Thursday, May 5, 2011

Marathon Risk? Compared to What?

Marathon Risk Perspective
Dr. Redelmeier, who has run a marathon, said he began his study out of annoyance with the enormous attention given to each death in a marathon — often even greater, he added, than the attention paid to the winner. When someone died in the Toronto Marathon, he said, there were immediate calls to close it down.
“It has a chilling effect,” he said, “and becomes one more excuse not to exercise.”
So he and his colleagues decided to examine data from 26 American marathons over 30 years. They included results from 3,292,268 runners on 750 race days and 14 million hours of running. For comparison, they also examined national data on traffic fatalities, estimating how many would be expected to occur in the area on marathon day and comparing that with the number that did occur.
Fewer than 1 in 100,000 people died while running a marathon, Dr. Redelmeier and his colleagues reported. The chance that a middle-aged man — the typical marathon fatality — would die while running a marathon was about the same as the chance a middle-aged man would suddenly die anyway.
Dr. Thompson, the Hartford cardiologist, said there was another way of making the comparison. He noted that middle-aged men who run marathons are not typical of men their age. He said their risk of dying while running a marathon, while low, was nonetheless about seven times their risk of dying at other times.
Dr. Redelmeier also said his results did not depend on the marathon — some, like the one in Boston, have rigorous entry criteria for most runners and so tend to have a fitter group of athletes. Some are run in the heat, others in the cold. On some the course is flat, and on others it is hilly. The death rate, on average, was the same low number.
The study also found that half the people who died in a marathon did so while running the last mile and almost no deaths occurred in the first 13 miles.

I like this article for the way it contextualizes risk - is it sad when a person dies while marathoning?  Yes, but that doesn't mean that someone wouldn't have died from something else were the marathoning stopped.  IOW - virtually every risk is a trade off for other risks. 

I wish the article had covered cause of death - dehydration, hyponatremia, rhabdomyolosis, or over heating seem to be the most likely causes.

What they didn't answer but should have was whether the risk of a bunch of folks traveling to Boston, for example, is riskier than running the marathon - it might be!  Another example of the same concept - a small child or baby was killed in an aborted takeoff.  It was determined that the life may have been saved if the child were required to be in its own seat with a 'carseat' type restraint vice its mother's arms.  Would lives be saved if it was a requirement to have a paid airline seat for all children regardless of age?  Not necessarily - because some would not be able to afford the extra seat and might choose to travel by auto, which is statistically riskier.  IOW - the law to require all ages of children to travel in a paid for seat in a child restraint might result in MORE deaths, vice fewer.

In fitness generally, there is a lack of clarity in thinking as regards injury.  Sports of any kind are riskier than virtually any training in weights or 'cardio' - basketball, jogging, softball, or soccer, each is far more risky than virtually any weight training regimen.  But mainstream fitness has been 'dumbed down' so far that there's no risk and virtually no reward. 

More to follow on this topic, generally, but specifically, what risks would you be willing to face in order to gain your desired level of fitness? 

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