New research has identified how marathon organisers and medical teams can cut the risks of medical and life-threatening emergencies during and after marathon and ultra-marathon races.

The research has found that marathon runners who run very fast, run very slow, compete in high temperatures or are female face significantly higher risks of a medical or serious life-threatening medical emergency.

Lead researcher Nicola Sewry of the University of Pretoria said “The findings could help race organisers and medical teams create safety and prevention plans tailored to these risks.”

The research, published in the November 2024 edition of the Journal of Science and Medicine in Sport (JSAMS), found that age only has a minor impact.

Risk factors for all medical emergencies include:

• Being female increased the risk (47% higher than men).
• Age had a minor impact.
• Hotter weather (higher WBGT, wet-bulb globe temperature) increased the risk by 33%.
• Running either very fast (in the top quarter) or very slow (in the bottom quarter) increased the risk by about 50% compared to middle-paced runners.
• The downhill route was slightly riskier than the uphill route.

Risk factors for serious life-threatening medical emergencies include:

• Risk was almost twice as high for women compared to men.
• Downhill races were riskier than uphill races.
• Both fast and slow runners had more than twice the risk of middle-paced runners.

The research examined five years of data from the world’s oldest and largest ultra-marathon, between the South African cities of Durban and Pietermaritzburg. More than 103,000 runners competed during the research period.

The study is published in the November 2024 edition of the Journal of Science and Medicine in Sport.

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About JSAMS

The Journal of Science and Medicine in Sport (JSAMS) is published by Sports Medicine Australia.

The journal provides high-quality, original research papers to keep Sports Medicine Australia members and subscribers informed of developments in the areas of sports exercise and medicine, sports injury, physical activity, and sports exercise and science.