Are deaths during marathons increasing?

Note: This post is the next in a series of posts focusing on topics related to Olympic sports. For more discussion of injuries and topics related to athletes in this year’s Olympic Games, check out Episode 49 of The Dr. David Geier Show. Also share your suggestions for topics related to the Summer Olympics below!

There seems to be increased media attention on deaths that occurred during or after marathon events recently. In fact I discussed the idea of catastrophic cardiac events related to ultra-endurance training on a recent episode of my show, but I did not specifically focus on the actual marathon event.

But are deaths in marathons actually increasing? Is the media focus just creating the sense that deaths are rising? If there is an increase in deaths, is it related to an increase in participation in marathons? Or does the increased popularity of marathon running lead more unhealthy people to attempt to run them, which could increase the death rates?

With the Women’s Marathon scheduled for Sunday, August 5 and the Men’s event scheduled for the final day of competition, August 12, I thought it would be a good time to discuss catastrophic events in marathons. A recent study in the July 2012 issue of The American Journal of Sports Medicine offers some insight into these questions.

Simon C. Matthews et al searched three comprehensive running databases for all marathons held in the United States from 2000 to 2009. During that time, there were 3184 marathons with 6341 races. The number of marathon events held in United States increased each year during that period. The number of runners who finished marathons in these races also increased during this time from 299,018 in 2000 to 473,354 in 2009. Overall 3,718,336 people participated in marathon events during this 10-year period.

With respect to deaths during these races, the authors shared some interesting data:

  • 28 people died between 2000 and 2009. 22 males and 6 females died during or within 24 hours of finishing the marathon.
  • The death rate during marathon events was 0.75 per 100,000 participants. This statistic remained essentially unchanged throughout these 10 years.
  • The median age of runners who died was 41.5 years.
  • 50% of all runners who died were less than 45 years old.
  • Heart disease caused most of the fatalities. Myocardial infarction and coronary atherosclerosis was the known cause of death for 93% of the fatalities.
  • The median distance the participants who died had run during the marathon was 22.5 miles.
  • The month of October saw by far the highest proportion of marathon deaths. Despite only 17.5% of races being held during the month of October, 39.3% of all deaths occurred during the month of October.

The authors concluded that while there has been a significant increase in participation in marathons across the United States over this decade, there has not been a subsequent increase in deaths. Also the assumption that less active people were running marathons and subsequently dying more often did not actually prove to be true. In fact, the average finishing time of marathons did not really change. In 2000, the average finishing time was 4:34:47, compared to 4:35:28 in 2009.

I don’t share this study or its statistics to scare people away from running. I would argue that the death rate from marathon events is comparable to many athletic competitions. Also the benefits of regular exercise, not just for physical health but also for many other aspects of health and well being, are tremendous.

I think this study has value, though, for marathon participants as well as event organizers. Runners planning to compete in marathons might consider seeing their personal physician prior to the event and even undergoing an ECG or other diagnostic cardiac testing if needed. Also marathon organizers need to have appropriate medical personnel in place prepared to treat runners should these events develop. Maybe they could place the majority of responders along the end of the course and at the finish line, since most of the deaths seemed to occur at or after the 22-mile mark. Further studies to better identify risks of cardiac deaths that could predict which runners could be in danger will help decrease these deaths in the future.

What do you think? Do these statistics surprise you? If you are a marathon runner, do you worry about suffering a heart attack from training or during marathon competition? Share your thoughts below!

7 Responses to Are deaths during marathons increasing?

  1. This is probably a pet subject of mine right now.

    I have been running for the past 25 years. I have been in 10k races where there have been deaths. I have also been in longer trail runs where a man died of hyponatremia.

    I ran with the cross country team in college, then ran for years to perform better in triathlons, and more recently in long (multi-day) adventure races.

    I won’t argue with the research, but I also to look at my personal experience.

    Long distance runnings requires consuming large amounts of carbs, which aren’t that great for the body.

    I know I feel much better when I am not eating a lot of carbs. Does this mean I can’t run ? Nop but I prefer to run shorter distances.

    With age I also noticed that many runners around me develop issues with their back, knees, hips and other joints.

    • Great thoughts John! When I read this study, my initial concern was that the idea of deaths during marathons might scare people from pursuing that goal. I think that the benefits of running, and really all exercise, far outweigh the risks. If you choose to run marathons, you should probably see your doctor every year for a physical and make sure you aren’t developing long-term changes in your heart and its blood vessels. And I agree that people with other joint issues might consider shorter distances and/or other forms of exercise. Lastly, it’s funny you say that about the carbs. I largely gave them up about 18 months ago, and despite people saying I would feel tired, I actually feel much better. That’s just me, though. Thanks again for the great comments!

  2. I used another risk measurement ‘FAR’ (Fatal Accident Rate -death rate per 100million hours of activity), assuming a 4hour average time per athlete. Using the data above I arrived at 188 deaths per 100million hrs of activity over the 10 year period. Still not alarming to me! Great article-and well supported with data. It would be good to know the average age of all runners for comparison with the average age of those who died. I just read somewhere that the over 50’s should embrace long distance running without fear. Wish I had seen this article earlier-so interesting.

  3. Well to clarify above, the FAR arrived at (188/100mill hrs) is far higher than that of other industries, so on that basis one can argue about the comparative risk being higher than say a construction worker or a daily commuter. I still think the benefits of marathon running far outweigh the risks.

    • Hey, I really appreciate the thoughts and comments. Yes, I agree the benefits of running are tremendous. I think regular marathon runners might want to have regular EKGs performed by their doctors to follow any cardiac changes. Thanks for reading and for the feedback!

      • In 1991, I published in the LANCET; Extraordinary unremitting endurance exercise and permanent injury to normal heart; it was a result of my study of Sy Mah, holder of the Guinness Book of Records for completing 524 marathons.It has been cited in the medical literature well over 50 times.The primary problem— particularly in males with a cardiovascular mortality rate 6 times higher than females, under age 35— is the reduction of magnesium ion levels; in turn higher adrenaline levels and vicious cycles.

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