Introduction: Intensification of economic activities in the northern regions of Russia requires a better understanding of the combined health effect of cold environment and occupational risk factors. Objective: To assess the risk of developing health disorders in gas and electric welders exposed to low and normal workplace temperatures. Materials and methods: We conducted a comparative analysis of working conditions and health status of welders at two enterprises. The main cohort included 310 workers exposed to welding fumes and cold microclimate in an underground mine. The control cohort included 282 employees of a railcar manufacturing facility performing their functional duties in workshops with acceptable microclimate parameters. Results: According to the results of periodic medical examinations, 499 chronic diseases were diagnosed in welders of the main cohort against 230 among the controls. Compared to the reference cohort, underground welders were at higher risk of developing diseases of the digestive system (RR = 2.63; CI: 1.47–4.70; p = 0.0006), genitourinary (RR = 6.55; CI: 1.51–28.4; p = 0.004), musculoskeletal (RR = 1.50; CI: 1.14–1.97; p = 0.003), and nervous systems (RR = 5.29; CI 1.19–23.4; p = 0.014), skin (RR = 3.85; CI: 1.61–9.18; p = 0.001), respiratory organs (RR = 3.23; CI: 1.84–5.69; p < 0.001), as well as infectious and parasitic diseases (RR = 8.61; CI: 2.03–36.5; p = 0.0004). Thus, the number of healthy workers was smaller while the number of workers suffering from two or more chronic diseases was bigger in this cohort (p < 0.001). Conclusions: The welders working in cold environment were significantly less healthy than those working in normal workplace temperatures. The results necessitate the development of additional measures of disease prevention for this category of employees.