Mortality Among Marathon Runners in the United States, 2000-2009

Background:As participation in marathon running has increased, there has also been concern regarding its safety.Purpose:To determine if the increase in marathon participation from 2000 to 2009 has affected mortality and overall performance.Study Design:Descriptive epidemiology study.Methods:We used publicly available racing and news databases to analyze the number of marathon races, finishing race times, and deaths from 2000 to 2009 in marathons in the United States.Results:The total number of marathon finishers has increased over this decade from 299,018 in 2000 to 473,354 in 2009. The average overall marathon finishing time has remained unchanged from 2000 to 2009 (4:34:47 vs 4:35:28; P = .85). Of 3,718,336 total marathon participants over the 10-year study period, we identified 28 people (6 women and 22 men) who died during the marathon race and up to 24 hours after finishing. The overall, male, and female death rates for the 10-year period were 0.75 (95% confidence interval [CI], 0.38-1.13), 0.98 (95%...