Shoveling snow can be more than just an annoying chore. It can also be harmful and, in rare cases, lethal.

In this storm alone, at least three men have died of heart attacks while shoveling snow. A study found that 1,600 people died of heart attacks related to snow removal between 1990 and 2006. Many thousands were injured.

[Here’s why some people drop dead while shoveling snow]

The American Heart Association, the American Academy of Orthopaedic Surgeons and a cardiologist offer the following tips for safely shoveling snow:

— Consider whether you’re healthy enough to tackle the snow; familiarize yourself with the signs of a heart attack and hypothermia. The cold raises the risk of heart attack and other injuries because it constricts blood vessels. “If you haven’t been exercising and you haven’t been exerting yourself, this is not the time to start,” Lawrence Phillips, a cardiologist at NYU Langone Medical Center, told my colleague Brady Dennis.

— Don’t drink alcohol or eat a heavy meal before tackling the snow. Alcohol can make it difficult for people to tell how much they are straining themselves (and not to mention increase the chances that you will topple over), and a heavy meal can place strain on the heart.

— Shovel early, shovel often and take breaks. It’s easier to attack the heaps of snow in small pieces, so it’s wise to shovel throughout the storm if it’s safe enough to do so. But if you rode out the storm without picking up a shovel, be sure to take plenty of breaks.

— Push, don’t lift. The American Academy of Orthopaedic Surgeons says you should push the snow instead of scooping it up and moving it to the side. If you must lift the snow, make sure you use proper technique. Keep your feet about hip-width distance apart and keep your back straight. Do not twist your back to throw the snow behind you.

— Don’t be afraid to ask for help. If you’re not healthy enough to shovel snow, don’t be afraid to hire someone or ask a neighbor for help.

— If you are healthy enough, help out your neighbors. Snow shoveling is a good workout and can be safe with good technique. If you live in the District, help out your elderly neighbors by joining the D.C. Resident Snow Team.