Cold Stress Injuries and Fatalities U.S.: 40+ Statistics 2025

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Cold Stress Injuries and Fatalities in the U.S.: 40+ Statistics Through 2025

Cold-related deaths in the U.S. increased 109% between 1999 and 2022, with a 95% spike concentrated between 2017 and 2022 alone, according to a landmark JAMA study published in December 2024. In 2023, 1,024 deaths were attributed to excessive cold or hypothermia, with January accounting for nearly 20% of annual deaths. Workplace cold stress caused 53 worker deaths and 2,770 serious injuries between 2003 and 2019. Low temperatures are associated with approximately 45,992 mean annual deaths across all causes – more than 13 times the toll from high temperatures. This article compiles 40+ statistics from CDC, NIOSH, BLS, OSHA, and JAMA data through 2025.

40+ Statistics

JAMA December 2024

CDC MMWR 2025

BLS Workplace Data

109%

Increase in cold-related mortality rate in the U.S. from 1999 to 2022, with the sharpest rise – 95% – occurring between 2017 and 2022

Liu, Patel, Wadhera. JAMA, December 2024

1,024

Deaths attributed to excessive cold or hypothermia in the U.S. in 2023 – with 19.9% occurring in January alone

CDC MMWR, February 2025

45,992

Mean annual U.S. deaths associated with low temperatures across all causes – 13x higher than the 3,414 annual deaths from high temperatures

JAMA Network Open, November 2025

Cold is a more lethal force in the United States than most public health discussions acknowledge. A landmark JAMA study published in December 2024 found that cold-related mortality rates increased 109% between 1999 and 2022, with the steepest acceleration – 95% – occurring between 2017 and 2022. A separate 2025 JAMA Network Open study analyzing 54 million death records found that low temperatures are associated with approximately 45,992 mean annual deaths – more than 13 times the toll from high temperatures – because cold-related deaths span cardiovascular, respiratory, and renal causes that standard “cold death” coding misses.

The workplace dimension is equally significant. Between 2003 and 2019, cold exposure caused 31 occupational fatalities and 2,770 serious nonfatal injuries – an average of 163 workers hurt each year. In 2020 alone, 53 workers died from environmental cold exposure. OSHA has no specific cold stress standard, but the General Duty Clause obligates employers to protect workers from recognized cold hazards. Below we compile 40+ statistics from CDC, NIOSH, BLS, OSHA, and peer-reviewed research through 2025.

Editor's Choice: Key Cold Stress Statistics for 2024-25

0.92

Cold-related deaths per 100,000 persons in 2022, up from 0.44 per 100,000 in 1999 – a 109% increase in age-adjusted mortality rate over 23 years. The 3.4% annual increase was statistically significant (P less than 0.001). (JAMA, December 2024)

40,000+

Total deaths attributable to cold exposure in the U.S. between 1999 and 2022, based on death certificate coding for hypothermia and cold exposure. The true total across all cold-attributable causes is substantially higher. (JAMA, December 2024)

Ages 45-74

The age group showing the largest absolute increase in cold-related deaths in the JAMA 2024 study – a shift from the traditionally most vulnerable group (75 and older), suggesting that middle-aged adults are increasingly at risk. (JAMA, December 2024)

$3.38B+

Economic damage from 21 winter weather events in the 2024-25 North American winter season, with 55 associated deaths – including the January 2025 Gulf Coast blizzard that killed 13 people and caused $200 million in damage. (Wikipedia / NWS, 2025)

1,300

Americans who die from hypothermia on average each year, according to CDC figures cited in occupational safety guidance – forming the baseline against which the upward trend in cold mortality must be understood. (CDC / OSHA Online Center, 2025)

40%

of cold-related deaths in the U.S. occur in January and February alone, making these two months the highest-risk period for cold exposure deaths across all populations. (existing data / original article)

1. National Cold-Related Mortality Trends: The JAMA December 2024 Findings

Cold-Related Age-Adjusted Mortality Rate (AAMR) Trend 1999-2022 (per 100,000 persons)

0.44

1999

0.46

2005

0.48

2010

0.47

2017

0.74

2020

0.92

2022

Source: Liu, Patel, Wadhera. Cold-Related Deaths in the US. JAMA 2024;333(5):427-429 (published December 19, 2024). The shaded acceleration post-2017 represents a 95% increase.

A landmark study of U.S. death certificate data published in JAMA on December 19, 2024 found that the cold-related age-adjusted mortality rate increased from 0.44 per 100,000 persons in 1999 to 0.92 per 100,000 in 2022 – a 109% increase, with a statistically significant 3.4% annual increase throughout the study period (P less than 0.001). (Liu, Patel, Wadhera. JAMA, December 2024)
The increase was not steady across the study period. Cold-related mortality was relatively stable through approximately 2017, after which rates surged by 95% between 2017 and 2022 alone. Study co-author Dr. Rishi Wadhera described the findings as “surprising” given that mean temperatures have been increasing. (JAMA, December 2024; WBUR, December 2024)
Between 1999 and 2022, more than 40,000 people died due to cold exposure in the United States based on underlying cause of death coding for hypothermia and cold exposure – a figure that substantially undercounts the true cold-attributable burden. (JAMA, December 2024)
In 2023, the CDC MMWR reported that 1,024 deaths were attributed to excessive cold or hypothermia, based on ICD-10 code X31 (Exposure to excessive natural cold) and T68 (Hypothermia) from the National Vital Statistics System. (CDC MMWR, February 27, 2025, Vol. 74, No. 6)
A 2025 JAMA Network Open study analyzing 54.2 million death records found that low temperatures are associated with approximately 45,992 mean annual deaths across all causes (not just hypothermia-coded deaths) – more than 13 times the 3,414 mean annual deaths from high temperatures. The burden from high temperatures increased 53% between 2000-2009 and 2010-2020, but cold remains the dominant temperature-related cause of death. (JAMA Network Open, November 2025)

2. When Cold Deaths Happen: Monthly Distribution in 2023

Percentage Distribution of U.S. Cold/Hypothermia Deaths by Month – 2023 (Total: 1,024)

19.9%

Jan

16.9%

Feb

14.2%

Mar

5.8%

Apr

2.7%

May

1.9%

Jun

1.6%

Jul

1.4%

Aug

2.1%

Sep

5.0%

Oct

11.9%

Nov

16.7%

Dec

Source: CDC MMWR Vol. 74 No. 6, February 27, 2025. National Center for Health Statistics, National Vital Statistics System, Mortality Data, 2023.

January 2023 accounted for 19.9% of all cold/hypothermia deaths (204 of 1,024), making it the single deadliest month. February was second at 16.9% (173 deaths) and December third at 16.7% (171 deaths). (CDC MMWR, February 2025)
Combining January and February, approximately 36.8% of all 2023 cold deaths occurred in the first two months of the year. When November and December are added, the four coldest months account for approximately 65.4% of all annual cold fatalities. (CDC MMWR, February 2025; calculated)
Even summer months show some cold-related mortality: July and August recorded 1.6% and 1.4% of deaths respectively (16 and 14 deaths), reflecting cold-environment worker deaths, hypothermia from cold water immersion, and air conditioning-related cold events. (CDC MMWR, February 2025)
For workplace safety planning, the CDC data confirms that cold stress prevention programs must be operationally active by November at the latest, not just during the January-February peak. October already accounts for 5% of annual cold fatalities. (CDC MMWR, 2025; OSHA guidance)

3. Who Is Most At Risk: Demographics, Geography, and Vulnerability Factors

Age 75 and Older – Highest Rate

Highest cold-related death rate per capita. Bodies lose heat faster, often live alone, limited access to warm shelter, and reduced physiological capacity to detect or respond to temperature drops.

Ages 45-74 – Fastest Growing

Showed the largest absolute increase in cold-related deaths in the JAMA 2024 study. The reasons include rising homelessness among working-age adults, increased drug/alcohol use, and social isolation. Men in this group are disproportionately affected.

Rural Areas – Higher Rates

During 2018-2020, noncore rural males had cold death rates of 0.93 per 100,000, versus 0.29 for large central metro males. Rural females: 0.40 per 100,000 vs 0.11 in large central metros. (CDC MMWR, 2022)

Men – Higher Mortality

Men are significantly more likely than women to die from cold exposure across all age groups and geographic areas, reflecting differences in occupation, outdoor activity, clothing behavior, and help-seeking patterns.

Adults aged 75 and older carry the highest cold-related death rate per capita, driven by impaired thermoregulation, chronic disease, medication effects, social isolation, and reduced ability to respond to cold warning signs. (JAMA, December 2024)
The JAMA 2024 study found that adults aged 45 to 74 showed the largest absolute increase in cold-related deaths over the study period. The researchers identified homelessness, drug and alcohol use, and social isolation among this age group as potential drivers of the accelerated mortality rise after 2017. (JAMA, December 2024; WBUR, December 2024)
During 2018-2020, rural males in noncore areas had cold death rates of 0.93 per 100,000 – more than three times the 0.29 rate for large central metro males. Rural areas have lower access to emergency services, heating resources, and cold weather shelter infrastructure. (CDC MMWR, February 2022)
Three structural factors that the JAMA 2024 researchers identified as likely drivers of the post-2017 surge: the rising unsheltered homeless population; the growing share of Americans aged 50 and older who are less physiologically resilient; and youth social isolation, which reduces the informal monitoring that historically reduced cold deaths. (JAMA, December 2024; WBUR)
People with hypertension, hypothyroidism, diabetes, poor circulation, or prior frostbite are at elevated risk from cold stress – conditions that are more prevalent in older adults and workers in sedentary roles who may underestimate their exposure risk. (OSHA.com; CDC-NIOSH)

4. Cold Stress in the Workplace: Occupational Fatalities and Injuries

Occupational cold-exposure fatalities 2003-2019 (avg. 1.9/year)

BLS / NIOSH

2,770

Serious nonfatal workplace cold injuries 2003-2019 (avg. 163/year)

BLS / NIOSH

Worker deaths from environmental cold in 2020 – 22 linked to snow, ice, or sleet

BLS 2020

Specific OSHA cold stress standard exists – General Duty Clause applies instead

OSHA.gov

Between 2003 and 2019, cold exposure caused 31 occupational fatalities and 2,770 serious nonfatal injuries in the U.S. workforce – an average of approximately 1.9 deaths and 163 injuries per year directly attributable to cold environmental conditions. (BLS / NIOSH)
In 2020, 53 workers died from exposure to environmental cold, with 22 of those deaths directly tied to snow, ice, or sleet conditions that create compounding hazards including slips, falls, vehicle crashes, and direct cold exposure. (BLS, cited in DuraLabel, November 2025)
The industries with highest cold stress risk include construction, snow removal, agriculture, utilities, transportation, and outdoor security. Workers in these sectors face prolonged exposure to wind chill, wet conditions, and inadequate warm-up opportunities during winter months. (OSHA; CDC-NIOSH, March 2026)
OSHA does not have a specific standard covering cold stress. However, under the OSH Act of 1970, employers have a General Duty Clause obligation to protect workers from recognized hazards – including cold stress hazards – that are causing or likely to cause death or serious physical harm. (OSHA.gov; OSHA.com, December 2024)
Cold stress injuries in the workplace include hypothermia, frostbite, trench foot, and chilblains. Cold immersion hypothermia develops far faster than standard hypothermia and can occur in any water temperature below 70 degrees F – a particular risk for workers in marine, construction, and utility environments. (CDC-NIOSH, March 2026)
Workers in indoor cold environments – refrigerated warehouses, walk-in freezers, cold storage facilities – face cold stress risks that are often underrecognized because they are not in traditional outdoor winter settings. Sedentary workers in cold environments are at particular risk because reduced physical activity lowers heat generation. (OSHA.com; CDC-NIOSH)

5. Military Cold Injury Data: 2024-25 U.S. Armed Forces Statistics

6.4 to 31.1

Cold injuries per 100,000 person-years in U.S. Armed Forces 2019-2024, showing wide variation year to year depending on training location, exercise conditions, and winter severity. (U.S. Armed Forces data)

456

Service members diagnosed with at least one cold injury in the 2023-2024 winter season. The Army and Marine Corps reported the highest rates, reflecting their higher proportion of outdoor training exercises in cold climates. (MSMR / AMSED 2024)

U.S. Armed Forces cold injury rates between 2019 and 2024 ranged from 6.4 to 31.1 cold injuries per 100,000 person-years – a nearly five-fold variation reflecting the impact of specific training cycles, geographic assignments, and winter severity on military cold injury rates. (U.S. Armed Forces Medical Surveillance data)
In the 2023-2024 winter season, 456 service members were diagnosed with at least one cold injury. The Army and Marine Corps reported the highest rates among the services, consistent with their greater proportion of ground combat training under winter field conditions. (MSMR / Medical Surveillance Monthly Report)
Military cold injury data has occupational safety implications beyond the armed forces: it demonstrates that even highly trained, physically fit individuals with access to proper gear and medical support can suffer cold stress injuries under sustained cold exposure. Training and equipment do not eliminate cold stress risk; they manage it.

6. The 2024-25 Winter Season and the Structural Drivers of Rising Cold Mortality

2024-25 Winter Season (North America)

21 total WPC-issued storms, 55 total fatalities, over $3.38 billion in damages. Notable: January 2025 Gulf Coast blizzard (first major blizzard since 1895 for the region) killed 13 people and caused $200 million in damage.

Homelessness and Housing Instability

Rising homelessness exposes more people to freezing temperatures at night. JAMA 2024 identified this as a primary driver of the post-2017 surge in cold mortality among adults aged 45-74, who represent a growing share of the unhoused population.

Climate Change and Extreme Cold Events

Despite rising mean temperatures, climate science research links climate change to more frequent episodes of severe winter weather in some regions. The 2025 Gulf Coast blizzard, affecting areas unaccustomed to extreme cold, illustrates this paradox.

The 2024-25 North American winter was characterized by 21 weather prediction center storm events, producing 55 total fatalities and over $3.38 billion in property damage. The 2024-25 season was described as considerably colder and more wintry than recent years. (Wikipedia / NWS, 2025)
The January 20-22, 2025 Gulf Coast blizzard brought historic snow accumulations to areas including New Orleans, southern Alabama, and the Florida Panhandle – regions with minimal cold weather infrastructure, unaccustomed populations, and populations particularly vulnerable to sudden cold exposure. The event caused 13 deaths and $200 million in damage. (NWS; Wikipedia, 2025)
JAMA’s 2025 JAMA Network Open analysis found that the world experienced its record-breaking warmest year in 2024 alongside unusually low temperatures in the U.S. in the winter of 2025, illustrating the coexistence of warming trends with extreme cold events that disproportionately affect unprepared populations. (JAMA Network Open, November 2025)
The JAMA December 2024 authors identified three structural contributors to the rising cold mortality rate: more Americans lacking stable housing; a growing proportion of adults aged 50 and older with reduced physiological resilience; and increased social isolation among younger adults that reduces the informal social monitoring that historically protected vulnerable people during cold events. (JAMA, December 2024; WBUR)
Drug and alcohol use impair the body’s ability to sense cold and respond to it, and contribute to outdoor sleeping behavior during cold periods. The JAMA 2024 study period coincided with the surge in U.S. overdose deaths, and the researchers identified this as a probable contributor to accelerated cold mortality among adults aged 45-74 specifically. (JAMA, December 2024)

7. Cold Stress Prevention: What OSHA and NIOSH Recommend in 2025-26

Engineering Controls

Radiant heaters for outdoor security stations. Wind shields to reduce wind chill at work areas. Heated rest areas accessible within safe walking distance. Insulated floors in cold storage areas to reduce conducted cold.

Work Practice Controls

Schedule cold jobs for warmer parts of the day. Use relief workers for long cold-exposure tasks. Provide warm sweetened liquids. Avoid alcohol. Buddy systems for early symptom recognition. Mandatory warm-up break schedules.

PPE and Training

Insulated, waterproof gloves and boots. Layered clothing with moisture-wicking base layers. Coverage of all exposed skin. Training on symptoms of hypothermia, frostbite, trench foot, and chilblains – and what to do in each case.

OSHA’s Cold Stress Guide (updated 2025-26) specifies that employers must train workers on prevention, recognition, and first aid for cold stress illnesses, and must provide appropriate engineering controls, personal protective equipment, and safe work practices. (OSHA Cold Stress Guide, OSHA.gov)
Cold stress prevention does not require sub-freezing temperatures to be legally applicable. OSHA notes that hypothermia can occur above 40 degrees F when wetness, wind, or physical fatigue are present – meaning cold stress hazard assessment should begin well above freezing in wet or windy conditions. (OSHA.com, December 2024)
The CDC-NIOSH Cold Stress page (updated March 3, 2026) identifies four cold-related illness categories for worker recognition training: hypothermia, frostbite, trench foot, and chilblains. Each has distinct onset timing, symptoms, and first aid requirements that workers should be able to identify in themselves and colleagues. (CDC-NIOSH, March 2026)
Wind chill is the primary amplifier of cold stress risk: wind speeds that make the effective temperature feel lower than the air temperature accelerate heat loss from exposed skin. OSHA recommends that employers know the wind chill temperature during outdoor cold work – not just the ambient temperature – before assigning workers to prolonged outdoor tasks. (OSHA Winter Weather – Cold Stress page)
For workers in cold water environments, cold immersion hypothermia represents the highest-urgency cold stress emergency: survival times in water below 70 degrees F are measured in minutes to hours depending on water temperature and physical condition, and immersion hypothermia develops much faster than standard air cold exposure. (CDC-NIOSH, March 2026)

Key Takeaways for Safety Managers and Occupational Health Professionals

Cold-related mortality doubled in 23 years – and the trend accelerated after 2017

A 109% increase in cold-related mortality from 1999 to 2022, with a 95% spike concentrated in just five years (2017-2022), is not consistent with random variation. It reflects structural social changes – homelessness, isolation, drug use – that are not winter-weather variables. Safety programs and public health planning need to address these upstream determinants, not just temperature forecasts.

Cold kills far more than heat – but heat gets the headlines

The JAMA Network Open 2025 analysis of 54 million death records found low temperatures associated with 45,992 mean annual deaths versus 3,414 for high temperatures – a 13-to-1 ratio. Cold-related mortality is chronically underreported and underemphasized in public health communication relative to its actual toll.

The workplace cold toll is preventable – and largely unregulated

31 fatalities and 2,770 injuries over 16 years (2003-2019) represent a preventable toll in industries where cold exposure is predictable and manageable. OSHA has no specific cold standard, which means prevention depends entirely on employer action under the General Duty Clause. Organizations waiting for regulatory mandates will remain behind the curve.

Start prevention in October, not January

October accounts for 5% of cold fatalities. November accounts for 11.9%. By the time January arrives – the deadliest single month at 19.9% – the window for establishing prevention programs, training workers, and deploying PPE has already closed. Cold stress prevention must be fully operational before the first sustained cold event of the season.

Middle-aged workers are a growing high-risk group

The fastest-growing cold mortality demographic is adults aged 45-74 – the core of the outdoor and manual labor workforce. Construction workers, delivery drivers, agricultural workers, and utility field crews in this age group face both elevated occupational exposure and rising personal vulnerability from homelessness risk, substance use, and social isolation.

Climate change is not just a heat problem for safety managers

The 2025 Gulf Coast blizzard affected populations with no cold-weather infrastructure or preparedness. JAMA Network Open 2025 confirmed that while heat burden is growing, cold mortality remains dominant – and extreme cold events are now reaching historically warm areas. Safety plans for southern operations, logistics routes, and distributed workforces need cold contingency procedures.

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