Snow shovelling can kill

<i>The context is that many people pick up a shovel and do maximum effort despite living a sedentary life.</i><p>The alternative argument would be that this kind of exercise is simply bad for a person, especially a men over 50 - that it should be avoided even by those otherwise in &quot;good shape&quot;.<p>And yet a third possibility is that this kind of exercise is that this sort of exercise merely moves forward the occurrence of a heart disease event that would have otherwise occurred reasonably soon otherwise.<p>Anyone know any studies puzzling these possibilities out.

The real tragedy here is that folks are living such sedentary lives that a simple activity like clearing snow from your sidewalk&#x2F;driveway becomes lethal.<p>I was once a typical neckbeard programmer who drank way too much coke and red bull and lived off of unhealthy foods. I have a 180º different lifestyle now and will never go back. I enjoy shoveling my driveway.<p>Everyone should invest in their own physical fitness. Make time for it. Make it your lifestyle so it&#x27;s not a chore or a second-thought, but a regular part of your routine. At the very least, do it for your mental health.

&gt; The context is that many people pick up a shovel and do maximum effort despite living a sedentary life.<p>This. Shoveling after last week&#x27;s storm was definitely the most concerted exercise I&#x27;ve had in a year or more. I definitely felt at one point that my heart was working <i>way</i> too hard (for whatever physiological reason; likely those outlined in the article) and forced myself to rest a few minutes, despite not being physically exhausted. And I&#x27;m neither overweight nor have high blood pressure.

Sexist or not, I rarely see women shoveling snow. My wife will on occasion (and even less so now that we live in Seattle), but it&#x27;s almost always been me because, well, I&#x27;m better built for it.<p>But what I didn&#x27;t hear mentioned is that women have a much lower risk for heart attacks until menopause. And I don&#x27;t know that I&#x27;ve ever seen a 55 year old woman shoveling snow (again, anecdata). If you strapping young lads were raised right, you&#x27;d go down and do it for her since you already have the shovel out. :-)<p>More so, shoveling snow is amazingly hard work on a level that most people probably rarely experience. I&#x27;m a lifelong distance runner with a healthy heart (though weeny little runner arms), and shoveling sure gets my heart going. I can&#x27;t imagine the strain on a 54 year old guy with a beer gut who spends most of his day sitting. That <i>does</i> sound like a recipe for a heart attack.

Sounds like one theory of the actual mechanism is the Valsalva maneuver? <a href="https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Valsalva_maneuver" rel="nofollow">https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Valsalva_maneuver</a><p>Could that be mitigated by just learning to not do it? People training in martial arts often practice this by combining breathing with specific moves, such as exhaling while punching. I imagine you could also learn to exhale as you lift the shovel.

Snow shoveling for me has always caused insane lower back pain. I have a bad back and have been laid up in bed for days because of it, even doing silly things like bending over to pick something small up.<p>I used that as an excuse to buy a snowblower. Now, removing snow is as easy as using a self-propelled lawnmower. It&#x27;s one of those things I didn&#x27;t realize I was missing out on and wish I had bought years ago.

Similarly, you&#x27;re more likely to get a have sudden cardiac death while you&#x27;re running a longer race, even if marathoners are unlikely to suffer from sudden cardiac death overall[1].<p>1 = <a href="http:&#x2F;&#x2F;www.nejm.org&#x2F;doi&#x2F;full&#x2F;10.1056&#x2F;NEJMoa1106468#t=abstract" rel="nofollow">http:&#x2F;&#x2F;www.nejm.org&#x2F;doi&#x2F;full&#x2F;10.1056&#x2F;NEJMoa1106468#t=abstrac...</a><p>My point in mentioning this is that there are multiple lines of evidence suggesting that your risk of adverse cardiovascular outcomes is highest during peak exercise, not that I think this would be particularly controversial.

You could also skip buying the &quot;snow shovel&quot; that holds too much snow at a time or is shaped badly for snow removal. You are not power lifting, just clearing an area. Be slow and steady.<p>Instead of the crap snow shovel buy a grain shovel[1], one of the snow pushers[2], or a Toro Power Shovel[3]. If you live in an area that gets a lot of snow then hire a service.<p>1) <a href="https:&#x2F;&#x2F;www.tractorsupply.com&#x2F;tsc&#x2F;product&#x2F;stanley-fatmax-fiberglass-d-handle-grain-shovel?cm_vc=-10005" rel="nofollow">https:&#x2F;&#x2F;www.tractorsupply.com&#x2F;tsc&#x2F;product&#x2F;stanley-fatmax-fib...</a><p>2) <a href="http:&#x2F;&#x2F;www.truevalue.com&#x2F;product&#x2F;Polar-Tuff-Snow-Plow-Pusher-38-In-&#x2F;70231.uts?keyword=snow%20pusher" rel="nofollow">http:&#x2F;&#x2F;www.truevalue.com&#x2F;product&#x2F;Polar-Tuff-Snow-Plow-Pusher...</a><p>3) <a href="https:&#x2F;&#x2F;www.toro.com&#x2F;en&#x2F;homeowner&#x2F;snow-blowers&#x2F;power-shovel-38361" rel="nofollow">https:&#x2F;&#x2F;www.toro.com&#x2F;en&#x2F;homeowner&#x2F;snow-blowers&#x2F;power-shovel-...</a> my dad had one an it worked well

My takeaways: show shovelling can cause heart attacks because of the type of exertion you&#x27;re doing + the cold weather, and it&#x27;s much more likely in men because presumably more men than women shovel snow.

I mentioned this to my wife (who is a doctor) and her response was basically &quot;no duh.&quot; She said they learned about this in med school. Her explanation was that this is typically happening to people who rarely exercise and then all of a sudden are physically exerting themselves for a sustained period of time.

So I understand that sudden exercise can cause clots to become loose and get stuck in one of your coronary arteries causing a heart attack.<p>But those clots are there whether you exercise or not, right? So they are going to cause a heart attack at some point. So by avoiding exercise, you just delay the inevitable.<p>Am I missing something?

&gt; To be perfectly scientific, the researchers have no way of knowing know that shovelling did the guys in.<p>Devil&#x27;s advocate - perhaps it&#x27;s some other activity altogether? Just for example, being snowed in with the spouse could lead to some indoor exertion?

If you don&#x27;t shovel it, you risk having it compact into an icy mess, which can be unhealthy in its own way.

Here&#x27;s a quick review of the large studies which the article cites:<p>[1] says that snowfall in Canada is correlated with heart attacks in men, but not in women. Shoveling is just a postulated cause.<p>[2] reports the proportions of different types of snow shoveling injuries in people treated in US hospital emergency departments. I did not find any statements in [2] to support the article&#x27;s statement that &quot;of the patients with heart attack after shoveling snow, 80 per cent were men.&quot; Perhaps the article&#x27;s author had access to this data or read this result elsewhere. [2] did say that 6.7% of the snow shoveling injuries were cardiac-related. 0.8% of the injuries were fatal; all fatal injuries were cardiac-related.<p>Regarding gender as a risk factor, [2] did report that in patients age ≥ 55 years, males were twice as likely as females to have their injury be cardiac-related. This suggests that being old and male does confer extra risk of snow shoveling-related heart attack.<p>Note that [2] cites work saying that cold temperatures alone, even absent physical exertion, are associated with heart attack in at-risk patients. Cold temperature, independent of snow shoveling, could therefore be a cause for the results in [1].<p>[1] <a href="http:&#x2F;&#x2F;www.cmaj.ca&#x2F;content&#x2F;189&#x2F;6&#x2F;E235" rel="nofollow">http:&#x2F;&#x2F;www.cmaj.ca&#x2F;content&#x2F;189&#x2F;6&#x2F;E235</a> [2] <a href="http:&#x2F;&#x2F;www.sciencedirect.com&#x2F;science&#x2F;article&#x2F;pii&#x2F;S0735675709003714" rel="nofollow">http:&#x2F;&#x2F;www.sciencedirect.com&#x2F;science&#x2F;article&#x2F;pii&#x2F;S0735675709...</a>

In Vancouver, last winter, GlobalBC News made such a big deal out of people not shovelling their sidewalks. They even went so far to shame some owners. They seemed wreck-less about this issue considering that some people (like my dad who&#x27;s a senior) would be risking their life shovelling the snow. Can you tell I hate the news sometimes? On some issues they really like to stir up outrage.<p>[Edit]At one point people were talking about the issue at work over lunch. Ugh.

Friend of my parents had this happen (&amp; hey, we&#x27;re in Canada)<p>Guy shovelled, went inside, had a shower, passed out in bed. Had to be rushed to hospital, bedridden for a couple days. Survived, but now his wife&#x27;s a bit worrisome about him shovelling now

I loved that they put the word suspect in bold. I wish other publications would do this.

My cousin died in his late 30s while attempting to pull-start a chain saw in very cold conditions. The explanation I heard was arteries and vessels constrict in extreme cold, and combined with exertion triggered the heart attack.

&gt; The correlation was true regardless of the patient&#x27;s age, the presence or absence of cardiovascular risk like high blood pressure or other health conditions.<p>Perhaps we should say that a sedentary lifestyle is by itself a cardiovascular risk factor, even if it affects the majority of the population. The same thing goes for body weight: even if the majority of adults in the US are overweight, we don&#x27;t redefine that as the new normal weight, for good physiological and medical reasons. Perhaps with physical activity we have already normalized an unhealthy lifestyle.

Get one of these: [0]: <a href="http:&#x2F;&#x2F;www.biltema.se&#x2F;sv&#x2F;Fritid&#x2F;Tradgard&#x2F;Vinter&#x2F;Snoslade-2000034889&#x2F;" rel="nofollow">http:&#x2F;&#x2F;www.biltema.se&#x2F;sv&#x2F;Fritid&#x2F;Tradgard&#x2F;Vinter&#x2F;Snoslade-200...</a> [1]: <a href="http:&#x2F;&#x2F;www.acehardware.com&#x2F;product&#x2F;index.jsp?productId=3994134" rel="nofollow">http:&#x2F;&#x2F;www.acehardware.com&#x2F;product&#x2F;index.jsp?productId=39941...</a> - in the US<p>for moving 90% of the snow and if you have to scoop the last bit it&#x27;s not backbreaking.

From the linked paper <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed&#x2F;20825768" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pubmed&#x2F;20825768</a> &gt;The average annual rate of snow shovel-related injuries and medical emergencies was 4.15 per 100,000 population.<p>That&#x27;s actually much more than I would have guessed, but is that still high enough for the general public, or HN readers to care enough to change their behavior (i.e. decision to shovel or not)?<p>For comparison, car related fatalities were 11.59 per 100,000 in 2016.

The other big killer is pooping.<p>No joke. If someone at potential risk of a heart attack seems winded or has pain, don’t let them sit on the toilet. That clenching stops your heart.

Cold constricts blood vessels, increasing blood pressure. Combine that with the fact that shoveling is mostly strenuous on your arm muscles —- where upper body exercise causes an increased HR and BP as compared to lower body exercise [0].<p>[0] <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pmc&#x2F;articles&#x2F;PMC4183232&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pmc&#x2F;articles&#x2F;PMC4183232&#x2F;</a>

&gt;The context is that many people pick up a shovel and do maximum effort despite living a sedentary life.<p>I&#x27;d like to point out that even those of us that work out regularly suffer terribly from shoveling. As someone in his mid 40s who works out regularly, daily exercise may prevent a shoveling-induced heart attack but it does absolutely nothing to prevent crippling lower-back pain that lasts for days&#x2F;weeks.

I guess I am not a numbers guy, but in six months 68k suffer heart attacks and 60k in the other six months so its snow, for what 8k extra?<p>yeah it can be hard work and some people just keep going regardless of when their body says stop. still I bet a lot of it is purely genetic, thresholds are higher for some in the same health than others. regardless, just some activity per day is good

title caught my eye. thought I&#x27;d share a little anecdotal evidence: grandpa died from a heart attack while shoveling snow

I wonder if there is data on this about snow sports, it seems like it should be common too. Skiing meets most of the same criteria - extreme cold, surprisingly exhausting, high altitude&#x2F;low oxygen and often getting dehydrated. It is more of a sustained aerobic exercise vs. bursts of exertion though.

Seems like an easy way to help fix this would be to require a snow blower or have the city do it. Or at the very least something in place to make it easier for someone at risk to not have to do the work themselves.

So basically I have a medical reason not to shovel snow. I&#x27;m OK with this.

Does this also mean that areas that rarely get snowfall also have a lower rate of heart attacks?

&quot;The notion that women might shovel snow with less risk is an intriguing one that just might make a good study.&quot;<p>Is it really sexist to just point out the obvious answer? Women have their men go out and shovel the snow.

Great uncle had a heart attack at 63 while shoveling snow.

Suit up, stay hydrated, and use a snowblower you knuckleheads.

Key takeaways:<p>&gt; <i>Researchers... looked at more than 128,000 patients admitted to hospital for a heart attack, and more than 68,000 heart attack deaths in Quebec between 1981 and 2014 from November to April. They also got weather information... and used it to track snowfall prior to the admission to hospital and&#x2F;or death.</i><p>&gt; <i>Among the men, a third of the heart attacks occurred the day after a snowfall. The association between shovelling and heart attack was very strong. If the snow fell for two to three days, the association between shovelling and a heart attack was even stronger. The correlation was true regardless of the patient&#x27;s age, the presence or absence of cardiovascular risk like high blood pressure or other health conditions.</i><p>&gt; <i>But here&#x27;s the thing. The correlation was only true for men – not women. The researchers say they suspect that shovelling caused heart attacks because men are more likely than women to shovel snow. That may be true, or it might be a sexist assumption. But there may be another explanation for the findings: that women shovel snow in a way that doesn&#x27;t cause heart attacks.</i><p>&gt; <i>Men age 50 and older with heart disease should avoid shovelling snow period.</i><p>Why is it sexist to assume that snow shoveling is mostly done by men? It sounds more plausible than secret shoveling techniques.