As Americans brace themselves for storm number two of the season, doctors remind all the devoted shovelers out there to have "great respect" for the dangers of winter conditions, both during and after a storm.
And just in time for the nor'easter, a study published in the American Journal of Emergency Medicine has revealed the most common snow-related injuries. The research also showed that snow shoveling can raise heart rates above the recommended limits after only two minutes of digging.
Scientists from the Research Institute at Nationwide Children's Hospital and Ohio State University College of Medicine analyzed data from US emergency departments over a 17-year period.
Around 195,100 Americans were treated in emergency rooms for snow shoveling-related incidences from 1990 to 2006. Approximately two-thirds of the injured patients were males, and children 18 and younger made up about 15 percent of the cases.
Cardiac problems accounted for almost seven percent of the cases, and made up all of the 1647 deaths in the study.
Doctors say slips and falls are the most common injuries caused by snow and ice, but heart dangers can create the largest health hazard to come with a snowfall.
"The risk of heart attack is increased by the combination of heavy, upper body exertion and cold weather encountered while shoveling snow," said Dr. William Abraham, director of the division of cardiovascular medicine at Ohio State University. "People, especially those at risk for coronary heart disease, should avoid heavy exertion in cold weather conditions."
That's because people can be unaware of their own heart blockages, and even an insignificant heart condition can suddenly become significant in certain weather, said Dr. Randy Zusman, director of the hypertension program at the Massachusetts General Hospital Heart Center.
There are two major points that can put people at risk for heart problems when it's cold.
"For one, most people don't realize that when their hands get cold, it causes blood vessels in the heart to constrict and reduce the blood supply to their heart," said Zusman. "I always tell people to invest in the best pair of gloves they can afford and remember to be all buttoned up before going outside."
So, if a blood vessel is 20 percent to 30 percent blocked, it can become up to 70 percent to 80 percent blocked due to the constricting walls in the cold weather conditions, said Zusman.
And once the shovel comes out of the garage, things can often get much worse.
"People like shoveling snow. They complain about it, but they're devoted to that snow shoveling," said Zusman.
And with that devotion can come two things: raised blood pressure and an accelerated heart rate.
"Lifting heavy snow is like heavy weight lifting," said Zusman. "It puts a strain on the heart, and the blood pressure and heart rate go up in response to it."
And if those levels increase too much in a person who has a pre-existing heart condition, it can lead to angina or even a heart attack.
Because of this, Zusman said that people with any sort of heart conditions should avoid shoveling all together.
"I can be rather unbending on this issue," Zusman continued.
Adelman said even those with healthy hearts should be ready for the winter exertion by staying in shape throughout the year. "That way, when a physical demand is placed on a person [like shoveling], they are ready to react," said Adelman.