As winter arrives, it’s worth noting that each year about 11,500 people in the United States are treated in emergency rooms for injuries related to snow shoveling. On average, 100 of those injuries are fatal, generally heart attacks. The data, compiled by the Consumer Product Safety Commission and analyzed a few years ago by the Center for Injury Research and Policy at Nationwide Children’s Hospital in Ohio, indicates that soft tissue injuries are the most common (55 percent), followed by lacerations (16 percent), fractures (7 percent) and heart-related injuries (7 percent). In the 17-year span of the data, however, cardiovascular injuries accounted for half of the hospitalizations and 100 percent of the fatalities. The combination of cold (which can cause blood vessels to constrict, decreasing your blood supply) and the strenuous exertion of shoveling (which can quickly increase your heart rate and blood pressure) raises the risk for a heart attack. The quantity and duration of a snowfall seem to increase the chances of injury and death, according to 30 years of data gathered in Quebec and published in the Canadian Medical Association Journal. The longer it snowed and the deeper the snow, the higher the rates of hospitalization and death — especially for men. For instance, after snowfalls of more than eight inches, hospital admissions were 16 percent greater than on snow-free days, and 34 percent more deaths were recorded from heart attacks, the researchers found. To keep from becoming one of these statistics, experts say it’s important to do some warm-up exercises before shoveling and take frequent breaks. Push the snow out of the way rather than lift it, and use an ergonomically designed shovel that reduces bending. Or, if you can afford it, consider hiring someone else to remove the snow.