OBJECTIVES: The following is a report on a case of cold sensitization in a worker who served as a forklift truck driver in a cold storage warehouse for 5 years from 1996. METHODS: We examined the patient's blood chemistry and infrared computerized thermographic measurements. We also reviewed the environmental temperatures at his workplace and interviewed other workers. RESULTS: The worker was a 32-year-old male who had worked in a cold storage warehouse for 5 years (1996-2000). He complained of headaches, arthralgia, and slight dyspnea after 2 years work serving as a forklift truck driver in a cold storage facility. In the laboratory record of his blood and those of others, the C-reactive protein, rheumatoid facror, anti-nuclear antibody, cryoglobulin and other blood chemistries were all negative except that the anti-streptolysin O titer was reactive and alkaline phosphatase was also increased. The radiologic findings were normal. Using infrared computerized thermographic measurements, the patient's hands were at around 30 degrees C and below in the first infrared image and around 27 degrees C in the third image. Accordingly, he was diagnosed as having cold sensitization, which occurs in persons exposed to cold for long time, especially below freezing point. CONCLUSIONS: We confirmed that the cold sensitization occurred in this patient as an occupational disease due to an exposure to cold. To prevent cold injury, we must modify work procedures, begin comprehensive medical surveillances, educate workers on risks of cold, and increase workers awareness of safety regulations in the workplace.