Marathons are bad even for people who aren’t running them

Image: Reuters/Fabrizio Bensch
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It’s no surprise that marathons, at 26.2 miles (42 km) long, are taxing on the body. Even the most conditioned runners finish races with similar body chemistry to patients who have undergone major surgery. But these races can also be harmful to people just near them.

A lot of marathons—especially the biggest ones—weave through major cities. Their hefty entry fees go in part to the costs involved in blocking off city roadways to accommodate thousands of runners. Great for marathon participants; not so good for those living nearby with poor health. A new report published by researchers at the Harvard Medical School shows that the disruptions to these usual routes of traffic can actually increase the death rates of patients trying to get to hospital emergency rooms in the area.

For their work, published (paywall) on April 13 in the New England Journal of Medicine, researchers pored over 10 years of Medicare data in 11 cities that all hold large marathons, including New York, Honolulu, Los Angeles, and Washington, DC. To narrow the scope of the work, the research team looked at patients who were admitted to hospitals specifically for heart attacks. They separated these patients by zip code to account for those who live nearby marathon courses and those who live farther away from them. Finally, they compared those who were admitted during marathon times (typically just the morning of the event) to those who were admitted before or after.

Of over 12,000 heart attacks—among patients split roughly 50/50 by gender, with an average age of 76—1,145 occurred during marathon racing hours near the race course. Compared to patients treated at other times or farther away, patients close to the marathon courses were 13.3% more likely to die in the month following their heart attack if it occurred during a race. Per race, that’s almost four more patient deaths.

Further examination of the data shows the poor outcomes are probably not because of the quality of care patients received, or due to pre-existing conditions. Rather, it seems to be a result of a longer ride in the ambulance.

Ambulances on the road during marathons took an average of 4.4 more minutes to get to the hospital than those working typical days. Even this short amount of time, just 264 seconds, makes for a 32% longer trip, and it has huge consequences for these patients. “Heart muscle dies quickly during a heart attack, so current guidelines call for rapid intervention,” Anupam Jena, a physician at the Harvard Medical School and lead author of the paper, said in a statement. “Minutes do matter.”

It’s not just marathons that pose these risks. Any large city-wide event, like parades (which really are just like slower marathons with more costumes and music), fireworks, or street festivals that block off or delay traffic pose a risk to patients trying to get medical attention. “The organizers of these events need to…find better ways to make sure that the race’s neighbors are able to receive the lifesaving care that they need quickly,” Jena said.

So runners, fear not—your hobby only puts you at risk. But the city’s planning around it may be a problem for others.