El nivel de riesgo en lo relativo a la exposición al frío depende de cuatro factores fundamentales, que determinarán la magnitud de la amenaza. En la evaluación de riesgos se debe tener un conocimiento preciso de todos y cada uno de ellos en la tarea a realizar. Los factores a tener en cuenta son:

Temperatura del aire: La temperatura ambiental medida por un termómetro.
Velocidad del viento: Afecta de forma significativa a la capacidad de enfriamiento que el ambiente tiene sobre la piel del individuo. A mayor velocidad del viento, mayor capacidad de enfriamiento, y por tanto, mayor amenaza para una misma temperatura.

Humedad relativa: Dado que el agua conduce el calor 25 veces más rápido que el aire, a mayor humedad presente, mayor disipación de calor.

Actividad física: La actividad física aumenta la cantidad de calor producido por el cuerpo. Aunque es un factor difícil de medir, existen tablas en las que se indica la actividad física asociada a diversos tipos de acciones.

Con todos estos factores, se puede calcular el nivel de protección requerido para alcanzar el equilibrio térmico del individuo con el medio ambiente, teniendo en cuenta la capacidad de aislamiento de la vestimenta que use el trabajador. El nivel de protección que requiere la vestimenta del trabajador se denomina IREQ. La norma UNE-EN ISO 11079:2009 proporciona un método para la determinación e interpretación del estrés debido al frío empleando el IREQ.

Seleccionando el equipo

Para seleccionar los equipos necesarios, el IREQ se compara con la protección (aislamiento térmico efectivo de la ropa, Icl,r ) que proporciona la vestimenta del trabajador. Si el aislamiento es inferior al valor prescrito, la protección prestada por la ropa de protección es insuficiente. En este punto es importante señalar, que pese a que existen tablas orientativas acerca del aislamiento efectivo que proporciona la ropa genérica, sólo la ropa de protección que cumple los requisitos del RD 1407/1992 para la protección contra el frío, proporciona los valores específicos de aislamiento térmico. Sólo con estos valores, podremos calcular de la mejor forma posible el nivel de aislamiento que necesita un trabajador para unas condiciones específicas.

El tipo y cantidad de ropa de protección debe proporcionar un nivel de protección adecuado para evitar caer en la sub-protección, en la que el trabajador quedaría expuesto al frío; y en la sobre-protección, donde se corre el riesgo de una transpiración excesiva, humedeciendo la ropa más próxima al cuerpo, disminuyendo el aislamiento que proporcionan las prendas y propiciando un enfriamiento progresivo del cuerpo.

Los efectos del frío:

Cuando las prendas de protección contra el frío no ofrezcan el nivel de protección óptimo, los efectos del frío sobre el cuerpo dependerán del grado de exposición del trabajador. De forma general, los efectos del frío van desde dolor hasta la hipotermia.

Dolores

A la sensación de frío, le suele seguir dolor en la zona expuesta, constituyendo una de los primeros síntomas de congelación. En caso de continuar el descenso de la temperatura, el dolor desaparecerá como consecuencia de la pérdida de sensibilidad, lo cual puede provocar que se sufran graves lesiones sin apercibimiento.

Trastornos músculo-esqueléticos (TME)

Los TME son la primer causa de baja laboral en cualquier sector. Diversos estudios epidemiológicos han revelado el papel que juega directa o indirectamente el frío en la aparición dichos trastornos. Los TME se ven potenciados por la anemia parcial de los músculos y tendones generada por la vasoconstricción periférica derivada del frío. Así, por cada grado de temperatura muscular perdido, la fuerza muscular disminuye entre un 2% (fuerza de contracción muscular isométrica) y un 4% (fuerza de contracción dinámica).

Hipotermia

Se trata del síntoma más grave y que puede llevar a la muerte del trabajador en casos extremos. En la Tabla 1 se relacionan las distintas manifestaciones clínicas de la hipotermia.

Tabla 1 Manifestaciones clínicas de la hipotermia

Nivel de hipotermia Temperatura corporal ( ˚C) Síntomas
Ligero 35 – 32,2 Confusión mínima, temblores, pérdida de la coordinación motriz fina, aumento de la frecuencia cardíaca y de la presión arterial, vasoconstricción periférica
Moderada < 32,2 – 28 Coma vigil, pérdida de los reflejos osteotendinosos, rigidez muscular, desaparición de los temblores, bradicardia sinusal, colapso cardiovascular, hipoventilación, cianosis Severa < 28 Coma areactivo, rigidez, apnea, desaparición del pulso, fibrilación ventricular o asistolia, midriasis Otros efectos Además de los efectos ya nombrados, existe una gran variedad de efectos sobre la salud en relación al frío, como pueden ser: Hipersensibilidad y alergia al frío (urticaria, enfermedad de Raynaud, etc.) Afecciones respiratorias (asma, bronquitis, etc.), cardiovasculares (infarto de miocardio, accidentes vasculares centrales…), articulares (reumatismos), digestivos (hiperacidez gástrica, úlcera gastroduodenal), neuropsiquiátricos (epilepsia). Disminución de la eficacia de la visión, cólicos hepáticos y nefríticos. Por otro lado, en los casos de fuertes amplitudes térmicas, que en algunos casos pueden sobrepasar los 50 ˚C, se pueden registrar molestias respiratorias a la salida de las cámaras frigoríficas y una sensación de astenia al final de la jornada. Como vemos, los efectos de la exposición al frío van mucho más allá que unas simples tiritonas o catarros. Por ello, es absolutamente fundamental que al identificar el frío y/o humedad como agente de riesgo, se proceda a una evaluación de la naturaleza de la amenaza y se utilicen equipos certificados para poder ofrecer el nivel de aislamiento específico y que evitará las consecuencias de la exposición al frío. El uso de un equipo de protección contra el frío no certificado en situaciones en las que hemos determinado que el frío es un agente de riesgo en el entorno laboral no es aplicable; ya que por un lado, no tenemos los datos específicos de aislamiento térmico ofrecido por la prenda, y por otro lado (y por si lo anterior no es suficiente motivo para alguien), la utilización de EPI debidamente certificado es obligatorio en estas circunstancias según el RD 773/1997.

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