Snow shovelling can kill | Hacker News Reader

Snow shovelling can kill

cbc.ca

126 pointspedro84176 comments

The context is that many people pick up a shovel and do maximum effort despite living a sedentary life.

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 "good shape".

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.

Anyone know any studies puzzling these possibilities out.

I know so many men over 50 through the crossfit community that are in killer shape. Age has absolutely nothing to do with it. The fact of the matter is that most individuals are completely out of shape. Maximum effort should not be a seasonal chore around the house.

Age has quite a bit to do with it. You rarely see acute myocardial infarction in 15 year olds, and you often see it in 80 year olds. There is a continuum of risk, and age plays a role.

Because there are risk factors that are uncorrelated or imperfectly correlated with physical fitness and its outward manifestations, even physically fit individuals cannot escape this.

For those reading, acute myocardial infarction is the scientific word for heart attack. Not sure why that needed to be used in this context.

Second... if take a 15 year old who is out of shape and an 80 year old who is out of shape and have them shovel equal length driveways ... sure my money is on the 15 year old.

But... you can't say that this problem is due to people being older. 30 year old folks can still have heart attacks shoveling snow. There are loads of folks out there who are in their 40s and 50s who won't experience any medical issues with the exertion required to shovel a driveway.

So the point I was trying to illustrate is that it's not fair to blame age. Age is one variable in a very complex equation that influences your level of fitness.

Parent is a cardiology fellow.

They probably used that term for the same reason a programmer would say “binary” instead of “ones and zeroes”.

Earlier comment:

> Age has absolutely nothing to do with it.

This comment:

> Age is one variable in a very complex equation that influences your level of fitness.

I appreciate your conceding that age is a major factor in health.

> ...age is a major factor in health

Tangential, but: I read a fascinating book about ageing and death from a doctor who worked with such things. My big takeway, from a systems perspective, was that we generally don't die because of a single component-level failure but rather as a collective systematic overloads that push failure throughout the body until a component dies (and so do we).

Age makes our lungs, arteries, heart, organs, and the rest of it work sub optimally. Poorer lung function forces our hearts to work harder. Poor heart function causes our lungs to work harder. An unusual shock like shovelling pushes all components, which push each other, which is a great way to trigger failure modes.

This looks a lot like what we see in complex systems over time. Age is biological-debt :)

Well, one thing to consider is that age inevitable. Age is a factor in heart attacks but it's also simply a factor in dying from whatever cause.

A statement like "age has nothing to do with whether you die prematurely from a heart attack in particular - fitness is the main factor" might be true even if age is a big factor in whether one dies of a heart attack at a given moment ... because it is a big factor in whether you are going at a given moment.

Wake up older and you're more likely to die overall. Be unfit physically and engage in very vigorous exercise and a heart becomes n% more likely to be the way you die. Those might or might be deemed to two separate facts - ie "die prematurely of a heart attack" is itself pretty ambiguous, ha ha.

Do statistics correctly is hard and describing statistical situations with everyday language is a hard problem on top of this original challenge.

Quoting from "How We Die" (1) by the late Sherwin B. Nuland:

the muscle cell of the heart is one of those that cannot reproduce — as it gets older, it simply wears out and dies. The biological processes that throughout life have been making replacement parts for dying structures within each cell can no longer do their job. The mechanism by which a newly generated piece of cell membrane or intracellular structure can take the place of a section dead of too much use finally becomes inoperative. After a lifetime of regenerating spare parts, the nerve and muscle cells' capacity of rejuvenation gradually shuts down. The tactic of continuous renewal within each heart-muscle cell is then defeated by the overwhelming strategy through which aging is achieving its ultimate objective of destruction.

There is a gradual decrease in the cardiac output while at rest, and when the heart is stressed by exercise or emotion, its ability to increase is less than required by the needs of arms, lungs, and every other structure of the body. The maximal rate attainable by a perfectly healthy heart falls by one beat every year, a figure' so reliable that it can be determined by subtracting age from 220. If you are fifty years old, it is unlikely that your heart can manage much more than 170 beats per minute, even under the most extreme conditions of emotion or exercise. These are only some of the ways in which the aging and stiffening myocardium loses its ability to adapt to the challenges presented to it by everyday life.

1. https://archive.org/stream/HowWeDie/How%20We%20Die_djvu.txt

"the muscle cell of the heart is one of those that cannot reproduce -- as it gets older, it simply wears out and dies."

Has there been any research in creating replacement muscle cells for the heart? Maybe using stem cells?

There is allegedly one study from the Rhode Island blizzard of 1978 showing an increase in deaths during the storm and abnormally low rates after, so the deaths were moved forward by a couple of weeks. Similar things have been observed with runners (die during the race, but lower mortality aftewrards)

The real tragedy here is that folks are living such sedentary lives that a simple activity like clearing snow from your sidewalk/driveway becomes lethal.

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.

Everyone should invest in their own physical fitness. Make time for it. Make it your lifestyle so it'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.

I'm an above average runner (fast enough to qualify for Boston anyway), mid-40s, been running about 15 years. I've run dozens of marathons and a few ultras, some over 24 hours and/or 100 miles. I also did CrossFit for about 15 months a couple years back. So I'm in pretty good shape and I have a pretty good idea of physical exertion levels, both aerobic and anaerobic. With all that said, I've had to shovel snow a few times, most recently last week – it is (or at least can be) as strenuous an activity as I've ever done.

Shoveling snow should not kill you, but it's a mistake to underestimate the level of effort it requires.

Then again, I was raised in Florida so maybe I just suck at it.

It can be done at a reasonable pace. If you try to distance throw large amounts of wet, heavy snow, you're going to have a bad time. If you make good use of appropriate shovels, minimize wasted effort, and take your time, it's really not that bad.

> and take your time

That's the catch. In some cities, you have to shovel snow in front of your house by a certain time or get a ticket. If you have responsibilities (kids or whatever), have to get to work, and have to shovel before heading out or take a fine, you don't exactly have time to do it slowly. Health be damned.

So I live in a condo and hire people to do it ;)

Wow, that sounds terrible, akin to the brown lawn tickets cities like Grand Rapids, MI give out. Why would people re-elect politicians that put horrid ordinances like these in place?

It's a very common requirement in cities that property owners have to keep their sidewalks clear; the rules are often less well-enforced or not there in more suburban environments. These rules are not by any means new--laws on clearing out the street gutter on your property date at least as far back as Medieval times.

In my experience, it's usually 24-48 hours after the snowfall ends so there's plenty of time to get it done. Also in my experience, it is very rarely enforced. In many places, the sidewalk is the only safe place to walk the street so it's a real drag when someone doesn't clear their sidewalk. You either trudge through the snow or risk life and limb walking in the street. If you own property, you're responsible for keeping the sidewalk clear and it's your duty to the community to do it.

In this city its -6 hours- after the snowfall ends, and people almost wait on the clock to call 311 and get you fined if you don't do it. If you commute away to work, there are possibilities that the timing could be very awkward (unless you like shoveling while its snowing).

Much rather the city use my taxes to do it with proper equipment, like my hometown did... Oh well. Condo ftw.

The ordinance isn't ticky-tack, it allows people to use the sidewalk.

A lot of towns have similar and don't enforce it very much.

And snow plows that my tax dollars pay for are what keep the roads clear for vehicles. Why isn't it the same way for the sidewalk? Why do I have to take care of public property?

Because few people would want to pay the taxes needed to have public workers do it, is my guess. Plowing streets can be done fairly quickly with trucks; sidewalks would probably require more workers.

They make small trucks to plow the sidewalks. It's what cities that do it use. It's quite efficient.

Yep, they are super nice machines too, they do the job super duper fast and really well. My city uses them but only to plow "city streets," or rather "streets not in front of anyone's property and streets in front of city property"

I really really wish they'd do my property. I pay a ton in property tax, you'd think they could afford it.

Either way, it would be more expensive.

I'm not sure if the operators are hourly or salaried but it would probably cost more in manpower to do all the streets, they would probably need more machines too plus there would be an increase in maintenance costs and a reduction in lifetime of the machines.

I still can't see it as being efficient like streets. sidewalks are disjointed, have trees in them, curbs, and any number of other obstacles.

Dunno what to tell you. It works in practice in a lot of cities, including large metro areas that get a shitload of snow.

> Why isn't it the same way for the sidewalk?

Your tax dollars pay to keep the roads clear for the sake of emergency vehicles. It wouldn't be done otherwise.

Trying to plow it from the sidewalk would result in more problems than it solves.

> Why do I have to take care of public property?

Scalability. It's manual work and the city doesn't have an army of shovelers on-hand.

The plough sidewalks in Quebec, it can be done.

West Quebec here. They do indeed take care of sidewalks here. They do on the other side of the river, in Ottawa, Ontario, too.

The thing with local politics is that engagement is low and extremely self-selected. I'm never surprised when local voters and politicians are disproportionately on the busybody end of the spectrum rather than "live and let live".

It's also extremely populist. Since the effect of local politics are...well, localized, people don't notice nearly as much when the mayor screws up in small towns. They just have to wave the "lower rent!" "more construction!" "inclusive!" "think of the children!" flag a bit and people will vote for them no matter what they actually do. Kind of like the federal politics but without the news outlets and Twitter freaking out.

In this particular case, generally renters don't even have to shovel (the landlord does it or hire someone to do it), so most people don't even seem to know its a requirement unless it says in their lease that they have to handle the shoveling. The owner (who does have to handle it) may not be allowed to vote if they don't live near by.

It's an issue, why no just buy a machine to do it for you? You can get a low end snowblower for ~200$ which are probably not worthless.

Let me assure you, a $200 snow blower is worthless. When I lived in Minnesota, my motto was: "Life is too short for a crappy snowblower." If it didn't start on the second pull, SOLD. And it had better be two-stage and have some signifcant power.

When I moved to California I sold my snowblower to my then middle-school-aged nephew. He made a ton of money going up and down the street of his town clearing snow for sweet old grandmothers.

>>Let me assure you, a $200 snow blower is worthless

>>When I lived in Minnesota

You definitely don't want a $200 snowblower if you live in Minnesota.

But, if you live in somewhere like Ohio or Michigan in an area that doesn't get a ton of snow, a $200 snowblower can do the trick just fine. But that once or twice-a-year storm that dumps 10 inches might be too much.

What? On a average year Michigan gets way more snow than Minnesota. In the UP alone many areas average over a 150 to 200 inches. No where in Minnesota does it break 80 inches in average.

Nobody lives in the UP. The southeastern part of the state where everyone lives is lucky to see over 40 inches a year

Snow shoveling is more of the weightlifting kind of exertion (think squats) than the running kind. Your body is trained for the running kind, something very different.

I just got in from shoveling a lot of snow and I sure as hell won't be doing a marathon, ever. Shovelling snow is far, far easier.

That's because shoveling requires arm and back strength which running doesn't provide.

May I ask what age you changed your ways? I'm 38 and it feels like constant failure. I also worry the damage is done :(

If you feel like a failure and that the damage is done: I'd say you are damn near rock bottom. If you're at that point... there is truly no way to go but up.

You have many many years left on this earth. Do you want to spend them feeling this way about yourself, or do you want to give yourself a second chance and see how good you can be?

Put together a mental image in your mind of where you want to be and start taking the baby steps to get there. BABY steps. First, you need to start eating right. I say this for two reasons: 1, No amount of exercise is going to outrun a bad diet. 2, once you start to see positive changes in your body it will be like a snowball effect. You'll feel better about yourself, your confidence will rise, it will be easier to stick to it.

For me, I am a huge proponent of the ketogenic lifestyle. tl;dr - high fat, low carb. You might want to try the whole30 challenge to get things started.

Then you begin introducing exercise, again, with baby steps. Don't start crazy. If you're completely sedentary and never move: start walking. Get a dog and walk that sucker EVERY day!

After a few weeks and months of eating clean and moving every day, you will naturally start wanting more. You'll be able to explore gym routines with confidence and excitement. You might like weightlifting, or martial arts, boxing, rock climbing, crossfit, all of the above.

Once the snowball is moving, it's hard to stop. That is when you reach an inflection point in your life and it isn't a diet anymore: it's a lifestyle. You WANT to go outside. You WANT to go paddleboarding and hiking on vacation.

Baby steps. Do it right now, you can only get better!

I did at 36, Went from 250lbs to 185lbs in 7 months.

I have a spinal condition so no heavy weights (nothing over 35kg) so lots of reps, pull-ups, calisthetics and eating a 1500 calorie a day diet (which sucked but I adapted remarkably quickly), I've kept the weight off for 18mths and I'm still 185.

It's a lot easier to maintain fitness than lose it and get it back.

Going from a 44" stretch back to a 32-34" (depending on brand) waist in jeans was a nice feeling but the main improvement was energy levels, once I binned the sugary energy drinks and got use to drinking a few cups of coffee sweetened with a tea spoon of honey my energy levels through the day leveled out and I started sleeping better as well (which given the spine stuff was a major win).

I'll stay in shape for as long as I possibly can do.

> I did at 36, Went from 250lbs to 185lbs in 7 months.

This is crazy fast, hope it doesn't bounce back during the next 3-5 years. 18 months in, you're well on your way, keep it up with the consistency!

I count the calories of every meal I eat and every drink as well ruthlessly so unless something goes wrong with physics I'd be hard pressed to put on weight, I actually have the opposite problem, I have to slightly over eat to keep weight on.

Being ~38 combined with my wife eating better is what changed my ways... one day I decided I was tired of getting fatter while my wife get healthier.

I swore off pop/sugar/processed foods and lost 50+ pounds in a year (kept it off for a year too). Still more to go, but man what a difference.

If you're overweight, I'd recommend learning to fast. Lookup up the research in Russia and now some cancer research from UCSD to ensure you comfortable with the process and idea.

Once you get the monkey off your back, the one that is always urging you to eat (for a variety of reasons - stress, food ads, etc...), it's easier to say no to food. When you've committed to not eating, you don't get to rationalize or fool yourself about some "snack" you're having. After 3 days, the physical hunger goes away, though the psychological desires have not completely faded.

You'll learn about how much time you devote to food satiation. Some of that mental clutter will fade away as you fast. I've gone for 3 days, but am looking to do 5 in the future. Our bodies are amazing and designed to survive these calorie droughts - our ancestors evolved this adaptive ability to sustain our life through hardship. Observe this hardship, rather than reacting to it. Keep observing and see what you find about the nature of your body and this life. You are now halfway through, might be time ask some tough questions.

There might be things that can't be undone at this point (maybe, I dunno, I'm no doctor), but I don't think it's ever too late. Here's a story I don't feel like retyping: https://news.ycombinator.com/item?id=11941206. Summary: guy I sorta know weighs 400 lbs., doc says it's going to kill him, goes out and gets rid of almost 200 lbs., starts running 5Ks. I don't know his exact age, but he has to be pushing middle age. Neighbor that used to live next to me was a pretty chunky gal in her mid-late 30s, started running, worked up to half marathons. Pounds fell off, she said she felt immensely better. I have other examples I've personally witnessed.

Now I won't say it's easy. I know plenty of "failures", too. It's gotta be hard (if you read the linked story, it's a hardship I've never known). But plenty of others in this thread have good advice on where to start. I'm just here for moral support to tell that I've seen others do it at all ages, and it's never too late. Like in the story I linked, come back in a few years and give me something to cry about. :-)

I'm on to 37 and started skateboarding 10 months ago. Took back my way to block climbing which I didn't practice for 15 years. Also started calisthenics. This is after a sizable weight gain and huge drop in fitness down to rock bottom.

I was quite athletic when I was 18-22, but stopped doing sports with any regularity around 23-25 and gradually degraded physically. Some day around 32 I woke up and felt so bad in my own body I decided to put an end to this over the next 7-10 years (since it was the time I took to dig myself into that hole I figured out it would take about the same time to reliably dig myself out of it), changed my diet (this is key!), and started running, which I hate, but basically the only thing I could manage to do. Went like 500m at a ridiculously slow pace (something like 10min/km) and started puking right on the sidewalk. This is when I really realized Things Were Definitively Not OK, and that all the parties and fun and eating and drinking we're not worth that.

End result seven years later, lost the 20kg I had in excess, ran 18km in 1h30, stopped running regularly but (now that I'm more solid) swapped for sports I enjoy much more, and I feel so good it's like I could tear walls apart with my bare hands! In many ways I'm in as good or better a shape than I ever was even in my 20s. Random sample of newly met strangers give me between 8-15 years less than my age, and "less than 30, for sure".

It's never too late. Pace yourself, one step at a time. Set realistic short term goals, yet look up to the stars because on the long run basically anything is achievable. Your mind will resist change, but it can be overcome. The only obstacle between current you and future you is yourself. Choose what you will become, at every moment, consistently.

Fuck if I Ollied down 3 stairs a month ago and I'm now super close to land a tre flip barely a year in, and if that guy[0] can still be at the top of his shape[1] at 51 after having his hip joint basically fuse and fix it through dedicated stretching and exercise (and end up giving a talk where he draws parallels between FOSS and skateboarding), then it tells something about consistency and dedication.

[0]: https://m.youtube.com/watch?v=3GVO-MfIl1Q

[1]: https://m.youtube.com/watch?v=-3tDvMG87Ro

It is never too late. Start small, go for a walk at lunch time.

http://www.bbc.co.uk/news/health-42565137

I'm 34, in a similar situation. I think going w/ what whalesalad said is worth taking to heart.

There's a lot in life outside of our control but we can control, to some degree, what we put in our bodies. I'm paying much more attention to that now (using MyFitnessPal) and going for a daily walk.

These are baby steps and I'm hoping to work myself back into shape to at least play some pick up soccer games, start new hobbies, and have clothes fit well and look nice again.

A simple option is go get a gym membership and right now just do 30 minutes of walking 5 days a week. Then work to an hour.

Count your calories on the app 'my fitness pall' so your not over eating and in 6 months you will be in waaaaaay better shape then you are right now.

Then go on youtube and research intermediate level advice.

Start with basic yoga and find the stuff that needs work!

I also agree with this, yoga changed my life in a certain way.

Or maybe its a good thing that society has progressed far enough that physical vitality is no longer a necessary trait for the advancement of our species.

No way! Your brain grows and develops when you challenge your body physically. It's established science that strenuous exercise builds new neurons in your brain.

I wonder why you think that we've reached this point of progress? It seems like every day we're learning more about how consumer tech is killing us mentally, physically, and emotionally.

He said society, not our body.

For a large chunk of the population, society does not demand physical fitness. That's not the same thing as our bodily health not requiring physical fitness.

> The context is that many people pick up a shovel and do maximum effort despite living a sedentary life.

This. Shoveling after last week's storm was definitely the most concerted exercise I've had in a year or more. I definitely felt at one point that my heart was working way 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'm neither overweight nor have high blood pressure.

A high heart rate can be caused by lactate acid. Basically what happens is that you are using muscles beyond what they can sustain. In particular, beyond what the blood flow to those muscles can provide oxygen for.

You get into anaerobic exercise, even though you are not working particularly hard overall. This results in lactate acid reaching the blood stream.

For some reason, the human body confuses that with CO2 and makes both respiration and heart rate go up to get rid of it. Which doesn't work. But the heart can use lactate as fuel and the situation will soon be normal again.

Did you do warmups before shoveling snow?

I can't imagine going outside and doing that in cold weather with cold muscles.

Nope, didn't even know this was a thing! That's why the passage I quoted rings so true to me. I lead a sedentary life all year and then one day, with no preparation whatsoever, dive headlong into strenuous exercise in adverse conditions for an hour plus.

> Did you do warmups before shoveling snow?

Seriously? Who does this?

I do. I do it by starting with little tiny shovels of snow, working my way up to a full load. What, you want me to have a heart attack?

Shoveling snow is obviously exercise. Does it seem weird to you that people warm up before lifting or running?

No. Neither does it to the average person. I'm just saying doing a warmup before chores is not something that's common practice. Maybe it should be, but you can't just assume it is because it seems like the right thing to do that it's common knowledge.

Is there evidence that a warm-up is beneficial or is it something we do because it "seems right?"

I don't know the answer to this.

Either way, I don't personally warm up, I don't notice a difference between warming up vs not warming up.

I don't remember seeing this in the article, but overheating is a problem too. I know enough now to not bother bundling up, but I remember getting quickly overheated when I first moved to a snow area and started shoveling.

I think many grab a 16 inch plastic shovel and pick up a much snow as it will hold. That’s a good way to do yourself in, literally and figuratively. If it snows five inches, I’ll typically take it in three lifts. I go slow and take a break once an hour, more often if it’s in the teens like lately. For old and heavy snow, like the berm the town plow leaves across my drive, I’ll switch to a nine inch aluminum shovel.

Or, haul out the Ariens 12 hp snowthrower. It’s a lot faster, but horsing it around is no picnic either.

The main thing is to take it easy!

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's almost always been me because, well, I'm better built for it.

But what I didn't hear mentioned is that women have a much lower risk for heart attacks until menopause. And I don't know that I've ever seen a 55 year old woman shoveling snow (again, anecdata). If you strapping young lads were raised right, you'd go down and do it for her since you already have the shovel out. :-)

More so, shoveling snow is amazingly hard work on a level that most people probably rarely experience. I'm a lifelong distance runner with a healthy heart (though weeny little runner arms), and shoveling sure gets my heart going. I can't imagine the strain on a 54 year old guy with a beer gut who spends most of his day sitting. That does sound like a recipe for a heart attack.

On the other hand, women who do have heart attacks do not do as well, at least partly because people assume they aren't having one.

http://www.bbc.com/news/health-42590013

Probably the same reason that men have lower breast cancer survival rates than women - the common assumption is that it's a gender specific disease, which delays diagnosis and treatment: http://www.breastcancer.org/research-news/20120517

Yeah, I almost typed "immune" before menopause, but that's not entirely accurate. And as you point out, it implies that a pre-menopausal woman having a heart attack just doesn't happen. Hell, my brother-in-law had an nearly fatal heart attack when he was 34 (bad genetics, helped along by too much drinking and smoking). Gender and number of wrinkles are just data points, but not the deciders of who's having a heart attack and who's not when their arm goes numb.

My wife wen't out first to shovel this morning and she's 54 :-).

Anecdata indeed. I've seen women shovel snow all the time

Another data point here. In my general neighborhood who was shoveling mostly depended on who was up or had to go to work first.

I've never seen anyone shovel snow :(

(i.e. anecdotes in this sort of topic aren't useful)

My girlfriend shovels snow, and so does my mother (age 65). Just to add some anecdata :)

'Just to add some anecdata'

Is 2018 the year when anecdata becomes a thing, I wonder?

If we make it so. I had to duckduckgo it to make sure it was correct, but I like it and am adopting it. Seems more efficient to just say "anecdata" than "anecdotal evidence".

Now back OT, I find little microcosm issues like this that show a gender disparity very interesting given the current cultural climate. It shows that in many ways the inequality doesn't exist unidirectionally between male and female in all areas (though it does in some). Physical labor jobs are a great particular example of this.

The real lesson I've learned over the years is appreciation. Men tend to really not understand just how much women do for them or the family (I tried the househusband thing for a bit and learned much of it the hard way), but the reverse is true also, women often really don't understand how much men do for them or the family either. If we all just worked a bit more on saying "thank you" I think the world would be a better place.

With as much as gets thrown around on the Internet, I think it's time to start looking into building anecdata analysis tools and maybe even a big anecdata platform. Anecdata science is going to be a huge field!

Shoveling the next day is also likely to happen in the morning, maybe slightly after. At this time the blood pressure is rising close to its peak or even already peaking. The riskiest time to do hard physical work.

EDIT: why all the downvotes though? Do some people think doing physical work at peak blood pressure is not risky? It's not an anecdata.

So these morning gym workouts are killing us!?

Have you tried weight lifting soon after you wake up vs 2pm in the afternoon? The strength difference is telling.

There were several years where that was basically my routine. Wake up, eat a bit, go to the gym, weightlift, go home.

I’ve been weightlifting for about 12 years though.

No. I already know this is not a good idea but, strangely, I wouldn't have previously applied this obvious logic to shovelling snow?

I live in Maine, and plow snow for a property management company. Women would make great shovelers, but you never seem them doing it. It's probably because you're often called at midnight to meet some other sketchy guys who somehow enjoy shoveling for the next 8 hours without a break.

That's because they are too busy doing pretty much everything else: dinner planning, shopping and cooking, laundry, cleaning the house, looking after and managing kids and working full-time.

It's amazingly hard work in the cold. Which means it takes longer for the unpleasant feeling of sweat to reach the gloriously provider-focused man-brain. So men just keep pushing through. The impulse to push through has probably saved more lives than it has claimed over the centuries, I reckon.

I like that this article came out the same day that the Damore stuff is being rehashed.

Sounds like one theory of the actual mechanism is the Valsalva maneuver? https://en.wikipedia.org/wiki/Valsalva_maneuver

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.

Not doing the Valsalva maneuver means that you break your spine. It works by using the compressed air inside your lungs as support so that your abdominal and back muscles can do their work.

This is the reason that when you go to a physiotherapist and they crack your spine they ask you to exhale before, in order to be able to work without needing to fight your internal pressure. There is a reason we evolved with the instinct to do it.

Edit: to also comment on your note about martial arts: the very short scream you do when throwing a punch or kick is precisely a way to induce a Valsalva maneuver. Notice that you don't scream until you're out of breath, but you exhale very fast and you stop precisely when you hit, forcing pressure inside you to give you the support to need during the transfer of forces of the blow.

> Not doing the Valsalva maneuver means that you break your spine.

This is only anecdote, but if I fail to do the valsalva when exercising I just don't have as much power. I haven't broken my back yet.

The valsalva is useful at max effort, but doesn't seem necessary for a sustained activity such as shoveling snow. If they find valsalva is a problem, the answer may be not to shovel so much snow in one push.

You don't have as much power because your body automatically scales down to prevent you from injuring yourself. In addition, performing an exercise wrong doesn't mean that you automatically get injured, just that your chances of hurting yourself go up. If you're lucky, you're never going to break anything - this also depends on the kind of exercise you're doing and on its intensity.

As for the max-effort thing, the Valsalva maneuver can be performed at different degrees of intensity. It's not like every time you do it you have veins popping in your eyeballs, and I don't expect those untrained men referenced in the article to do it very strongly. It is correlated with the effort you're doing and on how much you're consciously compressing the air.

But yes, longer effort with less snow per shovel would definitely help.

Sounds like people already predisposed to a heart attack that are pushed over the edge by strenuous activity after long periods of no physical activity.

I'm confused -- if it's something you can do with both hands holding a shovel, why is it described as holding your nose?

I do this when I lift. I wonder if it is dangerous.

There's no consensus, but this provides a reasonable argument for "not really": https://startingstrength.com/article/heavy-lifting-and-heart...

(both authors are lifters, one is an MD. Take that as you will)

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.

I used that as an excuse to buy a snowblower. Now, removing snow is as easy as using a self-propelled lawnmower. It's one of those things I didn't realize I was missing out on and wish I had bought years ago.

Yep, people should hire someone or buy a snow blower. Or if you have too long of a drive get a plow.

Similarly, you're more likely to get a have sudden cardiac death while you're running a longer race, even if marathoners are unlikely to suffer from sudden cardiac death overall[1].

1 = http://www.nejm.org/doi/full/10.1056/NEJMoa1106468#t=abstrac...

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 "snow shovel" 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.

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.

1) https://www.tractorsupply.com/tsc/product/stanley-fatmax-fib...

2) http://www.truevalue.com/product/Polar-Tuff-Snow-Plow-Pusher...

3) https://www.toro.com/en/homeowner/snow-blowers/power-shovel-... my dad had one an it worked well

Will second the #2 recommendation above - I have a fair amount of sidewalk in front of my house and the front of my office that I bought the snow pushers for. They're fast and move a lot of snow with minimal heavy breathing. 4 years and zero heart attacks. =)

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

it's much more likely in men because presumably more men than women shovel snow.

The article said that's a suspicion, but is not a conclusion:

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't cause heart attacks.

Hence my "presumably." I'd be surprised if that wasn't true, however.

Isn't "all women are naturally and inherently better at shoveling snow" just as sexist of an assumption as "women aren't as likely to shovel snow"?

If men are more likely to shovel snow, that's just statistics and sample sizes and can be controlled for to determine its validity. If all women everywhere are so much better at shoveling than men that it produces a statistically measurable outcome in an unrelated study, that is massively huge news about the innate physical differences between genders.

This isn't a case of better or worse at shoveling snow, though. I mean, it could be, but that's not what this implies. It simply states that maybe women shovel in a way that doesn't lead to heart attacks so easily, which wouldn't be that far into fantasy. It isn't the first time we've noticed such things.

For example, "throwing like a girl" is a thing for most girls, caused by the way the body is put together after puberty (before puberty, males and females throw similarly). There are some exercises that are great for men but not women - it makes the pelvic bone get weird for some women (can't remember the specifics. Its been 20 years).

Considering all this, it is quite possible that women naturally use different movements and different muscle groups to do the same job because of their physical differences. And perhaps this causes less strain. Or maybe it is hormones.

You know, or maybe more men shovel than women - they just didn't want to rest on such an assumption when they don't know it to be true.

Yeah, but it seems a lot more reasonable to suspect that women don't have a unique way of shoveling snow.

The author also said To be perfectly scientific, the researchers have no way of knowing know that shovelling [sic] did the guys in. So I guess you can discount the whole thing.

While this is just anecdotal, My wife and I have a very different style -- in heavy wet snow, I take a full shovel load before tossing it, while she takes much smaller shovel loads. This is probably a factor of me being larger and stronger than her, but it may also be a safer shoveling style for her to follow.

I think men are also more likely to have internalised a self-image about "manning up" and pushing on when their body is telling them to stop.

Or at least, every time I've seen someone staggering under the weight of a pile of chairs they can barely lift or carrying ten bags of shopping from the car in one trip, it's been a man :)

Yeah, I'm really baffled by people describing shovelling snow as such a strenuous task. Since HN is mostly men I can assume that these posters are more likely than not men. I'm an out of shape woman and I don't think it's really all that difficult or taxing on my body to shovel snow. I don't mind the physical work but the time consumption is so annoying.

Especially if it is the valsalva this is the problem. Large loads of snow means bigger effort, means you are more likely to valsalva.

I mentioned this to my wife (who is a doctor) and her response was basically "no duh." 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.

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.

Am I missing something?

The mechanism is that a plaque builds up in your coronary artery. This plaque can rupture, spontaneously or if disturbed for some reason. Then your blood starts rapidly forming a clot around the location of the rupture, and this is what blocks the artery.

https://www.verywell.com/stemi-st-segment-elevation-myocardi...

> To be perfectly scientific, the researchers have no way of knowing know that shovelling did the guys in.

Devil's advocate - perhaps it's some other activity altogether? Just for example, being snowed in with the spouse could lead to some indoor exertion?

If you don't shovel it, you risk having it compact into an icy mess, which can be unhealthy in its own way.

Here's a quick review of the large studies which the article cites:

[1] says that snowfall in Canada is correlated with heart attacks in men, but not in women. Shoveling is just a postulated cause.

[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's statement that "of the patients with heart attack after shoveling snow, 80 per cent were men." Perhaps the article'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.

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.

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].

[1] http://www.cmaj.ca/content/189/6/E235 [2] http://www.sciencedirect.com/science/article/pii/S0735675709...

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'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.

[Edit]At one point people were talking about the issue at work over lunch. Ugh.

If the law says the homeowner is responsible for clearing the sidewalk in front of their property (like in my town) then your dad needs to hire someone to do the work if he can't. My neighbor is well into her 80s so she hires. It's not even all that expensive. Not being physically able to do the work yourself is no excuse for neglecting your responsibility as a homeowner. Your dad should be shamed for putting pedestrians in danger.

Or just change the law. City could do it, jobs programs and all. You think I'm kidding but they do the streets anyway.

Making a phonecall is a lot easier than changing City law

Of course, they are out doing the sidewalk of city property, they have really nice machinery too.

Yeah, it's kind of a scam that you don't own the sidewalk but they force you to maintain it.

Well the only ones in danger are people visiting my Dad and he doesn't get too many visitors. Thanks for demonstrating how ridiculously judgemental people have gotten.

To be clear, my Dad does shovel the snow but I don't think he should risk it. I do it myself when I have the chance. I just do not like the level of outrage and fear.

Get your dad a snowblower (cheap) or hire someone to do it (more expensive but also cheap). It's even cheaper if you find a teenager whose just trying to make some extra cash, you can find them on Facebook groups really easily.

Yes I'm fucking judgement because I got hit by a fucking car due to some asshat not shoveling their sidewalk. Also there was an issue a few years ago with kids having to wait for the bus in the middle of the road. They started fining people after that incident, $100 a day.

To be clear, its really ok to be judgement when people's lives are at stake.

So you're pissed at someone for not shoveling their driveway, but not at the driver who hit you? Your anger seems a bit misplaced!

Where did I say I wasn't pissed at the person who hit me? They aren't mutually exclusive.

Where did I say I was pissed at someone who didn't shovel their driveway? The topic is public sidewalks, not driveways. I couldn't care less what you do with your driveway, that doesn't endanger me.

Moreso, where did I say I was pissed at all? I said I was judgement.

Friend of my parents had this happen (& hey, we're in Canada)

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's a bit worrisome about him shovelling now

Pure speculation but I wonder if that was caused by the rapid shift in environmental temperature resulting in rapid blood vessel dilation? [1] Or do you know it was a heart attack and not fainting?

[1] https://answers.webmd.com/answers/5038612/why-do-i-faint-or-...

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.

> The correlation was true regardless of the patient's age, the presence or absence of cardiovascular risk like high blood pressure or other health conditions.

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'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]: http://www.biltema.se/sv/Fritid/Tradgard/Vinter/Snoslade-200... [1]: http://www.acehardware.com/product/index.jsp?productId=39941... - in the US

for moving 90% of the snow and if you have to scoop the last bit it's not backbreaking.

From the linked paper https://www.ncbi.nlm.nih.gov/pubmed/20825768 >The average annual rate of snow shovel-related injuries and medical emergencies was 4.15 per 100,000 population.

That'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)?

For comparison, car related fatalities were 11.59 per 100,000 in 2016.

> HN readers to care enough to change their behavior (i.e. decision to shovel or not)?

Where I live its not an option unless you enjoy being sued. You are legally obligated to keep the sidewalks clear. If you don't, and someone "slips", you are on the hook for a massive settlement.

I'd also like to point out that the 4.15 per 100,000 only counts the people who went to the doctor or hospital for their injuries. You should have no doubt that droves of people who end up with back injuries (like myself) from shoveling do not seek medical treatment and are not counted in the statistics.

The other big killer is pooping.

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.

What about kneeling down with the body straight?

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].

[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4183232/

>The context is that many people pick up a shovel and do maximum effort despite living a sedentary life.

I'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/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?

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'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/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.

Or butt garages up to the street so there's no driveway to speak of. Oh no, now I also don't have a front lawn to mow. How will I ever get over such a loss.

The town I lived in you were responsible for shoveling and the overall condition of the sidewalk. It was something like $200 fine for not shoveling. I imagine there are probably many cities with similar laws.

Yeah, but the sidewalk’s like 1/10 the work of the driveway, if that. Heavier the snow the bigger the difference, too, since you have to move the snow so far from the middle to reach the side of the driveway.

I just shovel a path up my driveway to my house so no one slips. I don't think there was a fine for driveways.

The most effort is the bottom of the driveway where the snow plow packed in the snow.

>> Or butt garages up to the street so there's no driveway to speak of.

Talk about getting plowed in.

So basically I have a medical reason not to shovel snow. I'm OK with this.

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

"The notion that women might shovel snow with less risk is an intriguing one that just might make a good study."

Is it really sexist to just point out the obvious answer? Women have their men go out and shovel the snow.

Countless times in history the "obvious answer" has been dead wrong. It's really bad science to just assume the "obvious" rather than test it.

They acknowledge so.

To ignore the obvious and simplest hypothesis because you're afraid of being labelled politically incorrect is just as unscientific.

This is such a ridiculous comment that I'm pretty sure your just trolling

Nobody's ignoring it, it was assumed by the authors as the most likely reason for the disparity in the sentence before the one you quoted.

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

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

If I still lived in Indiana, for sure I'd buy a snow blower. But I'm not taking up space in my garage for something I'll use once a year at most in the Seattle area. So I keep a snow shovel around, make sure to stay in good shape, and remind myself that going all out versus shoveling at a sustainable rate will probably at most make ten minutes worth of difference.

If people got on with their neighbours I am sure one snow blower between 20 houses would suffice. Maybe the 'storer' gets their share for free. Could issue an ICO token for the share, for a laugh.

Oddly enough, even here in central Indiana a snowblower is only needed about once in one or two seasons. Most snows are 2" or less and handled with the shovel easier than getting the snowblower out and warmed up. But when you need it, you need it. Fortunately it fits easily under a workbench with the handle folded over when not in use.

Oddly enough, even here in central Indiana a snowblower is only needed about once in one or two seasons.

Yeah, I forgot that before we moved that it didn't seem to snow as much as it used to. Grew up spending entire winters cross-country skiing across the fields. Not so much as I got older. Wanna hear an old man's stories about the Blizzard of '78? :-)

Rent it or hire a service.

Snowblower is useless in digging your car out.

Can't use a snow blower on wooden decking.

This works fine https://www.toro.com/en/homeowner/snow-blowers/power-shovel-...

I dunno if it could throw the 2'+ we get here every couple of weeks. Definitely good for a laugh from the neighbors though : nice follow-on act from my electric chain saw.

It worked for my Dad in South Dakota, so it’s not exactly wimpy. I thought the same, but got proven wrong. It is very easy to handle.

Key takeaways:

> 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/or death.

> 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's age, the presence or absence of cardiovascular risk like high blood pressure or other health conditions.

> But here'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't cause heart attacks.

> Men age 50 and older with heart disease should avoid shovelling snow period.

Why is it sexist to assume that snow shoveling is mostly done by men? It sounds more plausible than secret shoveling techniques.

Sexist? The assumption itself would be slightly. But in this case assuming it would also be unscientific. And I feel that it's weird they didn't do even a quick check (walk the streets in the morning, or ask people - get a valid sample). Then they'd both have better information and avoid the weird wording.

Because discussing anything gender/identity-related nowadays has become bereft of all logic and always comes with emotional baggage.

Jesus, no, not at all, I have no idea why you'd jump to such wild conclusion as it's actually very informative and an important piece of information. I have no idea what sort of "emotion baggage" would cause the authors to write that, that would be really odd.

They are merely acknowledging the premise is based solely on gender roles and not any sort of data they have collected or any preliminary observations.

The alternative would be something like "we drove around town for an hour and observed that 80% of people shoveling snow at that time were men so our hypothesis is the reason for the sex difference is men do most of the shoveling. This needs more rigorous data collection to verify." Or even "in our personal experience most of the household shoveling is done by men."

It could have been worded better to be more clear.

>It could have been worded better to be more clear.

But it wasn't, and what we have from them is a needlessly adversarial conclusion. I don't know why you're trying to make excuses for them. This is the norm for news outlets nowadays.

It's just not good science. Why assume "most shoveling done by men" when you could also have "women are rate limited by arms that are on average weaker" for instance? There are plenty of other ideas to float, too. As a sibling poster mentions, I'd like it if they'd gone out & done a bit of surveying on this (send undergrads on a walk to record observations or something).

> Why is it sexist to assume that snow shoveling is mostly done by men?

They don't actually say that, they say that it's either true, or it's a sexist assumption. So they only imply its a sexist assumption in the hypothetical where it's false.

Right, they are saying basically

"We are just going to assume that is the reason but we know it is sexist to assume that and not based on any hard data."

They are acknowledging that their premise is based entirely on gender roles and not on anything else, not on data they collected and not on any sort of preliminary observation.

Could be also that men are more angry that they have to shovel or they are doing so more dynamically without warmup. Where women are less annoyed or do it slower not with secret techniques.

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