ZERO DROP "All the Shoes That Fit"

9Feb/11Off

Runner, 35, Dies at San Francisco Half-Marathon

It has happened again.  A death in a race. Last Sunday, a 35-year-old male runner died close to the finish line after nearly completing the Kaiser Permanente San Francisco half-marathon. Bay Area resident Peter Hass had been running for two hours when he collapsed. It was an unseasonably warm day. According to several media reports, witnesses said that Hass didn't have a "fighting chance," since medical staff and paramedics didn't arrive for  20 minutes.

What makes this death even more tragic and disturbing was that the title sponsor, Kaiser Permanente, is one of the state’s largest hospital chains. Yet, there were no paramedics or medical staff at the finish line. And the one ambulance provided by the race organizer, Rhodyco, which has been producing running events for over 20 years, was out on the course attending to another runner.

After Hass fell to the ground, race volunteers pleaded for help. An announcer made repeated calls for medical assistance, yet only runners standing around came to Hass' aid and performed CPR. Local blogs have been filled with commentary by runners who saw firsthand what happened. Here’s one comment: "{Hass) laid there for 31 minutes (I counted) without true medical support, other than the CPR being provided by staff at the finish line. Where were the paramedics? No defibrillator at the finish line? No ambulance at the finish line? You've got to be kidding right?”

It’s not the first time either that a man has died in a San Francisco race. In 2006, Bill Goggins, 43, died during the San Francisco Marathon. He had been a long-time editor at Wired magazine; in fact, Zero Drop knew Bill who interned at a magazine he helmed in the early 90s. He was fit.

Whenever a runner dies of heart failure in a race, it becomes an instant media story. Usually, the interest has to do with the intrinsic value of  long-distance running, of questioning whether pushing oneself too far or too fast is a sensible thing to do. Maybe running is unhealthy? But this viewpoint comes up short in several regards. Running prolongs life and general well-being. The real question should be how much running is good for heart health, especially for high-risk individuals. “The well-established risk factors for heart disease,” writes long-time New York Times health reporter Jane Brody, “remain intact: high cholesterol, high blood pressure, smoking, diabetes, abdominal obesity and sedentary living.” But when exercise enters the picture, matters significantly improve. As proof, Brody cites The No Bull Book on Heart Disease by Dr. Joel Okner, a cardiologist in Chicago, and Jeremy Clorfene, a cardiac psychologist. The authors point to a 1996 study that showed only fifteen minutes of exercise five days a week decreased the risk of cardiac death by 46 percent.

So why are people dying in marathons and half-marathons? Aren’t these people in good shape? At the 2009 Detroit Half-Marathon, three male runners died within sixteen minutes of one another.Their ages were twenty-six, thirty-six, and sixty- five. The previous weekend, a twenty-three-year-old male competing in the Baltimore Marathon died.

A study published in the British Medical Journal examined twenty-six U.S. marathons between 1975 and 2004. Over this thirty-year period, there were twenty-six sudden cardiac deaths, statistically equivalent to 0.8 fatalities per 100,000 participants.The typical victim was a forty-one-year-old male; 19 percent were women. Five of these deaths occurred in individuals who had previously completed a marathon. One fact from the study leaps out.  Most of these deaths took place within one mile of the finish.Which meant that the individual was pushing too hard, far past his or her physical limits.These deaths were preventable.

Actuarially speaking, the risk of sudden cardiac death in a marathon is two deaths per million hours of exercise. (The odds of dying from a bee sting are one in 117,000; from lightning they’re one in 79,000.) Of the twenty-four marathon autopsy reports available in the British Medical Journal study, most of the cases were due to atherosclerosis, followed by electrolyte abnormalities (water intoxication coupled with severe salt loss) and heat stroke.

Maybe it’s time to start requiring runners to have a medical checkup before entering a race (no matter the distance). Electrocardiograms are simple and inexpensive tests that can help diagnose many potentially fatal heart problems. Italy, in fact, requires all participants in a marathon to complete a medical sports fitness test that includes an electrocardiogram. Sadly, even the fittest people can be struck dead in a race. In 2007, Ryan Shay, twenty-eight, and one of the U.S.’s top long-distance runners, collapsed during the Olympic marathon trials. He had previously run seven marathons. His autopsy reported the cause of death to be cardiac arrhythmia and cardiac hypertrophy—abnormal beating due to an enlarged heart.

Until there's a coroner's report, the exact cause of Hass's death won't be known. But one thing is clear: better medical support at the finish line might have saved his life.

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