The debate over whether shoveling snow can kill you if you’re over 40 is trending on some social media platforms, including TikTok. But is it an actual threat?

Studies show that snow shoveling kills at least 100 Americans and injures more than 11,000 requiring emergency room treatment each year. American Journal of Emergency Medicine.

For the majority of Americans, shoveling snow remains a daily chore that poses no serious health risks. However, for some adults and children, this activity can be deadly.

Almost all snow shoveling-related deaths are heart-related. Cold temperatures cause blood vessels to constrict, reducing blood circulating throughout the body. This ultimately puts strain on the heart, increasing heart rate and blood pressure. Even healthy people with no underlying health conditions have this reaction to cold.

However, shoveling snow in cold temperatures can be a sudden and strenuous exercise due to lifting large amounts of snow. For sedentary seniors, sudden exertion can put strain on the heart, potentially leading to a heart attack.

Research published in Canadian Medical Association Journal The study, which looked at more than 128,000 hospitalized patients, found that heavy snowfall was associated with men being 6% more likely to be hospitalized for a heart attack and 34% more likely to die.

Of course, this doesn’t mean that only young people should shovel snow. The health damage caused by snow shoveling largely depends on the person’s physical fitness level. “Age should not be the only criterion,” says Dr. Jim Powers, a geriatrician at Vanderbilt University Medical Center. If you’re a regular jogger, maybe he’s 65 and retired, and you jog without chest pain, you’re probably okay with shoveling snow. ”

People with chronic conditions or risk factors for cardiovascular disease should use caution before shoveling snow. Risk factors for heart disease include diabetes, high blood pressure, obesity, smoking, and high cholesterol, to name a few. According to the CDC, the reality is that 60% of Americans have at least one chronic disease. Additionally, nearly half of American adults have cardiovascular disease, according to the American Heart Association.

Shoveling snow can be harmful to your health beyond your heart. Just as cold weather causes your blood vessels to constrict, your airways also narrow, making it difficult to breathe, especially when shoveling snow. This can cause shortness of breath and wheezing, especially in people with underlying health conditions such as asthma.

In addition, shoveling often involves repetitive motions such as lifting and bending, which can cause overexertion. This can definitely lead to musculoskeletal injuries such as herniated discs, lower back pain, muscle strains, and other symptoms. Snow shoveling research shows that musculoskeletal injuries are the most common form of injury after snow shoveling. American Journal of Emergency Medicine.

Whether shoveling snow is right for you is a personal decision based on your cardiovascular health risk factors and overall fitness level. Taking frequent breaks, staying hydrated, dressing appropriately, pushing snow instead of lifting it, and warming up before shoveling all help reduce the risks associated with snow shoveling. It’s also important to consult your health care provider before you start shoveling snow, especially if you have an underlying medical condition.