Shoveling snow safely: heart attack risk, technique, and warning signs¶

Shoveling heavy snow in the cold is one of the few household chores that can bring on a heart attack in an otherwise healthy looking adult. The work is hard, the air is cold, and the people doing it are often older, out of shape, or already living with heart disease they do not know about. Emergency departments see a wave of chest pain, back injuries and falls after every major snowfall.

This guide explains why snow shoveling strains the heart, who is at the highest risk, how to shovel with less strain, which warning signs mean you must stop at once, and what to do if you or someone near you collapses. For the broader picture of cold weather exertion, see snow shoveling and heavy exertion in extreme cold. For the heart attack itself, read heart attack.

Fais ça maintenant¶

1. Stop shoveling and sit down if you feel chest pressure, tightness, squeezing, pain in your arm, jaw, neck or back, shortness of breath, light headedness, or a cold sweat. Do not try to finish the job.
2. Call your local emergency number (911 in the United States and Canada, 112 across the European Union, 999 in the United Kingdom). Say that you think someone is having a heart attack. Other countries are listed on the numéros d'urgence page.
3. Sit or lie in a position that is comfortable, loosen tight clothing, and keep warm with a coat or blanket. Unlock the door and turn on an outside light so responders can find you.
4. If the person collapses, is not responding and is not breathing normally, start CPR at once and send someone for an automated external defibrillator (AED). See RCR.
5. Do not drive yourself to the hospital. Do not wait to see if the pain passes. Ambulance crews can start treatment on the way.

Why shoveling can trigger a heart attack¶

Several things happen at once when you shovel snow in the cold. Each one adds stress, and together they can overwhelm a heart that has narrowed arteries.

• Cold narrows blood vessels. Cold air makes arteries tighten, which raises blood pressure and reduces blood supply to the heart muscle.
• Heavy lifting raises heart rate and blood pressure. Lifting and throwing snow is an isometric effort, like lifting weights. It pushes heart rate and blood pressure up quickly, often more than a brisk walk or a treadmill test.
• Holding your breath makes it worse. Many people hold their breath when they lift. This raises pressure in the chest and strains the heart further.
• Cold air makes blood stickier and more prone to clotting. In some people this raises the chance that a clot forms on a plaque in a heart artery.
• People rush. There is a plow coming, a car to dig out, or an appointment. The urge to finish quickly makes people skip breaks.
• Breakfast and sleep matter. Shoveling before eating, soon after waking, or after a night of poor sleep puts the heart under extra stress.

A study of snow shoveling injuries in the United States found that emergency departments treated more than 11,000 shoveling related injuries and medical emergencies each year, and heart problems were the main cause of deaths. The American Heart Association (AHA) and the Mayo Clinic and other cardiology groups warn that adults who are inactive most of the year are especially vulnerable.

Who is at highest risk¶

Anyone can be hurt, but the risk is much higher for the following people. They should avoid shoveling altogether and arrange for help.

• People who have had a heart attack, bypass surgery, a stent, or have known heart disease
• People with high blood pressure, high cholesterol or diabetes that is not well controlled
• Smokers and former smokers
• Men over 45 and women over 55, and anyone else with a strong family history of early heart disease
• People who are overweight or who do not exercise regularly
• Anyone who has been told to avoid heavy lifting, or who has a pacemaker or implanted defibrillator and has not asked a doctor about exertion
• People with lung disease such as asthma or chronic obstructive pulmonary disease, because cold air can trigger breathing trouble
• Anyone who takes medicine that affects heart rate or blood pressure, or who feels dizzy after exertion
• People recovering from illness or a recent flu

If you are in any of these groups, ask a doctor whether you can shovel, and plan other ways to clear snow. Consider a neighbor, a family member, a local volunteer, a teenager looking for work, a snow removal service, or a municipal program that helps older adults. See assurer la sécurité des personnes âgées par temps froid for assistance programs.

Before you shovel¶

Decide whether you need to shovel¶

Not all snow needs clearing at once. If the snow is deep, wet and heavy, or more is coming, consider waiting. A few hours later the sun may soften it, and a second round of light work is easier than one long effort. Delay shoveling until you have warmed up and had something to eat. Do not shovel if the air temperature or wind chill is dangerously low, for example below about minus 20 degrees Celsius (minus 4 degrees Fahrenheit) with wind, because breathing very cold air can itself trigger chest pain and breathing problems.

Warm up¶

Spend five to ten minutes warming up. March in place, swing your arms, do gentle squats, and stretch your shoulders, back and hamstrings. Cold muscles strain and tear easily, so warm them before you lift.

Dress for the cold¶

• Portez plusieurs couches fines plutôt qu'une seule épaisse, afin de pouvoir retirer une couche lorsque vous chauffez et en ajouter une lorsque vous refroidissez.
• Portez un chapeau, car une grande partie de la chaleur corporelle est perdue par la tête, ainsi qu'un foulard ou un couvre-visage pour réchauffer l'air que vous respirez.
• Choisissez des gants ou des mitaines imperméables avec une bonne adhérence.
• Wear waterproof boots with a deep, non slip sole. Falls on ice are a leading cause of shoveling injuries. See glisser sur la glace et tomber.
• Évitez le coton contre la peau, car le coton mouillé vous refroidit. Utilisez des couches de base en laine ou synthétiques.
• Take your phone with you and keep it in an inside pocket.

Eat lightly and drink water¶

Do not shovel on a full stomach, since digestion competes with your muscles for blood. Do not shovel on an empty stomach either, because you need fuel. Have a light snack and drink water before you start and during breaks. Do not drink alcohol before or after shoveling. Alcohol widens blood vessels near the skin, which makes you feel warm while you lose heat faster, and it can make heart rhythm problems worse. Avoid caffeine and nicotine for at least an hour before heavy work, because both raise heart rate and blood pressure.

Check your equipment¶

Use a shovel that suits your height, with a curved or adjustable handle that lets you keep your back straight. A smaller blade with a plastic surface holds less snow and weighs less. Spray the blade lightly with cooking oil or a silicone spray before you begin, so that snow slides off rather than sticking. A push shovel with a wide scoop is easier on the back and heart than a lifting shovel, and a snow pusher on wheels is better still.

Shoveling technique¶

The aim is to move snow with the least effort and the least strain on your back and heart.

1. Push, do not lift. Push the snow to the side whenever you can. Pushing uses less energy than lifting and throwing.
2. Take small loads. Fill the shovel only partly, even though it feels slower. A half load of wet snow can still weigh several kilograms.
3. Lift with your legs. If you must lift, bend your knees, keep your back straight, and keep the load close to your body. Hold the shovel close, and straighten your legs to lift.
4. Do not twist. Do not throw snow over your shoulder or to the side while your feet stay planted. Turn your whole body, step toward where you are dumping, and place the snow down rather than tossing it.
5. Keep breathing. Breathe steadily. Exhale as you lift or push, and do not hold your breath. If you cannot talk in short sentences while you work, you are working too hard.
6. Work in layers. If the snow is deep, remove the top layer first, then the lower layer. For very heavy, wet snow, shovel several times through the storm.
7. Take frequent breaks. Rest for a few minutes every 10 to 15 minutes, and go indoors to warm up and drink water. Sit rather than stand while you rest.
8. Pace yourself. Set a steady, comfortable speed. Do not race the clock, and do not try to clear a large area in one go.
9. Use a team. Share the work with someone and watch each other. If you are alone, tell someone you are shoveling and when you expect to return.
10. Clear the right places first. Start with the path to your door and the route an ambulance would take. Walkways and steps matter more than the whole driveway.

Where to pile snow¶

Pile snow away from the street, hydrants, drains, vents and utility meters. Keep gas meters, dryer vents, furnace exhausts and chimney vents free of snow, because blocked vents can send carbon monoxide into the house. See monoxyde de carbone. Do not stack snow against the house wall, where it can melt into the foundation, and do not pile it on shrubs that are fragile.

Warning signs: stop at once¶

Stop shoveling and rest if you notice any of the following. Do not push through.

Women, older adults and people with diabetes¶

Heart attack signs can look different in women, older adults and people with diabetes. Instead of the classic crushing chest pain, they may notice unusual fatigue, shortness of breath, nausea, back or jaw pain, lightheadedness or a feeling of dread. Do not wait for chest pain to appear. If something feels wrong and you are in the cold after heavy exertion, treat it as serious.

What to do if someone has a heart attack while shoveling¶

1. Call your local emergency number first. Tell the dispatcher where you are, that the person has chest symptoms after shoveling, and whether the person is conscious.
2. Help the person sit down and rest. Move them out of the cold if you can, and keep them still. Half sitting, with knees bent and the back supported, is often the most comfortable position.
3. Keep them warm and calm. Put a coat or blanket over them. Loosen tight clothing around the neck and chest.
4. Follow the dispatcher's advice about aspirin. The dispatcher may tell a conscious person to chew an aspirin if they are not allergic and have no reason to avoid it. Do not give anything by mouth if the person is drowsy, vomiting or cannot swallow safely.
5. Prepare for an AED. Send someone to find an AED, and unlock the door. Many public buildings, shops and gyms have them.
6. Watch their breathing. If they stop responding and are not breathing normally, begin CPR right away.

CPR in the snow¶

If the person collapses, put them on their back on a firm surface. If you are outside, try to place something under them to insulate them from the snow, such as a coat or a shovel board, but do not delay compressions to do so. Push hard and fast in the center of the chest, at a rate of 100 to 120 compressions per minute, to a depth of about 5 to 6 centimeters (2 to 2.4 inches) for an adult, and let the chest rise fully after each push. If you are trained, give two rescue breaths after every 30 compressions, and if you are not trained, use hands only compressions. Use an AED as soon as it arrives and follow its voice prompts. Do not stop until the ambulance crew takes over, the person starts breathing normally, or you are too exhausted to continue.

For the full process, see RCR. For recognizing a heart attack and the role of an AED, see heart attack.

Other injuries from shoveling¶

Heart attacks are the most serious risk, but they are not the most common injury. Understand the others so that you can prevent them.

Back, shoulder and muscle strains¶

Lower back strain is the most common shoveling injury. It comes from twisting, lifting with a bent back, and moving heavy loads while cold. Prevent it by pushing rather than lifting, keeping the load close, and taking breaks. If back pain is severe, spreads to the legs, causes numbness, weakness or loss of bladder or bowel control, seek urgent medical care.

Slips and falls¶

Slips on ice are a leading cause of broken wrists, hips and head injuries. Spread salt, sand or non clumping cat litter on walkways, and wear boots with good grip. If you fall and hit your head, read blessures à la tête. For wrist and arm injuries, see fractures et entorses.

Frostbite and cold exposure¶

Fingers, toes, nose and ears are the first to freeze. Wet gloves and boots speed it up. Watch for pale, waxy, numb or hard skin, and go inside to warm gently. Do not rub frostbitten skin. See hypothermie et engelures.

Snow blower injuries¶

Snow blowers cause serious hand and finger injuries every winter. Never put your hand into the chute to clear a jam. Turn the machine off, wait for all parts to stop moving, and use the clearing tool or a stick. Keep children away, never leave a running machine unattended, and use ear protection. Fuel powered models also produce carbon monoxide, so run them outdoors only, not in a garage.

Déneigement de toiture¶

Le déneigement d'un toit comporte des risques distincts de chute, de glace et de contact avec les lignes électriques. Ne montez pas sur un toit dans des conditions de neige ou de verglas. Pour connaître les charges de neige, les barrages de glace et les signes avant-coureurs d'effondrement du toit, lisez snow load warning signs and safe roof snow removal.

Choisir une méthode : comparer les façons de déneiger¶

Decision flow while shoveling¶

flowchart TD
    A["You need to clear snow"] --> B{"Do you have heart disease<br/>or another high risk factor?"}
    B -->|"Oui"| C["Ask for help or hire a service"]
    B -->|"Non"| D["Warm up, dress in layers<br/>and drink water"]
    D --> E["Push snow in small loads<br/>and breathe steadily"]
    E --> F{"Une pression thoracique, une douleur, un essoufflement ou des vertiges ?"}
    F -->|"Oui"| G["Stop and sit down"]
    G --> H["Appelez votre numéro d'urgence local"]
    F -->|"Non"| I["Rest every 10 to 15 minutes"]
    I --> J{"Is the job finished?"}
    J -->|"Non"| E
    J -->|"Oui"| K["Go inside, warm up<br/>and rest"]

Helping a neighbor or relative¶

Many shoveling deaths happen to people who are alone. If you can, offer to shovel for an older neighbor or one who has a health condition. If you cannot, check in by phone before the storm to ask whether they have arranged help. Do not leave a neighbor out in the cold working alone while you watch.

If you find someone collapsed in the snow, check whether they respond and breathe normally. Call your local emergency number, begin CPR if they are not breathing normally, and use an AED if one is available. Move them from the cold when you can, but do not delay chest compressions to do so. When the person is breathing, keep them warm and still, because cold exposure makes any medical event worse. If they are very cold to the touch, see hypothermie et engelures.

Community help programs¶

Some towns offer free snow clearing for older adults, people with disabilities and people who are ill. Search for your city or county website, or ask at your local senior center or library. In the United States you can call 211 for local services. In the United Kingdom, your local council and organizations such as Age UK can often point to volunteer schemes. Ask a neighbor with a teenager or a young adult, many of whom are glad to earn a little.

Preparing before snow arrives¶

• Buy salt, sand or pet safe de-icer before the storm, and store it where you can reach it.
• Service your snow blower and check that fuel is fresh.
• Keep a pair of waterproof gloves, a hat and a scarf by the door.
• Choose a shovel that fits your height and strength, and keep it in an easy to reach place, not buried in a shed.
• Planifiez qui déneigera si vous ne pouvez pas et notez leur numéro.
• Apprenez aux adolescents et aux autres membres de la famille les signes avant-coureurs.
• Installez un détecteur de fumée et un détecteur de monoxyde de carbone à chaque étage de votre maison et testez-les chaque mois.

Pour le plan d'hiver complet, voir préparation à la maison en cas de tempête hivernale et plan de 72 heures.

Liste de contrôle avant de commencer à pelleter¶

• Je n’ai aucune douleur thoracique, aucune difficulté respiratoire, aucun étourdissement ou maladie aujourd’hui.
• J'ai vérifié la température et le refroidissement éolien et les conditions sont sûres pour l'effort.
• Je me suis échauffé pendant cinq à dix minutes.
• Je porte des couches, un chapeau, des gants et des bottes antidérapantes.
• J'ai pris une collation légère et un verre d'eau, mais pas d'alcool.
• Mon téléphone est dans ma poche et quelqu'un sait que je suis dehors.
• Je pousserai la neige plutôt que de la soulever et je prendrai de petites charges.
• Je me reposerai toutes les 10 à 15 minutes et m'arrêterai au premier panneau d'avertissement.

Quel est le poids de la neige que vous soulevez¶

Le poids de la neige varie bien plus que ce que la plupart des gens pensent. La poudre légère et sèche peut peser environ 1 kilogramme (2 livres) par charge de pelle, tandis qu'une pelle pleine de neige mouillée et tassée peut atteindre 7 kilogrammes (15 livres) ou plus. Déplacer même une petite allée peut nécessiter de soulever plusieurs tonnes au total. C'est pourquoi le même travail qui semblait facile la semaine dernière peut s'avérer dangereux après une tempête humide.

Ces poids sont des indications approximatives. Si une pelletée semble lourde, c’est le cas, alors réduisez la charge.

Après avoir fini¶

Lorsque vous rentrez à l’intérieur, enlevez les couches extérieures mouillées et mettez des vêtements secs. Buvez une boisson chaude sans alcool et mangez quelque chose. Asseyez-vous pendant un moment plutôt que de passer directement à une autre tâche. Une légère douleur est normale. Une pression thoracique, une fatigue inhabituelle ou un essoufflement une heure ou deux plus tard ne le sont pas, et il peut toujours s'agir d'un événement cardiaque. Si des symptômes apparaissent après votre arrivée, traitez-les de la même manière, asseyez-vous et appelez votre numéro d'urgence local.

Surveillez-vous et surveillez les autres pendant des heures après le travail. Les personnes âgées, en particulier, peuvent se sentir bien et développer des symptômes plus tard dans la soirée. Les mains et les pieds qui restent engourdis, blancs ou cireux après le réchauffement peuvent être gelés, ce qui nécessite un avis médical.

Parler à votre médecin¶

Si vous souffrez d'une maladie cardiaque, d'hypertension artérielle, de diabète, d'une maladie pulmonaire ou si vous êtes inactif depuis des années, demandez à votre médecin avant la saison des neiges si vous pouvez pelleter. Renseignez-vous spécifiquement sur le levage de charges lourdes, l'air froid et quels signes d'avertissement sont importants pour vous. Si vous prenez des médicaments pour le cœur, demandez-vous si vous devez les emporter sur vous lorsque vous sortez et quand les utiliser. Ne modifiez ni n'arrêtez aucun médicament sans avis médical. De nombreux groupes de cardiologie recommandent également de développer sa condition physique progressivement tout au long de l'année afin que les tâches hivernales ne soient pas un choc soudain pour le corps.

Teenagers and children¶

Healthy teenagers can usually shovel, but they still need breaks, water, warm clothing and supervision. Young children should not shovel heavy snow, and they should not be left to play near piles beside a road or near a plow. Tunnels and forts in deep snow can collapse and bury a child. Check on children who are playing in snow and bring them in when they are wet or shivering. Teach older children the warning signs of frostbite and tell them to come indoors if their fingers or toes feel numb.

Questions fréquemment posées¶

Why is shoveling snow so hard on the heart?¶

Shoveling combines heavy lifting, cold air and often a sudden start after months of little exercise. Cold narrows the arteries and raises blood pressure, while lifting and breath holding push heart rate and pressure up further. In a person with narrowed heart arteries, this mix can trigger chest pain or a heart attack.

Who should not shovel snow at all?¶

People who have had a heart attack, stent or bypass, who have known heart disease or poorly controlled high blood pressure or diabetes, and anyone with a pacemaker or lung disease should speak to a doctor before shoveling. Older adults who are not active, smokers and people with a strong family history of heart disease should also think about getting help. Hiring a service or asking a neighbor is a safe choice.

How often should I rest while shoveling?¶

Rest for a few minutes at least every 10 to 15 minutes, sit down if you can, and drink water. Stop earlier if you feel tightness in the chest, shortness of breath, dizziness or a cold sweat. If you cannot speak a short sentence while working, slow down.

What should I do if I think I am having a heart attack while shoveling?¶

Arrêtez-vous immédiatement, asseyez-vous et appelez votre numéro d'urgence local plutôt que de conduire vous-même. Informez le répartiteur de vos symptômes et de votre emplacement, déverrouillez la porte et restez au chaud. Si vous êtes avec une personne qui s’effondre et ne respire pas normalement, commencez la RCR et trouvez un DEA.

Sources vérifiées¶

Guidance on this page was checked against the American Heart Association (United States) advice on snow shoveling and heart attack warning signs, the Centers for Disease Control and Prevention (United States) pages on cold weather safety and heart disease, the National Weather Service (United States) wind chill and winter safety guidance, Ready.gov and the Federal Emergency Management Agency (United States) winter storm advice, the American Red Cross winter safety and CPR guidance, the National Health Service (United Kingdom) pages on heart attack and cold weather exercise, the British Heart Foundation (United Kingdom) winter advice, Health Canada winter safety guidance, and the Heart and Stroke Foundation of Canada. Where agencies differ, this page uses the more cautious advice.

Learn first aid and CPR¶

A hands-on course gives you the practice that reading cannot. The Red Cross, St John Ambulance and many local providers teach CPR, AED use and heart attack response in a few hours. Consider taking a course with the people who share your home, especially if anyone has a heart condition.

Guides associés¶

• Crise cardiaque
• RCR
• Pelletage de neige et efforts intenses par temps extrêmement froid
• Glisser sur la glace : comment tomber et quand demander des soins
• Sécurité contre les tempêtes hivernales : chauffage domestique et survie au froid