Avulsion injury occurred in 89 of 164 experiments (54%) with risk increasing with the detachment force (p < 0.001). Peak tongue detachment force was associated with contact time (p < 0.001), tongue region (apex versus basis, p < 0.01), and release type (rapid versus gradual, p < 0.001). A non-linear relationship was found between metal temperature and detachment force (p < 0.01), with peak adherence at approximately −7.5 °C. Histological evaluation demonstrated intra-epidermal damage that could be rationalized with computer modelling. Nearly all experiments (92%) caused macroscopic, but not microscopic, cold injury, with risk increasing at lower metal temperatures. Computer simulations suggest that tissue damage is related to superficial tissue freezing that occurs under typical winter conditions and short exposure times.
