Foot Health for People on the Job
People who work outdoors on their feet, such as construction workers, natural resources workers (oil and gas, forestry, land management), agriculture, police, fire and rescue, mail and courier delivery, and other jobs where a significant portion of the work is done outside should also follow the same general guidelines as people in manufacturing and service environments. But for those who work primarily outside, the climate and weather conditions are important factors in preventive foot care. It is especially important to be able to deal with extremes - both cold and high heat.
For extreme cold conditions…
- Choose boots or shoes carefully. Warmth and dryness are important. Look for boots with waterproof or water resistant uppers, outsoles that provide good traction in snowy or icy conditions, and an insulated interior. The boot height should reach above the ankle, and the upper should fit well (if working in snowy conditions, it should have an effective closure to keep snow from getting into the boots).
- Choose the right socks. Padded socks with good insulating and wicking capabilities (the ability to move moisture away from the feet) help keep the feet warm and dry. Avoid cotton socks altogether, and look for padded socks with engineered synthetic insulating fibers, and/or blends of wool and synthetic wicking fibers. Wool by itself is an excellent insulating fiber, but it tends to absorb moisture (even in cold weather, feet can perspire during vigorous activities). Moisture held next to the feet increases the risk of coldness and blistering, and generally speaking, in cold climates a dry foot is a warm foot.
- If any insoles are used (or in cases where a foot health professional may have prescribed them), they should be used in place of the insert or footbed that comes with the shoes or boots.
- Ensure the right fit. It is important to get feet measured each time you purchase shoes or boots, since the feet tend to get larger as we age, and sizes can vary from one brand to another, and among various shoe and boot styles. As always, IPFH recommends the integrated approach for selecting and fitting footwear.
- Maintain the right temperature. One study has shown an average foot surface temperature during waking hours in healthy adults of 87 degrees F. As would be expected, this is heavily influenced by ambient temperature and conditions. Insulation in socks and boots can help maintain a healthy temperature. Frostbite can be a danger if the feet get too cold. Also, make sure body temperature does not get too low. Watch for signs of hypothermia. Any time you feel chilled or experience cold in the toes or fingers, it’s best to take a break from the cold. Follow these tips from OSHA for protecting those who work outside in cold weather.
For high heat conditions…
- Choose appropriate footwear using the integrated approach. The best work boots or shoes for very hot weather are made from light, breathable materials that can help keep feet cool and dry, while still having the protective features of standard work boots. A breathable or vented upper is important, as is light weight. Padded socks made from synthetic engineered fibers can help wick moisture and keep the feet cool. Avoid cotton and other natural fibers, because they retain moisture and can promote blisters. Any inserts should utilize wicking materials, which can also help in moving moisture away from the feet.
- During prolonged exposure to heat, some people may experience water retention, resulting in swelling of the lower legs, ankles and feet. While this is usually temporary, it can produce discomfort. Heat can cause dilation of the blood vessels, and the veins may not be able to effectively return the blood back up the legs to the upper body. As a result, fluid can pool in the legs and feet. The extra fluid can make the skin tight and shiny and also cause swelling in the hands and fingers. The CDC notes that heat edema tends to occur when the body is not already acclimated to the hot environment. To prevent heat-related swelling, keep the body cool: Drink plenty of fluids to prevent dehydration, and take frequent breaks to cool down and gradually acclimate to the weather. As much as possible, avoid prolonged sitting or standing, as being immobile can contribute to fluids pooling in the feet, ankles and legs.
- If any swelling, redness or pain persists for more than a few days, consult your primary care physician or a foot health professional.
The U.S. Bureau of Labor Statistics recently published a report that indicated the average worker across all industries and occupations spends 61% of the time standing and 39% sitting. For office workers, the time sitting increases significantly, to around 75% across different occupations. Based on research, as mentioned previously, any stationary posture where energy expenditure is low can have a negative effect on an individual’s health, whether sitting or standing. This means that it is important for office workers who are in sitting positions for most of their work day to get up and move around periodically.
A recent study in the British Journal of Sports Medicine included the recommendation that “for those occupations which are predominantly desk-based, workers should aim to initially progress towards accumulating 2 hours per day of standing and light activity (light walking) during working hours, eventually progressing to a total accumulation of 4 hours per day [for part-time workers the time spent standing and sitting should be approximately the same]. To achieve this, seated-based work should be regularly broken up with standing-based work, the use of sit–stand desks, or the taking of short active standing breaks.”
In addition, IPFH recommends the simple foot exercises previously noted in this article, along with choosing appropriate and well-fitting footwear using the integrated approach. While office environments do not challenge the feet as much as manufacturing, service, or outdoor environments, it is always a good idea to take good proactive care of the feet and to choose footwear wisely.
Because so many people spend a significant amount of time at work, taking proper care of the feet is critical, and can result in greatly enhanced quality of life and diminished risk of minor and major foot conditions. It is always best to take care of your feet proactively, and not to wait until they start to hurt or show signs of distress.
“Foot Comfort and Safety at Work” Canadian Centre for Occupational Health and Safety: https://ccohs.ca/oshanswers/prevention/ppe/foot_com.html
Lori S. Weisenfeld, DPM, FACFAS
Scientific Advisory Board Member, Institute for Preventive Foot Health
September 12, 2017