How Safe is the Marathon?

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.

Speeding?

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.