For many, the Thanksgiving holiday is the best time of the year. It’s a day associated with eating far too much, catching up with extended family and, hopefully, feeling thankful.

But Thanksgiving can also be dangerous. Every year, the fourth Thursday of November sees a high number of fires, car accidents, food poisoning and emergency room visits. The death rate at Thanksgiving and Christmas spike almost every year. And while scientists have not yet figured out the exact cause of this phenomenon, there are some leading theories. Let’s take a look at these theories, and what you can do to avoid becoming a Thanksgiving statistic.

1. Car accidents

Over the Thanksgiving holiday, millions of Americans travel by car to visit their loved ones. This increase in traffic of course offers a greater potential for road accidents, but there are other factors at play. National Highway Traffic Safety Association (NHSTA) estimates 417 people may die on U.S. roads this Thanksgiving holiday, not to mention the other 50,000 who are injured.

Alcohol consumption is a major contributing factor. Nationwide, alcohol-impaired fatalities (involving blood-alcohol content of 0.08 g/dL or higher) in 2017 represented 29% of the total traffic fatalities. During the Thanksgiving Day period, 35% of fatalities involved an alcohol-impaired driver. According to another report from NHSTC, in 2015, 53 percent of those involved in Thanksgiving road fatalities were people not wearing their seat belts.

The advice? Buckle up! In the last decade, seat belts saved the lives of more than 100,000 people in the United States. Also, leave plenty of time to reach your destination and always have a designated driver or use a ride-sharing app.

2. Heart attacks

An unusually heavy meal can increase the risk of heart attack by about four times in the two hours after eating. That’s according to a study presented at the American Heart Association’s Scientific Sessions 2000.

Eating a heavy meal may act as a trigger for heart attack in much the same way as extreme physical exertion can. (Most of us know that shoveling snow is the classic activity associated with unexpected heart attacks.)

The higher risk of heart attacks that are directly related to Thanksgiving are in part due to the types of food we eat on this holiday. Increased food, salt, and alcohol consumption can all have adverse effects. Also, people on heart medication may forget their pills if they are traveling.

The advice? Don’t overdo it. If you have a heart condition make sure you consume everything in moderation. Do not over-exert yourself and make sure you carry all the relevant medications with you.

3. Fire

The Consumer Product Safety Commission (CPSC) estimates an average of 1,800 cooking fires occur on Thanksgiving Day each year, three times the number on any other day of the year. Deep frying turkey and leaving ovens unattended are the top culprits. A turkey fryer can start a fire in less than a minute.

The advice? Never leave food on the stove or in the oven unattended. Avoid wearing loose-fitting clothing and long sleeves that can easily catch fire while cooking. Keep children away from the cooking area. Keep flammable items like potholders and paper or plastic bags away from the stove and oven. Turn pan handles toward the back of the stove to prevent accidental knock overs.
Make sure you have a working smoke alarm on each level of the home, and inside and outside bedrooms.

4. Food poisoning

While you may have taken every precaution to avoid cross-contamination, you don’t know that Aunty Joan was so careful.

Surely one of the most hellish of maladies, food poisoning is no fun for anyone. But it can be avoided.

Two factors that come into play on Thanksgiving are the dangers of handling poultry and the dishes that other people bring to the feast. While you may have taken every precaution to avoid cross-contamination, you don’t know that Aunty Joan was so careful.

The Centers for Disease Control and Prevention states that “Handling poultry (chickens and turkey) incorrectly and undercooking it are the most common problems that lead to food-borne disease outbreaks linked to poultry.”

The advice? Thaw your frozen turkey safely. In the refrigerator in a container, in a leak-proof plastic bag in a sink of cold water (change the water every 30 minutes), or in the microwave, following the microwave oven manufacturer’s instructions.

Never thaw your turkey by leaving it out on the counter. A thawing turkey must defrost at a safe temperature. When the turkey is left out at room temperature for more than 2 hours, its temperature becomes unsafe. Bacteria can grow rapidly in the “danger zone” between 40°F and 140°F.

Always wash your hands after handling raw meat and make sure the turkey is cooked thoroughly by using a meat thermometer. It should reach an internal temperature of 165°F. Encourage family members who are bringing food to be extra careful when cooking in their own homes, too.

5. Dog bites

Thanksgiving is a great time for the humans in the family. But the arrival of strangers in a house, and all the frantic activity this creates, can be a time fraught with tension and anxiety for your pets.

The advice? The American Veterinary Medical Association (AVMA) suggests some ways you can protect your guests and your pet on Thanksgiving:

1. If you know your dog or cat is nervous when people visit your home, put him/her in another room or a crate with a favorite toy. This will reduce the emotional stress on your pet and protect your guests from possible injury.

 2. Even if your pets are comfortable around guests, make sure you watch them closely, especially when people are entering or leaving your home. While you’re welcoming guests and collecting coats, a four-legged family member may make a break for it out the door and become lost.

3. Eating turkey or turkey skin — sometimes even a small amount — can cause a life-threatening condition in pets known as pancreatitis. Fatty foods are hard for animals to digest, and many foods that are healthy for people are poisonous to pets – including onions, raisins and grapes. If you want to share a Thanksgiving treat with your pet, make or buy a treat that is made just for them.

Other advice for protecting your pets can be found on AVMA’s website.

6. Trips and falls

A house on Thanksgiving can be very crowded and overrun with people, dogs and children. Toys on the stairs, dogs underfoot — it can be a minefield. But trips and falls don’t just happen in the house. They can happen outside, in a packed grocery store or on the snow and ice.

The advice? Take your time. Walk slowly and carefully and don’t try to use your phone and walk at the same time. Make grandchildren aware that leaving toys around is dangerous and designate a room for their playtime. Test the sidewalk before stepping out to see if there’s ice on it. Walk with someone else if you can, so your friend can go for help if need be.

7. Food allergies

Food allergies can be deadly. Anaphylaxis from food allergies kills an estimated 200 people a year (although this statistic has yet to be confirmed by experts), but closer to 200,000 are hospitalized annually according to the Asthma and Allergy foundation of America.

Food allergies are on the rise. The CDC reports that the prevalence of food allergy in children increased by 50% between 1997 and 2011. So even though it may not impact your generation, the younger members of your family could be suffering with allergies.

The advice? The eight most common food allergies are milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat and soybeans. Make sure you check with everyone attending to see if any of these allergies apply to them.

If you are the person with a food allergy, make sure you carry your epi pen. It’s also important to share this information with anyone else who may be preparing food for the feast. Though it can seem like an inconvenience, it’s always better to be safe than sorry.

Are you ready for a piece of good news? There’s a common misconception that the suicide rate increases around the holidays but this has found to be false. The CDC’s National Center for Health Statistics reports that suicide rates actually peak in the spring and the fall. This pattern has not changed in recent years.

If you do have a family member who’s suffering from suicidal ideation however, make sure you offer them support. More information can be found here.

Eat, drink and be merry, but in moderation. You have so much to be thankful for — let’s keep it that way.