But with really big snow storms – and even everyday, run-of-the-mill snowfalls – comes a risk of death by shoveling. According to CBS News in Chicago, by early February 2015, around 18 people in the Chicago area had died in snow shoveling-related incidents. They ranged in age from their 40s to 75. Nationwide, snow shoveling is responsible for thousands of injuries and as many as 100 deaths each year.

So, why so many deaths? Shoveling snow is just another household chore, right?

Not at all, says Harvard Health Executive Editor Patrick J. Skerrett.

“Picking up a shovel and moving hundreds of pounds of snow, particularly after doing nothing physical for several months, can put a big strain on the heart,” Skerrett wrote in February 2013. Unlike other forms of exercise, people who shovel snow are goal and task driven…they want to get it done, so they don’t listen to their bodies as they would when they are attempting a new exercise regimen.

Pushing a heavy snow blower also can cause injury. And, there’s the cold factor. Cold weather can increase heart rate and blood pressure. It can make blood clot more easily and constrict arteries, which decreases blood supply. This is true even in healthy people. Individuals over the age of 40 or who are relatively inactive should be particularly careful.

National Safety Council recommends the following tips to shovel safely.

• Do not shovel after eating or while smoking
• Take it slow and stretch out before you begin
• Shovel only fresh, powdery snow; it’s lighter
• Push the snow rather than lifting it
• If you do lift it, use a small shovel or only partially fill the shovel
• Lift with your legs, not your back
• Do not work to the point of exhaustion, take breaks.

Don’t pick up that shovel without a doctor’s permission if you have a history of heart disease. If you feel tightness in the chest or dizziness, stop immediately. A clear driveway is not worth your life.