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Nonfreezing Cold-Induced Injuries
  1. Chris Imray, Professor1,2,
  2. P Richards, Centre for Altitude3,
  3. J Greeves, Department of Occupational Medicine3 and
  4. JW Castellani, Thermal and Mountain Medicine Division4
  1. 1Warwick Medical School, University Hospitals Coventry and Warwickshire NHS Trust, Coventry
  2. 2Space and Extreme Environment Medicine, University College London, Institute of Child Health, 30 Guilford Street, London
  3. 3Trenchard Lines, Upavon, Pewsey, Wilts
  4. 4United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
  1. Warwick Medical School, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK. Christopher.imray{at}


Non-freezing cold injury (NFCI) is the Cinderella of thermal injuries and is a clinical syndrome that occurs when tissues are exposed to cold temperatures close to freezing point for sustained periods. NFCI is insidious in onset, often difficult to recognize and problematic to treat, and yet the condition accounts for significant morbidity in both military and civilians who work in cold conditions. Consequently recognition of those at risk, limiting their exposure and the appropriate and timely use of suitable protective equipment are essential steps in trying to reduce the impact of the condition. This review addresses the issues surrounding NFCI.

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