Four people died from suspected carbon monoxide poisoning during the weekend in cars where a tailpipe was blocked after a major snowstorm. The Associated Press (AP) wrote about the deaths, which were in the Boston area and in Meriden, CT. Two children were hospitalized in Boston after a similar incident. They are expected to recover, AP said. Parts of New England and New York received 2 to 3 feet of snow February 8 through 9. In all, the storm was blamed for at least 15 deaths in the Northeast and Canada, AP reported. They included heart attacks while shoveling snow, at least one of them fatal. A New York man died after his tractor drove off an embankment while he was plowing snow, AP said. Boston police warned that people should clear the snow around the tailpipe of a car before starting the engine. Otherwise, deadly fumes back up into the car.

By Lori Wiviott Tishler, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

This morning dawned clear and cold here in the Northeast. The mountain of snow in my backyard is beautiful. I’m grateful for having heat, light and a well-organized community keeping our roads clear. That's why I can be in the house, writing this article, instead of outside shoveling! At the same time, I'm texting to my in-laws who are south of us with no power for the second day.

While I was following the news, I started to think that we, as doctors, talk to people a lot about sun safety, water safety, driving safety and other topics. I do routinely ask my elderly patients about whether or not they have enough heat in their homes, but I don't talk a lot about cold weather or winter safety.

Five people died because of the storm. Several people died from carbon monoxide poisoning. What happened? Carbon monoxide poisoning can happen during winter storms if exhaust from cars is not vented properly. A 14-year-old boy died keeping warm in the car while his father was shoveling. Fumes backed up into the car because the tailpipe was covered by snow. Another man died in a similar manner.

Sometimes people who don't have heat decide to use a charcoal grill in the house. This can lead to carbon monoxide poisoning. So can a blocked fireplace.

Another news story mentioned the dangers of using a snow blower. Injuries happen when people aren't paying attention. Hands and feet are injured most often. Carbon monoxide can be a danger from snow blowers as well. And, though it rarely makes the news, I expect to hear from a lot of people with backs and arms sore from snow shoveling.

In summary, the Blizzard of 2013 reminds us not to take winter safety for granted. Bundle up, stretch before you shovel, remember the silent dangers of carbon monoxide and be safe when you travel on icy roads.

What Changes Can I Make Now?

Whether you live in a snow-filled area or not, you can learn much from these winter safety tips. The risks of carbon monoxide transcend geography.

To protect yourself from the risk of carbon monoxide:

• Install and test a carbon monoxide detector in your house
• Have your chimneys and fireplaces inspected (by a professional)
• Make sure furnace, car, dryer and other vents are clear of snow and debris
• Don't grill inside
• Use portable generators in a well-ventilated area to prevent exhaust from coming into your home

For further suggestions, you can look at the website of the Federal Emergency Management Agency.

These tips can help to prevent injuries from snow removal:

• If you have a history of heart disease or are worried that you might, talk to your doctor before shoveling snow.
• Dress appropriately. Wear loose layers and nice warm footwear.
• Take breaks to rest and get warm.
• Warm up your muscles.
• Try to push the snow, not lift it, when you can.
• Keep kids away from the snowblower and keep your hands out of the motor!

The American Academy of Orthopedic Surgeons website offers these tips and many others.

What Can I Expect Looking to the Future?

We can always predict that the weather will be unpredictable. I hope that being prepared inside and outside of your homes will help ensure safety for all of you and your families, no matter where you live.