A large majority of the about 1 million jobs in cold working environments in Germany are in the food industry. The use of personal protective gear is limited by food law regulations and there are cases of occupational diseases suspected to be caused chronic cold exposure. Cold damage can be recognized as an occupational disease only in the form of skin disorders or occupational accidents. Decisive for legal recognition is not only the existence of specific conditions (severe and/ or repeated recidivism) but also the clinical picture, especially the demonstration of a positive Raynaud’s phenomenon after cold exposure or other characteristic clinical signs such as frost-bite or chilblains. In the absence of such symptoms an occupational disease is generally not recognized. In this paper we would like to discuss non-freezing-coldinjury (NFCI), another possible differential diagnosis of chronic cold damage. Since NFCI is a diagnosis by exclusion and is rarely known in the non-military area, the number of unknown cases among persons working in cold environments can be assumed to be high.
