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Snow removal led to 100 deaths and 11,500 injuries that required a trip to the emergency room each year between 1990 and 2006, a study reports. USA TODAY

Winter is coming and many parts of the country have already been walloped with serious snow storms. But shoveling your drivewaycan be more than just a chore it can be hazardous and even lethal if you're not careful.

Snow removal ledto about 100 deaths and 11,500injuriesthat required a trip to the emergency room each year between 1990 and 2006,a study published in the peer-reviewedAmerican Journal of Emergency Medicine found. The most common injuries were soft tissue damage, the lower back was the most frequently damaged part of the body, and cardiac-related injuries were responsible for all of the 1,647 fatalities.

The true total of injuries and deaths may be much higher, according to Barry Franklin, director of preventative cardiology and cardiac rehabilitation at William Beaumont Health in Royal Oak, Michigan. Franklin begin researching the issue because two of his friends died suddenly after clearing snow.

"Its important that older people simply dont go out and shovel and clear heavy, wet snow," Franklin said. "Unfortunately, every year when youve got major snowfalls you hear of people who go out and die suddenly."

Here's what you need to know to stay safe while digging yourself out after a big snow storm:

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If the forecast calls for a heavy snowfall over a long period of time, don't wait until it's over to pick up a shovel. Plan to clear the snow at least once while it's still falling and then again when the storm passes, Hope said.

If your driveway is far away from your house, Hope recommends starting in the middle of the driveway and working your way out until you've cleared a path wide enough for your car.

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If your driveway is very close to your house, Hope said to start at the edge closest to your home and go back in the opposite direction at the end of each pass, getting a little furtherfrom the house each time. If you're using a snowblower, turn the chute 180 degrees each time so that you're always throwing the snow away from the house.

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"Thatll obviously protect windows and siding and anybody who may be inside near a window," he said. "But it also helps ensure that any snow thats not fully thrown out of the driveway will be caught on a subsequent pass."

When shoveling, don'tthrow the snow over your shoulder or to the side because that twisting motion will stress your back, according to the American Academy of Orthopaedic Surgeons. Try to push the snow instead of lifting it.

"If you must lift, squat with your legs apart, knees bent, and back straight. Lift with your legs. Do not bend at the waist," the group said in a release. "Holding a shovelful of snow with your arms outstretched puts too much weight on your spine."

Franklin also suggests taking frequent breaks to watch for heart attack warning signs and avoid putting too much stress on your heart. Although chest pain is the most common symptom, women are more likely to experience other symptoms including shortness of breath, nausea/vomiting and back or jaw pain, according to the American Heart Association.

"Any discomfort that comesfrom the belly button on up could be an angina equivalent and would signal that you should stop shoveling immediately," Franklin said.

If you live in an area that gets constantly hit with major snowstorms, it might be safer to invest in a snowblower, according to Paul Hope, Home and Appliances Writer at Consumer Reports.

"From an injury standpoint alone, if properly used (a snowblower) has the potential to be infinitely safer," Hope said. "If they live in a really snow-heavy region, theyre essentially putting themselves at a greater risk if theyre trying to skate by without a snowblower."

There are five or six different types of snowblowers that are categorized by power source (corded electric, battery or gas) and the amount of snow they can handle (single, two, or three stage). Stage 1 machines can clear about 9 inches of snow while stage 3 machines can clear up to 18 inches, he said.

If you're shoveling when the snow is light and fresh, Hope recommends using a wide, all-purpose, plastic snow shovel. But ifthe snow has had time to get wet and heavy, Hope suggestsusinga metal shovel with sides to help break up icy patches.

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Franklin said that those most at risk are 55and older, haveknown or suspected coronary artery disease, orhave one or more risk factors such as diabetes, hypertension (high blood pressure)or a habitually sedentary lifestyle.

Snow shoveling is so dangerous because itincreases heart rate and blood pressure, Franklin explained, while exposure to the cold air decreases the flow of oxygenated blood to the heart.

"As George Clooney would say, 'It's a perfect storm'," he said.

Franklin saidthe average weight of a shovel full of heavy wet snow is 16 pounds, citing a small study he published in the Journal of the American Medical Association. Themen hestudiedwere able to lift 12 times perminute for 10 minutes, moving nearly 2,000 pounds of snow.

"That's the weight of a mid-size car," he said. "To ask a 50-, 60-, 70-year-old to move 2,000 pounds in 10 minutes in cold environmental conditions with the wind blowing, its not surprising that this activity triggers heart attacks and sudden death each year."

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Franklin said people over the age of 55 with known or suspected heart disease shouldn't shovel snow at all.

"Find a local kid in the neighborhood, hire a local plow," he suggested.

If you want to hire someone to plow your driveway, book that well in advance of the coming storm to avoid having to frantically shovel yourself out, Hope said.

"If youre caught in a big snow storm and you cant get somebody to come plow your driveway and youve only got a shovel, that sort of is a recipe for injury," he said.

If you have to shovel, Franklin said to avoid heavy meals, smoking cigarettes or drinking alcohol both before and after clearing snow because that can put extra stress on your heart.

TheAmerican Academy of Orthopedic Surgeonsrecommends warming up your muscles for 10 minutes with light exercise before you begin shoveling. Wear layers to provide insulation as well as a hat, gloves that will keep your hands dry and shoes that have slip-resistant soles.

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Follow N'dea Yancey-Bragg on Twitter: @NdeaYanceyBragg

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Are you shoveling your snow wrong? Here's what you need to know to stay safe this winter - USA TODAY

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