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March 15, 1995, Vol 273, No. 11 >
ARTICLE | March 15, 1995

Cardiac Demands of Heavy Snow Shoveling FREE

Barry A. Franklin, PhD; Patrick Hogan, MA; Kim Bonzheim, MSA; Donovan Bakalyar, PhD; Edward Terrien, MD; Seymour Gordon, MD; Gerald C. Timmis, MD
[+] Author Affiliations

Presented in part at the 43rd Annual Scientific Session, American College of Cardiology, Atlanta, Ga, March 16, 1994, and the American College of Sports Medicine annual meeting, Indianapolis, Ind, June 4, 1994.

Reprint requests to Cardiac Rehabilitation and Exercise Laboratories, William Beaumont Hospital, Beaumont Rehabilitation and Health Center, 746 Purdy St, Birmingham, Ml 48009 (Dr Franklin).


JAMA. 1995;273(11):880-882. doi:10.1001/jama.1995.03520350062030
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Article
References

Objective.  —To assess the physiologic responses to manual (shoveling) vs automated (electric snow thrower) snow removal in healthy, untrained men.

Design.  —Observational, controlled trial.

Setting.  —A community-based, acute care, teaching-research hospital.

Participants.  —A volunteer sample of 10 apparently healthy untrained men (mean ±SD age = 32.4±2.1 years) met all eligibility criteria and completed the study.

Intervention.  —Each subject cleared two 10±2-cm-high, 15-m-long tracts of heavy, wet snow in the cold (2°C), using self-paced manual and automated methods, in random order, with 10- to 15-minute rest periods between each 10-minute bout of work.

Main Outcome Measures.  —Heart rate, blood pressure, oxygen uptake, and perceived exertion during snow removal were compared with values obtained during maximal arm-ergometer and treadmill tests.

Results.  —Mean heart rate during shoveling was 154 and 173 beats per minute at 2 and 10 minutes, respectively, corresponding to 86% and 97% of maximal heart rate. Relative heart rate (percentage of maximal heart rate) during shoveling was inversely related to aerobic fitness (r= —0.65; P=.05). The highest heart rate and perceived exertion responses during shoveling, arm-ergometer, and treadmill testing were comparable. Systolic blood pressure during snow shoveling (198±17 mm Hg) was significantly greater (P<.003) than during arm ergometry or automated snow removal and slightly greater than during maximal treadmill testing (181 ±25 mm Hg). Oxygen uptake during shoveling was similar to that for arm ergometry (5.7 vs 6.3 metabolic equivalents), but lower than for treadmill testing (9.3 metabolic equivalents). Cardiorespiratory and perceived exertion responses were reduced during automated snow removal.

Conclusion.  —Heavy snow shoveling elicits myocardial and aerobic demands that rival maximal treadmill and arm-ergometer testing in sedentary men. These responses may contribute to cardiovascular events reported after heavy snowfalls.(JAMA. 1995;273:880-882)

REFERENCES

1 +
Sheldahl LM, Wilke NA, Dougherty SM, Levandoski SG, Hoffman MD, Tristani FE.  Effect of age and coronary artery disease on response to snow shoveling. J Am Coll Cardiol . 1992;;20:1111-1117.
2 +
Anderson T, Rochard C.  Cold snaps, snowfall and sudden death from ischemic heart disease. Can Med Assoc J . 1979;;121:1580-1583.
3 +
Baker-Blocker A.  Winter weather and cardiovascular mortality in Minneapolis-St. Paul. Am J Public Health . 1982;;72:261-265.
4 +
Glass RI, Zack MM.  Increase in deaths from ischemic heart disease after blizzards. Lancet . 1979;; 1:485-487.
5 +
Glass RI, Wiesenthal AM, Zack MM, Preston M.  Risk factors for myocardial infarction associated with the Chicago snowstorm of Jan 13-15, 1979. JAMA . 1981;;245:164-165.
6 +
Heppell R, Hawley SK, Channer KS.  Snow shoveller's infarction. BMJ . 1991;;302:469-470.
7 +
Shaefer J, Finkelstein J, Betzold M.  Icier weather on the way; 30 fatalities in Detroit area. The Detroit Free Press . (January 16) , 1992;;section A:1.
8 +
Mundal R, Erikssen R, Rodahl K.  Assessment of physical activity by questionnaire and personal interview with particular reference to fitness and coronary mortality. Eur J Appl Physiol . 1987;;56:245-252.
9 +
Wetherbee S, Franklin BA, Hollingsworth V, Gordon S, Timmis GC.  Relationship between arm and leg training work loads in men with heart disease. Chest . 1991;;99:1271-1273.
10 +
Bruce RA, Kusumi F, Hosmer D.  Maximal oxygen intake and nomographic assessment of functional aerobic impairment in cardiovascular disease. Am Heart J . 1973;;85:546-562.
11 +
Borg G.  Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med . 1970;;2:92-98.
12 +
Segal KR, Chatr-Aryamontri B, Guvakov D.  Validation of a new portable metabolic measurement system. Med Sci Sports Exerc . 1994;;26( (suppl) ): S54. Abstract.
13 +
Matthews DE, Farewell VT. Using and Understanding Medical Statistics . 2nd ed. Basel, Switzerland: Karger; 1988;:178.
14 +
Kawahara J, Sano H, Fukuzaki H, Saito K, Hirouchi H.  Acute effects of exposure to cold on blood pressure, platelet function and sympathetic nervous activity in humans. Am J Hypertens . 1989;; 2:724-726.
15 +
Juneau M, Johnstone M, Dempsey E, Waters DD.  Exercise-induced myocardial ischemia in a cold environment. Circulation . 1989;;79:1015-1020.
16 +
American College of Sports Medicine. Guidelines for Graded Exercise Testing and Exercise Prescription . 4th ed. Philadelphia, Pa: Lea & Febiger; 1991;:98,115.
17 +
Kitamura K, Jorgenson CR, Gobel FL, Taylor HL, Wang Y.  Hemodynamic correlates of myocardial oxygen consumption during upright exercise. J Appl Physiol . 1972;;32:516-522.
18 +
Nelson RR, Gobel FL, Jorgensen CR, et al.  Hemodynamic predictors of myocardial oxygen consumption during static and dynamic exercise. Circulation . 1974;;50:1179-1189.
19 +
Franklin BA, Parker S, Mitchell M, Rubenfire M.  Hazards of snow shoveling. Physician Sportsmed . 1980;;8:40-48.
20 +
Hattenhauer M, Neill WA.  The effect of cold air inhalation on angina pectoris and myocardial oxygen supply. Circulation . 1975;;51:1053-1058.
21 +
Mittleman MA, Maclure M, Tofler GH, Sherwood JB, Goldberg RJ, Muller JE.  Triggering of acute myocardial infarction by heavy physical exertion. N Engl J Med . 1993;;329:1677-1683.
22 +
Willich SN, Lewis M, Löwel H, Arntz HR, Schubert F, Schröder R.  Physical exertion as a trigger of acute myocardial infarction. N Engl J Med . 1993;;329:1684-1690.
23 +
Richardson PD, Davies MJ, Born GV.  Influence of plaque configuration and stress distribution on fissuring of coronary atherosclerotic plaques. Lancet . 1989;;2:941-944.
24 +
Kestin AS, Ellis PA, Barnard MR, Errichetti A, Rosner BA, Michelson AD.  Effect of strenuous exercise on platelet activation state and reactivity. Circulation . 1993;;88:1502-1511.
25 +
Cobb LA, Weaver WD.  Exercise: a risk for sudden death in patients with coronary heart disease. J Am Coll Cardiol . 1986;;7:215-219.

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Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Sheldahl LM, Wilke NA, Dougherty SM, Levandoski SG, Hoffman MD, Tristani FE.  Effect of age and coronary artery disease on response to snow shoveling. J Am Coll Cardiol . 1992;;20:1111-1117.
2 +
Anderson T, Rochard C.  Cold snaps, snowfall and sudden death from ischemic heart disease. Can Med Assoc J . 1979;;121:1580-1583.
3 +
Baker-Blocker A.  Winter weather and cardiovascular mortality in Minneapolis-St. Paul. Am J Public Health . 1982;;72:261-265.
4 +
Glass RI, Zack MM.  Increase in deaths from ischemic heart disease after blizzards. Lancet . 1979;; 1:485-487.
5 +
Glass RI, Wiesenthal AM, Zack MM, Preston M.  Risk factors for myocardial infarction associated with the Chicago snowstorm of Jan 13-15, 1979. JAMA . 1981;;245:164-165.
6 +
Heppell R, Hawley SK, Channer KS.  Snow shoveller's infarction. BMJ . 1991;;302:469-470.
7 +
Shaefer J, Finkelstein J, Betzold M.  Icier weather on the way; 30 fatalities in Detroit area. The Detroit Free Press . (January 16) , 1992;;section A:1.
8 +
Mundal R, Erikssen R, Rodahl K.  Assessment of physical activity by questionnaire and personal interview with particular reference to fitness and coronary mortality. Eur J Appl Physiol . 1987;;56:245-252.
9 +
Wetherbee S, Franklin BA, Hollingsworth V, Gordon S, Timmis GC.  Relationship between arm and leg training work loads in men with heart disease. Chest . 1991;;99:1271-1273.
10 +
Bruce RA, Kusumi F, Hosmer D.  Maximal oxygen intake and nomographic assessment of functional aerobic impairment in cardiovascular disease. Am Heart J . 1973;;85:546-562.
11 +
Borg G.  Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med . 1970;;2:92-98.
12 +
Segal KR, Chatr-Aryamontri B, Guvakov D.  Validation of a new portable metabolic measurement system. Med Sci Sports Exerc . 1994;;26( (suppl) ): S54. Abstract.
13 +
Matthews DE, Farewell VT. Using and Understanding Medical Statistics . 2nd ed. Basel, Switzerland: Karger; 1988;:178.
14 +
Kawahara J, Sano H, Fukuzaki H, Saito K, Hirouchi H.  Acute effects of exposure to cold on blood pressure, platelet function and sympathetic nervous activity in humans. Am J Hypertens . 1989;; 2:724-726.
15 +
Juneau M, Johnstone M, Dempsey E, Waters DD.  Exercise-induced myocardial ischemia in a cold environment. Circulation . 1989;;79:1015-1020.
16 +
American College of Sports Medicine. Guidelines for Graded Exercise Testing and Exercise Prescription . 4th ed. Philadelphia, Pa: Lea & Febiger; 1991;:98,115.
17 +
Kitamura K, Jorgenson CR, Gobel FL, Taylor HL, Wang Y.  Hemodynamic correlates of myocardial oxygen consumption during upright exercise. J Appl Physiol . 1972;;32:516-522.
18 +
Nelson RR, Gobel FL, Jorgensen CR, et al.  Hemodynamic predictors of myocardial oxygen consumption during static and dynamic exercise. Circulation . 1974;;50:1179-1189.
19 +
Franklin BA, Parker S, Mitchell M, Rubenfire M.  Hazards of snow shoveling. Physician Sportsmed . 1980;;8:40-48.
20 +
Hattenhauer M, Neill WA.  The effect of cold air inhalation on angina pectoris and myocardial oxygen supply. Circulation . 1975;;51:1053-1058.
21 +
Mittleman MA, Maclure M, Tofler GH, Sherwood JB, Goldberg RJ, Muller JE.  Triggering of acute myocardial infarction by heavy physical exertion. N Engl J Med . 1993;;329:1677-1683.
22 +
Willich SN, Lewis M, Löwel H, Arntz HR, Schubert F, Schröder R.  Physical exertion as a trigger of acute myocardial infarction. N Engl J Med . 1993;;329:1684-1690.
23 +
Richardson PD, Davies MJ, Born GV.  Influence of plaque configuration and stress distribution on fissuring of coronary atherosclerotic plaques. Lancet . 1989;;2:941-944.
24 +
Kestin AS, Ellis PA, Barnard MR, Errichetti A, Rosner BA, Michelson AD.  Effect of strenuous exercise on platelet activation state and reactivity. Circulation . 1993;;88:1502-1511.
25 +
Cobb LA, Weaver WD.  Exercise: a risk for sudden death in patients with coronary heart disease. J Am Coll Cardiol . 1986;;7:215-219.

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