How Safe is the Marathon?

Posted: November 22, 2011 in Training
Tags: , ,

Two weekends ago, quite sadly there were two fatalities at the Rock n’ Roll Marathon held in San Antonio, TX.

This past Sunday I was searching for news about the Philadelphia Marathon which was marking the 5 year anniversary of my first marathon in Philly back in 2006.  Instead of reading about a tremendous race in a wonderful city with near perfect weather once again the headlines spoke of two more marathon related deaths.

This has been a tough year for the sport of marathoning with respect to running related deaths.  Savannah, Los Angeles, Chicago, Toronto all experienced fatalities during their events this year.  The sudden and surprising loss of a loved one – especially while participating in an endurance event that quite frankly very few can understand who have not taken on the challenge personally – seems unnecessary and quite tragic.

Comments after each article contain some level of a public appeal to “ban the marathon” as it simply is not worth the inherent risk.

The reality is that there is a significant “myth” surrounding the dangers of the marathon, just as there is a “myth” surrounding the story of Phillipedes who legend tells was the first marathon related death in history.

There have been numerous scientific/medical studies surrounding the inherent risk in marathoning – which after pouring over races, participant lists and related deaths come back with an estimate that there is an expected mortality rate of roughly 1:50,000.

One study conducted by the British Medical Journal (BMJ) examined all major marathons (with a participant list of over 1,000 runners) between 1975 and 2004.  These marathons held over 750 different days included 3,292,268 runners covering more than 14 million hours of exercise.

There were 26 fatalities.

0.8 in 100,000 participants.

Now I am not for one moment trivializing even .08 of one death in 100,000.  That is .08 too many.

But as I left the office for lunch today and walked by the 9 individuals smoking cigarettes outside the building – what exactly is the percent chance that one or more of those individuals are going to experience a fatality directly related to their chosen activity or “pastime”?

Well, according to Life Science Smoking accounts for 30 percent of all cancer deaths and 87 percent of lung cancer deaths; the risk of developing lung cancer is about 23 times higher in male smokers compared to non-smokers; smoking is associated with increased risk of at least 15 types of cancer; or that smoking causes millions of deaths worldwide.

What does this mean?  To the happy and dedicated smoker, it means nothing.  The Internet is rife with pro-smoking sites dismissing these kinds of facts.  There are billions of people, the argument goes, and they have to die of something, even rare diseases.  Rarely are simple messages heard, such as the fact that about half of all smokers will die from smoking, and of these, about half will die before or around age 50. 

Similarly, research from the ongoing Nurses’ Health Study, published in May this year in the Journal of the American Medical Association, finds that 64 percent of nurses who smoked died from smoking-related causes.  The life expectancy for a smoker in the United States is about 64, which is 14 years shorter than the national average (which includes smokers), according to the Centers for Disease Control and Prevention.

Going by these numbers it becomes clear that few pastimes, habits or addictions are deadlier than smoking.  Only Russian roulette and scorpion juggling come to mind.

I don’t see a requirement that before you pick up a pack of Marlborough’s you have to pass a stress test or undergo a rigorous cardio exam.  It’s a choice that individuals are making in how they want to live their lives.

How about wearing your seatbelt?  Seems like that should be done 100% of the time.


Drinking and driving?

Hell, I could make a case that eating Chicken Fried Steak is far more dangerous than marathoning, but I don’t want my neighbors showing up on my lawn tonight here in TX with pitchforks and torches.  (I do enjoy me a fine “chicken-fried” every now and again).

I think it is extremely wise for anyone who is thinking about taking up the sport of distance running to have a full physical.  I did so before I started training for my first marathon in 2006.  I was also told by my physician, a University of Pennsylvania Medical School Graduate with more than 25 years experience in practice that she would not be able to tell much at all about my readiness to train for the marathon by a simple examination.  My numbers, blood pressure, cholesterol levels all were excellent.

But if I had a genetic defect or a heart related congenital issue – it would not show up on any test.

The bottom line is that every runner who toes the line at a marathon is doing so for their own set of personal reasons.  They have weighed the risks and decided that the marathon is for them.  It is hard.  It is not for everyone.  That is part of the allure of the event itself, where athletes are there to test themselves and see if they have what it takes to do something that most others cannot or will not.

I can only speak for myself in saying that if I had not taken up the sport in 2005 I more than likely would still be at least 46 lbs. heavier than I am today (my weight before starting to run topped at 176 lbs.), I would be eating poorly and probably drinking a bit more than I should.

"Before" the Marathon and "After"

If you were going to lay odds, which “Dad” would have a better chance of being there to walk my daughter Landry down the aisle in twenty-five years?  Which one would be more likely to meet his grandchildren?

I’m putting my money on the six-time marathoner.  Run on people.

  1. Kim says:

    Excellent post, Joe!

    Good for you for taking control of your life and making changes! I am sure Landry will appreciate that as she grows & gets to know her dad.


  2. Kelly says:

    Thank you for writing this. I ran the Philly Half last weekend and it was a great race. One of the runners who died was a 21 year old college student running the Half (crossing only minutes after me), so this is not just related to older runners, or to running a full marathon. I have run many races where someone didn’t make it and many, many more races where there were no major injuries. Sadly, humans are mortal and people die every day, and 2 people out of 30k runners, plus thousands of volunteers and even double as many spectators, are actually pretty low odds. I run because I love it, but to stay healthy and to beat the health odds that plague my otherwise sedentary family history. I am very sad that even one of my fellow running comrades didn’t make it to celebrate their finish in the race, but it could have easily have been anyone on the race course including me, but it certainly wasn’t for lack of support by the race crew. Running in a race is an individual’s choice. We are not forced to sign up for a race and train for it. We also know the risks (even if some are hidden like an unknown heart defect), but choose to do it anyway. Banning a marathon (where it is adequately supported) will not stop people from running those distances on their own (unsupported). And I’m not going to stop running (or doing triathlons) any time soon, because I believe it makes my body and mind stronger and healthier than it does without it. And I plan to continue having fun running and doing triathlons until I’m well in my 80s+, or die trying.

    • joerunfordom says:

      Here, here Kelly – I think you really hit the nail sqaurely on the head. I think the changes that could be made would surround the number/amount and location of EMT/EMS individuals and those types of precautions in some cases, but for the most part at the larger events – this is more than well covered as well. It is a real tragedy what happened in Philadelphia and elsewhere so far this year, but could you even imagine the number of lives that have been prolonged and saved by running, training and racing? It is far greater than 1:50,000 or 1:100,000 that is for sure. Best to you – continued success in your racing and training!

  3. Jeff says:

    I think I’ve seen it written that if you want to live today you should stay in bed. But if you want to live 40 years from now, you should go running.

  4. wymberley says:

    I was at San Antonio. It was such a sad thing to hear a fellow runner died. Honestly, I think too many sign up and are under trained at the start. Many just don’t know what they are getting in to.

    • Joseph Marruchella says:

      Hi Wymberley! San Antonio certainly was a hot, hot day. The irony is a lot of the fatalities are not first-timers, but are repeat marathoners and people who have in fact trained and trained well. It is more common that there is an underlying heart issue that is undiagnosed than anything else – truly a sad, sad situation, but not one where simply blaming the sport or banning the event(s) will address. I think there is an answer out there, those two solutions just aren’t it …. take good care and congrats again on your race in S.A.!

  5. smacalli says:

    Great timing of this blog, Joe. Just yesterday I was looking into marathon deaths after seeing how many people have died this year and I found an article that said you should limit your caffeine to under 200 mg on race day and you should be careful with how hard you push at the end of the race. I’m not sure if either of those is true, but I love running and I’m not giving it up because of the unfortunate deaths of a small amount of runners. My 21-yr-old cousin died in 1990 from a congenital heart defect that nobody knew about until the autopsy. He was riding a bike with a friend in the mountains near El Paso to try to lose some weight. He played sports all throughout high school and failed the physical he took to get clearance to try out for college football because of a bad knee. No heart problem was ever detected. I guess what I’m saying is how many people in other situations pass away because of a previously undected health problem? Of course, it’s tragic. To think of the excitement, preparation, and everything that goes into race day culminating with a death is heartbreaking. But put it into perspective with everything else in our lives. I’ll take my chances, too, but it’s not really a “risk” when you look at the facts.

    • Joseph Marruchella says:

      Shelley – so sorry to hear about your cousin – just tragic. Stories like that one are all too common. If you think about the HS and College Basketball players who have suffered similar sudden heart failures after physicals and being in tremendous shape – it is something that truly comes with the territory with athletics, sports and fitness. We’re a special group obviously when you talk about distance runners and endurance athletes where going into an event we expect to be pushing our limits before we stop – I think that makes it a bit more difficult for us to self-monitor if we start feeling badly, everyone feels bad during the late stages of a marathon – but with all the course support and medical professionals on hand, I think the organizers and directors are doing all they can to prepare for any health-related issues. In the end it is a choice we are making and we have to own and understand the inherent risks. As we have all stated – the trade-off is a big win for being fit.

  6. Layla says:

    Thank you for posting this, and for taking the time to do some research. My friends and family thought I was nuts for jumping out of an airplane, and I know people who say skydiving should be banned. But when I ask them how many fatal car crashes they hear about, and how many miles they drive every year, they get quiet. The same thing applies to marathoning. When it comes down to it, I would much rather die while running and LIVING, than while mindlessly driving my car.

    • Joseph Marruchella says:

      Layla – thanks so much for the visit and the message! One of my favorite quotes from a favorite movie is, “Get busy livin’ or get busy dying.” From Shawshank Redemption. Exactly right. Best to you Layla! Have a great Thanksgiving Holiday.

  7. traintotri says:

    Interesting post, Joe. It’s definitely a difficult subject – I certainly don’t think marathons should be banned or regulated. On the other hand, it’s easy for runners to say that they accept the risks – but how seriously do they believe that it could actually happen to them? They feel healthy and strong – they’re endurance athletes, after all. I collapsed at Mile 24 of my first marathon. Thankfully medical personnel were close by and I was OK after a few days in the hospital. I freely admit that my failure was mostly my fault for not respecting the conditions – a sudden heat wave on the day of my November race – but no one ever thinks it’s actually going to happen to them. We obviously don’t want to stop people from running, so maybe the answer lies in greater awareness – by race and medical officials as well as by fellow runners. It really could happen to any of us, and, as you pointed out, there’s often no way to predict it before it happens. Thanks for bringing up the topic.

    • joerunfordom says:

      Scary stuff indeed, so sorry to hear about that first marathon experience of yours – kudos to you for coming back and teeing it up again – not sure I would have had the gumption to do that. I think you hit it spot on where the EMS/EMT presence and course monitoring is where I think positive changes could be made at some events – others, I think they are doing really all that could be expected.

      The athlete knows best how they are and what their body signs are telling them – unfortunately, we’re talking about usually a Type-A personality, push through the pain, you’re tougher than this type of athlete – asking for help or quitting just isn’t wired in the DNA of a lot of marathoners … therein lies a large portion of the challenge.

      The next marathon I feel “great” in over the final 4 miles will be my first. Sad but very true.

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