Causes and Consequences of Freezing Cold Injuries in the Norwegian Armed Forces from the Soldier’s Perspective—A Qualitative Study

Freezing cold injury (FCI) is a localized injury caused by prolonged exposure to sub-zero temperatures, posing a significant health risk to military personnel operating in extreme climates. This study aimed to explore how FCI affects the health and lives of soldiers in the Norwegian Armed Forces (NAF), addressing the broader context of its impact on military readiness and the personnel's well-being. Sixteen participants with a history of grade 2 FCI were recruited through the Norwegian Armed Forces Health Registry and interviewed. Systematic content analysis was used to identify key themes related to the causes and consequences of FCI, as well as the influence of military culture. The findings indicate that FCI results from interacting environmental, behavioural, and systemic factors. Environmental contributors included cold exposure and limited opportunities to eat or drink. Behavioural and individual contributors included reduced awareness of bodily cues in cold conditions and the need to remove gloves for weapon handling under time pressure. Systemic contributors, particularly military cultural norms emphasizing strict discipline and toughness, were perceived to discourage early symptom reporting and the use of preventive measures. Most participants (11/16) reported long-term consequences, including chronic physical discomfort, functional limitations, and negative impacts on their careers and daily lives. This study highlights the significant short- and long-term consequences of FCI, which extend beyond physical harm to affect soldiers' overall health, functioning, and career progression. The findings emphasize the need for targeted preventive measures to mitigate the risks of FCI and protect military personnel in extreme climates.