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The risks of marathon running: should you be worried?

Researchers in France took a look at the numbers to find out just how dangerous marathon running really is

Across the world, millions of people run marathons and other endurance races every year, and the vast majority of them experience no adverse health effects. Still, every so often you hear a tragic story of a runner who did not make it to the finish line. As with any physical activity, there are certain risks associated with participating in a marathon, but should runners be concerned? Recent research from France took a deep dive into the health risks of endurance running, and concluded that most runners needn’t give up their marathon dreams just yet.

STWM 2019 race start. Photo: Maxine Gravina

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The researchers involved in the study analyzed race results from the Paris Race Registry, which recorded all life-threatening or fatal events that occurring during 46 marathons from 2006 to 2016. Out of more than one million participants during that time period, they recorded 3.35 per life-threatening events per 100,000 runners, 1.02 instances of exertional heat stroke per 100,000 runners and 2.33 major cardiac events (including 18 sudden cardiac arrests) per 100,000 runners. One third of the runners who experienced a major cardiac event had clinical symptoms prior to the race, and these events were more common if there was a lot of air pollution on the day of the race.

Similarly, the researchers looked at a meta-analysis of eight long-distance race registries comprising more than 16 million runners, and also found a very low instance of sudden cardiac arrest and fatality, at 0.82 per 100,000 and 0.39 per 100,000, respectively.

The takeaway

While the instance of race-related life-threatening events remains very rare, when they do happen, they can be serious. The researchers conclude that better information on the risks of pre-clinical symptoms as well as outside air pollution on race day is necessary. In simpler terms, it’s important for runners to be aware of the symptoms of a heart attack, and to be aware of their health status prior to participating in a marathon or other long race. You may also want to consider air pollution as a factor when deciding which race you want to enter.

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