Workers, both indoors and outdoors, in services, transportation, agriculture, construction, and other industries may be exposed to environmental cold stress that can lead to thermal discomfort and in some cases even severe injuries, illnesses, or death. The National Institute for occupational Safety and Health (NIOSH) recommends that employers implement a cold-related illness and injury prevention program that includes preventive measures such as using engineering controls, establishing work/ rest schedules, training workers about the hazards of working in cold environments, and providing appropriate cold-weather gear.