Shoveling in the cold is a potentially lethal activity

Q&A

February 04, 2005|By Judy Foreman | Judy Foreman,Special to the Sun

Why does shoveling trigger heart attacks? How can you avoid becoming a victim?

Shoveling snow is a nasty heart-attack trigger, especially for out-of-shape people, said Dr. Richard Nesto, chairman of the department of cardiovascular medicine at the Lahey Clinic in Burlington, Mass. In fact, it's much worse for sedentary types than other forms of abrupt physical activity, like suddenly going for a jog.

While jogging gradually raises heart rate and blood pressure, snow shoveling produces a rapid, very steep rise in both. Shoveling is an isometric exercise, like weight lifting, "and there is no form of activity more strenuous to the heart than that," Nesto said. "The stress on your heart can go from normal to wicked high in five seconds."

Cold is also a trigger, which is why some people who use snow blowers also have heart attacks, he added.

In a normal person with no blocked coronary arteries, cold dilates, rather than constricts, the arteries, noted Dr. Richard Lange, chief of clinical cardiology at Johns Hopkins Hospital. But in people with atherosclerosis, or plaque in the arteries, cold causes a constriction of the arteries, which places an extra burden on the heart. This can happen even if just part of the face is exposed to frigid air.

This constriction, plus the increases in heart rate and blood pressure, can cause "vulnerable" plaques in coronary artery walls to rupture, allowing blood clots to block the flow of blood to the heart, said Dr. Murray Mittleman, director of cardiovascular epidemiology at Beth Israel Deaconess Medical Center.

If that weren't bad enough, many people shovel in the morning, when heart attack risk is highest. And many shovel right after eating, which causes blood to flow to the digestive organs and away from other areas of the body --such as the heart.

How can you protect yourself? Do not shovel or use a snow blower without your doctor's OK if you have had a heart attack or cardiac procedure, such as bypass surgery, an angiogram or angioplasty.

Ditto if you are out of shape or have heart attack risk factors such as smoking, high blood pressure, high cholesterol or a family history of heart disease.

If you're shoveling and have chest pain, shortness of breath, nausea, vomiting or sweating, seek medical care immediately.

"Often these symptoms are ignored," said Lange. "These people die."

Is there a link between deodorant use and breast cancer?

The idea of such a connection has been floating around for years, but appears meritless.

The theory had been that women were putting themselves at risk by applying deodorants or antiperspirants within a short time of shaving their armpits, thereby introducing chemicals into their bloodstream.

But in the best epidemiological study to date, published in 2002 in the Journal of the National Cancer Institute, researchers studying 1,600 women found no link to breast cancer.

The National Cancer Institute says on its Web site (http: / / cis.nci. nih.gov / fact / 3_66.htm) that "there is no conclusive research linking the use of underarm antiperspirants or deodorants and the subsequent development of breast cancer."

That doesn't totally settle things, however. In 2003, a study, reported in the European Journal of Cancer Prevention, of 437 women who had had breast cancer found that the age of diagnosis was earlier in women who had used deodorants or antiperspirants and who shaved under their arms more frequently than those who did not. This study is inconclusive for several reasons, including the fact that there was no control group of women without cancer.

Some toxicology studies have also hinted at a potential link. One 2004 study in the Journal of Applied Toxicology looked at 20 samples of breast tumors and found preservatives used in underarm cosmetics.

But the study was flawed and did not directly link deodorant or antiperspirant use to the preservatives, said Dr. Kala Visvanathan, a cancer specialist at the Sidney Kimmel Comprehensive Cancer Center at the Johns Hopkins Hospital.

"I don't think there is reason to be greatly concerned," added Dr. Eric Winer, director of the breast oncology center at Dana-Farber Cancer Institute.

Do you have a medical question? You can submit questions via e-mail to foreman@baltsun. com.

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