BACKGROUND: Relatively few occupational epidemiological studies have been conducted concerning the association between cold ambient temperatures and cold exposure injuries, and fewer still of traumatic occupational injuries and cold ambient temperatures. METHODS: The association of ambient temperature and wind data from the National Climatic Data Center with injury data from mines reported to the Mine Safety and Health Administration (MSHA) was evaluated over a 6 year period from 1985-1990; 72,716 injuries from the seven states with the most numerous injuries were included. Temperature and wind data from each state's metropolitan weather stations were averaged for each day of the 6 year period. A weighted linear regression tested the relationship of ungrouped daily temperature and injury rate for all injury classes. For cold exposure injuries and fall injuries, relative incidence rates for grouped temperature data were fit with Poisson regression. RESULTS: As temperatures decreased, injury rates increased for both cold exposure injuries and slip and fall injuries. The association of slip and fall injuries with temperature was inverse but not strictly linear. The strongest association appeared with temperatures 29 degrees F and below. The injury rates for other accident categories increased with increasing ambient temperatures. CONCLUSIONS: This study suggests that statewide average ambient temperature reflects the expected association between the thermal environment and cold exposure injuries for workers, but more importantly, documents an association between ambient temperatures and occupational slip and fall injuries. Copyright Published 2000 Wiley-Liss, Inc.