The winter weather combination of a little more than an inch of snowfall and temperatures that dip below 20 degrees can cause death rates from heart attacks to triple among men 35 to 49 years old.
One of the main culprits responsible for this increase in winter weather-related heart attacks is the simple activity of shoveling snow.
"If you're not a regular exerciser or are in poor physical shape, your body won't be prepared for the stress of shoveling snow, which increases your chance of sustaining muscle pulls, back injuries, or a heart attack," explained John Dawson, D.O., Assistant Medical Director for Salem Community Hospital's Emergency Department. "In some cases, snow shoveling can be compared to weight lifting, while working out on a treadmill."
An average shovelful of heavy, wet snow weighs 16 to 20 pounds. That means for every 10 minutes of typical shoveling, a person can clear more than 2,000 pounds of snow.
Researchers have also found that within two minutes of shoveling, many people exceed their upper heart rate limit for aerobic exercise training. For example, the amount of energy used to shovel snow is comparable to that of speed walking at 5 miles per hour.
Most at Risk
Because this activity places such high stress on the heart, people should always talk with their doctor about shoveling or snow blowing in advance of the first winter storm.
"If you have a medical condition or don't exercise regularly, consider hiring someone to remove the snow for you," Dr. Dawson advised. "Even people, who regularly exercise can find shoveling to be strenuous if they try to tackle the job without taking breaks. Shoveling causes a quick increase in the body's heart rate and blood pressure. Those most at risk during shoveling are people who have already had a heart attack, people with a history of heart disease, those with high blood pressure or high cholesterol levels, smokers and people who lead a sedentary lifestyle.
"One of the reasons heart attacks can occur during snow shoveling is the combination of colder temperatures and physical exertion. Cold weather places an additional strain on the heart while the body is trying to keep warm. The combination of sudden physical exertion and cold weather increases the workload for the heart and can cause a heart attack. The heart is a muscle just like any other muscle in the body, and when it gets strained, it shuts down because it can't handle the increased load."
Back and Muscle Safety
"Back and muscle safety is also important to consider when shoveling snow," Dr. Dawson said. "Even if a person exercises regularly, improper shoveling techniques could lead to a strained or sore back.
"When preparing to shovel snow, purchase an ergonomically correct shovel. These shovels are typically much lighter than normal shovels and have a contoured handle that is designed to reduce or eliminate bending and decrease the amount of weight lifted.
"Before starting to shovel, it is important to warm up your muscles by walking for a few minutes or stretching. Muscles in the arms, legs and back especially need to be stretched to work more efficiently and prevent injury.
"Once you start shoveling, try to push the snow instead of lifting it," Dr. Dawson suggested. "Be sure not to overload the shovel, and never use your back to lift snow. If you have to lift, bend your knees and lift with your legs, and avoid twisting or throwing snow over your shoulder.
"Lastly, if you are experiencing snowfall levels of 12-inches or more, try to remove the snow in layers. New fallen snow is lighter than packed, heavy snow, so start shoveling when a light covering of snow is on the ground."
Other Shoveling Safety Tips:
- Give yourself a break: Take frequent rest breaks so you don't overstress your heart. Pay attention to how your body feels during these breaks. Stop if you feel pain or observe heart attack warning signs. These may include chest pain as well as shoulder, neck or arm pain; dizziness, fainting, sweating or nausea; or shortness of breath. If you think you're having a heart attack, seek medical help immediately.
- Don't eat before shoveling snow, and avoid smoking or the use of caffeinated beverages, which are stimulants that may increase heart rate and cause blood vessels to constrict, putting an extra load on your heart.
- Don't drink alcoholic beverages before shoveling, because alcohol may increase the sensation of warmth and cause people to underestimate the extra strain their body is under in the cold.
- Dress appropriately: Light, layered, water-repellent clothing provides both ventilation and insulation. In addition, wear the appropriate head coverings, as well as mittens or gloves and thick, warm socks. Avoid falls by wearing shoes or boots that have slip-resistant soles.
John Dawson, D.O., is the Assistant Medical Director for Salem Community Hospital's Emergency Department.