Trench foot is often associated with World War I soldiers. It was first described in 1812 by a French physician treating soldiers during Napoleon’s march on Moscow. Incredibly, the condition remains a health concern to this day, potentially impacting employees working in moist, unsanitary or freezing environments. Public Works, WWTP, Public Safety and other public employees exposed to the elements are all vulnerable.

Trench foot is a type of non-freezing cold injury. This means the temperature that causes the condition is usually low but above freezing. Also known as Immersion Foot Syndrome, the condition usually occurs when feet are cold and wet for extended periods; however, it can occur in as little as 10 to 14 hours and with temperatures up to 60°F. Wearing wet socks inside leaking (or sweaty) shoes increases the risk.

Recognizing the signs and symptoms of trench foot is critical to preventing more serious medical complications. Look for:

• Tingling or pins-and-needles sensations in the toes
• Numbness across parts of the foot
• Red, blotchy or pale skin
• A feeling of heaviness or stiffness when walking

At this stage, the damage is reversible provided the feet are dried, warmed and cared for properly. However, continuing exposure to wet and cold conditions allows the injury to progress.

If trench foot is suspected, promptly apply first aid measures:

1. Remove wet footwear and socks.
2. Dry the feet gently and rewarm them slowly, not with direct heat, but with blankets or body warmth. Rapid heating such as holding feet over a fire or space heater can cause additional tissue injury.
3. Elevating the feet to improve circulation and reduce swelling
4. Allowing the feet to air-dry completely before putting on new socks
5. Avoiding walking long distances until pain subsides
6. Seek medical attention if the condition does not resolve promptly

Trench foot is highly preventable by implementing a few prudent precautions:

• Change out of wet socks and shoes/boots as soon as possible.
• Let your feet air-dry and make sure your feet stay dry.
• Keep your feet elevated while on breaks or resting.
• Change into a new pair of socks at least once during a shift when you have been exposed to cold, wet conditions.
• Wear properly fitting boots or shoes.

Relegate trench foot to the history books by taking precautions and knowing what to do at the first sign of trouble.

Sources:

Bush JS, Lofgran T, Watson S. Trench Foot (https://www.ncbi.nlm.nih.gov/books/NBK482364/). 2021 Aug 11. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2022 Jan-. Accessed 10/30/2022.
Centers for Disease Control and Prevention. Trench Foot or Immersion Foot (https://www.cdc.gov/disasters/trenchfoot.html). Accessed 10/30/2022.
Merck Manual. Nonfreezing Tissue Injuries (https://www.merckmanuals.com/home/injuries-and-poisoning/cold-injuries/nonfreezing-tissue-injuries). Accessed 10/30/2022.
Zafren K. Nonfreezing Cold Injury (Trench Foot) (https://pubmed.ncbi.nlm.nih.gov/34639782/). Int J Environ Res Public Health. 2021;18(19):10482. Accessed 10/30/2022.