Annales Medicinae Militaris Fenniae"},{"key":"2025122209281571000_311.7021.1661.11","first-page":"59","article-title":"Prevention of frostbites. (In Finnish.)","volume":"51","author":"Koskenvuo","year":"1976","journal-title":"Annales Medicinae Militaris Fenniae"},{"key":"2025122209281571000_311.7021.1661.12","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/S0278-5919(20)30863-2","article-title":"Cold exposure injuries: prevention and treatment.","volume":"8","author":"Fritz","year":"1989","journal-title":"Clin Sports Med"},{"key":"2025122209281571000_311.7021.1661.13","unstructured":"Tervahauta R Hassi J Anttonen H Vuori E Lehmuskallio E .Maintaining military performance in cold environment. In: Koskenvuo K ed.Field surgery and medicine. Hdmeenlinna: Medical Section of the Finnish Defence Staff, Karisto Oy,1993: 461\u201370. (In Finnish; English version in preparation.)"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.311.7021.1661","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.311.7021.1661","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T17:29:22Z","timestamp":1766424562000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.311.7021.1661"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,12,23]]},"references-count":13,"journal-issue":{"issue":"7021","published-online":{"date-parts":[[1995,12,23]]},"published-print":{"date-parts":[[1995,12,23]]}},"alternative-id":["10.1136\/bmj.311.7021.1661"],"URL":"https:\/\/doi.org\/10.1136\/bmj.311.7021.1661","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"value":"0959-8138","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,12,23]]}}}