LAUSR

Background During the last decade, an increasing popularity of marathons has been seen. Although running has been shown to have considerable positive health effects, the risk of sudden death, most often due to sudden cardiac arrests, is also a risk runners expose themselves to. Whilst there are some studies on the mortality amongst long-distance runners, much of the evidence is dated. Given the increased popularity in running during the 21st century as well as the improvements in medical care at marathons, more knowledge is required on the mortality risk. Materials and method Publicly available racing and news databases were used to identify the number of entrants and finishers in half to full marathons in Sweden between 2007 and 2016 and the number of deaths that occurred in conjunction with the races. Results A total of 1,156,271 runners entered a long distance (21-42km) running race in Sweden between 2007 and 2016, and 834,412 runners finished the races (72.2%). A large majority of the finishers (677,050 (81%)) competed in distances under a full marathon. Two deaths occurred during the time period, meaning that the death rate was 0.24 (95% confidence interval 0.04–0.79) per 100,000 finishers. Conclusions This study can show that death rates in long distance running races between 2007 and 2016 in Sweden are very low, compared to previous studies. When added to the existing literature, the combined picture suggests a general downward trend in the risk of death during marathons since the 1980s.