Marathon running and sudden deaths

Exercise is an integral element in the advise for a healthy and long life. There are those , including myself who love running and run or ran marathons.
The distance is considerable and the training demanding. People die on such runs.
It is therefore interesting to read a paper which studies marathon running and the chances of sudden death.
Redelmeir and Greenwald looked at the risk of sudden cardiac death associated with running in an organised marathon compared with the risk of dying from a motor vehicle crash that might otherwise have taken place if the roads had not been closed.
They looked at Marathons with at least 1000 participants that had two decades of history and took place on public roads in the United States, 1975-2004.
The marathons provided results for 3,292,268 runners on 750 separate days about 14 million hours of exercise.
There were 26 sudden cardiac deaths observed, equivalent lo a rate of 0.8 per 100000 participants. Because of road closure, an estimated 46 motor vehicle fatalities were prevented, equivalent to a relative risk reduction of 35%. The net reduction in sudden death during marathons amounted to a ratio of about 1.8 crash deaths saved for each case of sudden cardiac death observed (95% confidence interval: 0.7 to 3.8). The net reduction in total deaths could not be explained by re-routing traffic to other regions or days and was consistent across different parts of the country, decades of the century, seasons of the year, days of the week, degree of competition, and course difficulty. So organised marathons are not associated with an increase in sudden deaths from a societal perspective, contrary to anecdotal impressions fostered by news media.
Redelmeier and Grenwald 2007 Competing risks of mortality with marathons: retrospective analyis BMJ . vol 335, 1275-7

Martin Eastwood
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