With several inches of snow falling across the U.S. this week and more on the way, experts warn that shoveling snow may be risky — and in some cases, even fatal — for certain individuals.

Each winter, thousands of Americans are injured while clearing snow, and emergency rooms see sharp increases in heart attacks, muscle strains, and falls. Medical studies show that the combination of cold temperatures and strenuous exertion can significantly raise the risk of cardiac events, especially in older adults and people with underlying health conditions.

Between 1990 and 2006, nearly 200,000 adults were treated in emergency rooms for snow-shoveling injuries, with more than 1,600 deaths reported during that period, according to the American Journal of Emergency Medicine.

“Shoveling a little snow off your sidewalk may not seem like hard work. However, the strain of heavy snow shoveling may be as or even more demanding on the heart than taking a treadmill stress test,” said Barry Franklin, former American Heart Association (AHA) volunteer and director of preventive cardiology and cardiac rehabilitation at William Beaumont University Hospital.

So when should you hand the shovel to someone else?

Dr. John Osborne, chief medical officer of the AHA, advises that people over age 65 — and anyone with heart disease risk factors — should be especially cautious. But Franklin believes the age cutoff should be even lower, according to USA Today. He points to a 2001 study showing that 85% of adults over age 50 have atherosclerosis, a condition that can lead to coronary artery disease.

Cold weather only increases the danger. Franklin notes that cold-related cardiovascular deaths occur at nearly twice the rate of heat-related events, particularly among men over 65.

Beyond heart risks, snow shoveling can also cause sprains, broken bones, and back injuries. The repetitive twisting and lifting involved can strain muscles and joints, posing hazards for people of all ages — but especially older adults. Experts recommend taking breaks, using ergonomic shovels, and consulting a physician before shoveling if you have medical concerns.

To reduce your risk of injury, follow these tips:

• Warm up first: Stretch and do light movement indoors before heading outside.
• Dress appropriately: Wear layers, waterproof gloves, and slip-resistant boots. Cover your nose and mouth.
• Use the right equipment: Choose a lightweight, ergonomic shovel.
• Push, don’t lift: Push snow when possible; if lifting, use your legs and keep loads manageable.
• Take frequent breaks: Rest often, especially if you feel tired or short of breath.
• Stay hydrated: Drink fluids before and after shoveling.
• Listen to your body: Chest pain, dizziness, or shortness of breath require immediate medical attention.
• Know your limits: If you are over 45, have heart disease risk factors, or other health issues, ask for help or hire someone.

Using a Snowblower

Franklin says using a snowblower may be safer for the heart than shoveling. However, snowblowers come with their own risks. The U.S. Consumer Product Safety Commission offers the following safety tips:

• Stop the engine and use a long stick to unclog wet snow; never use your hands.
• Keep hands and feet away from moving parts.
• Never run the machine in an enclosed area.
• Add fuel outdoors before starting the machine; never refuel a running or hot engine.
• Store gasoline safely, away from ignition sources.
• For electric snowblowers, be mindful of the power cord’s location.
• Turn off the machine before clearing the chute or blades.