INDIANAPOLIS (AP) — The state Department of Health is urging Indiana residents to take steps to prevent injuries while clearing driveways and sidewalks of snow and ice.

Health Commissioner Jerome Adams says people need to take steps to prevent injury or death. He says shoveling snow can put a strain on the heart and muscles. He says people with a history of heart disease shouldn’t pick up a shovel without a doctor’s permission.

He suggests warming up by stretching and doing a few exercises before shoveling. Other recommendations include dressing warmly in layers, avoiding smoking or eating a large meal before shoveling, shoveling heavy snow in stages and taking frequent breaks to stand and stretch.

Other recommendations including watching for ice patches and uneven surfaces and drinking water during breaks to avoid dehydration.