Endurance events tend to be tales of triumph but, like the Greek fable for which marathons are named, they are occasionally marred by the deaths of participants. Most recently, the London Marathon experienced the death of 31-year-old Captain David Seath just three miles from the finish line; it was the 14th death in the event’s 35-year history.

Statistically, endurance deaths are rare: one study found that the risk of dying at a marathon is 0.8 per 100,000 people, with triathlon deaths at 1.5 per 100,000 people. But given that more than half a million people run marathons each year in the U.S. alone, it is a very real possibility that all race organizers must prepare for.

Why Deaths Happen

While seizures, asthma attacks and heat strokes do happen, the most common cause of endurance deaths is an underlying heart problem. For racers over 45, it is heart disease. For younger racers, it is often a cardiac disorder they didn’t know they had.

In addition, some speculate that the rise in endurance races’ popularity has led more untrained amateurs to participate, leading to both more injuries and more deaths.

How to Prevent Them

Education and preparation. These deaths often happen because people are either unaware of their condition or uneducated about proper training and the toll of a race. The London Marathon (and many other races) send entrants a medical advice sheet and waiver. It suggests participants be able to run 15 miles one month before the event and speak with their doctor about any concerns; participants must also agree they are responsible for their own health.

You, too, will have to create a waiver with a lawyer and educate your participants. Recommend athletes examine their family history and get a physical exam as well as an electrocardiogram (EKG) to test for any cardiac abnormalities. Tightness in the chest or arms during exercise can also signal a heart problem.

You will also want to teach participants (and your team!) about proper hydration and nutrition. Alcohol, caffeine, and sodium can dehydrate and increase the risk of heat stroke. Some medications can also trigger reactions.

Race Day Precautions

race-organizers_chronotrackIf you think you have more medical staff than you need, you’re doing it right! It should go without saying that medical support is not something to skimp on. Advise hospitals beforehand and place clearly marked first aid tents along the course so racers who are even slightly concerned have a place to rest (or at least grab more moleskin). Consider renting misters and shade canopies for summer races.

Be aware of your course’s limitations. Factor in race day commotion and test your medics’ response times to different points on the course. This is especially important if you have a unique course such as a trail or, in triathlons’ case, water. If race day conditions are dangerous, don’t be afraid to change the course or cut it short. The 2015 Rock ‘n Roll Savannah Marathon, for example, had to be shortened by almost 7 miles due to the heat. Participants from that race understood the need for safety first (though it doesn’t hurt to give them a rain check for next year).

If Something Happens

Once the facts are confirmed, speak with your race’s medical director and issue a statement to inform the public and offer your condolences. You do not have to say much, but be sure to consult the participant’s family before releasing any identifying details.

And though it may seem strange to continue celebrating after such an incident, you cannot forget your other racers. While not saying anything would seem disingenuous, cancelling the rest of your event would also be inappropriate. Instead, take a moment of silence with your participants then continue the congratulations afterwards.

Just as you would with any incident, you will want to conduct an internal report to analyze the death and your race in order to fine-tune your responses and prevent future deaths.

Don’t Fear the Race

The stories of endurance race deaths could alarm even the most experienced athlete or race organizer. But the benefits of exercise typically outweigh the risks, and deaths at races continue to be rare. As sports medicine specialist Dr. Joel Brenner stated, “It’s not a reason not to run, it’s a reason to run smart.”

As a race organizer, don’t worry about scaring off participants by presenting the facts. They’ll appreciate the tips and trust us, they’ll understand. Endurance athletes don’t underestimate the achievement of a race, so why would they underestimate the challenge?

For more race management tips, contact ChronoTrack!