codoon report: over 100 million chinese runners face risk of sudden death
According to the '2017 China Marathon Big Data Analysis Report,' the number of marathon participants in China reached 4.98 million in 2017, a 77.9% increase from 2.8 million in 2016. As the marathon craze sweeps across the country, incidents of injuries and even sudden deaths during races continue to occur. In 2017 alone, according to incomplete statistics, there were at least 8 reported cases of sudden deaths during marathons and at least 24 cases of fainting, with countless other injuries. To investigate the reasons behind this phenomenon and identify measures to reduce exercise risks, Codoon conducted a nationwide survey on the risk of sudden death in marathons, ultimately receiving 13,628 valid questionnaires.
The report found that a lack of understanding or misconceptions about scientific exercise knowledge, not undergoing regular physical examinations, and not paying attention to heart health are among the reasons why 35% of the 300 million domestic runners, including marathon participants (approximately 105 million people), are at high risk of exercise-related injuries and sudden death.
(1) Nearly 50% of marathon runners do not meet physical fitness and experience standards, posing significant safety risks.
Experts believe that to participate in a marathon, one should have at least one year of continuous running experience to ensure that their body can withstand the immense challenge of a marathon.
A high 44.75% of respondents stated that they had participated in a marathon. However, among these people, 43.31% had less than one year of running experience, 39.75% had 2-3 years of running experience, ranking second, and only 12.99% had more than four years of running experience. Additionally, 3.95% had no running experience at all and never exercised regularly, yet they had participated in a marathon.
Those with less than one year of running experience and those with no running experience combined accounted for a high 47%, making these physically unqualified participants a significant safety risk in marathon events.
In China, well-known events such as the Beijing Marathon and the Shanghai Marathon review participants' past performance to ensure their physical fitness. However, in recent years, the craze for hosting marathons has surged across various regions. Many small and medium-sized event organizers have significantly lowered the entry thresholds and review standards to attract participants, which has, to some extent, fueled the misconception that 'anyone who can run can participate in a marathon.'
(2) More than 50% of marathon runners never undergo pre-race physical examinations, mistakenly treating marathons as fitness activities.
Many marathon event organizers require participants to undergo pre-race physical examinations. However, in the survey, 57.07% of participants admitted that they had never undergone the required pre-race physical examination, while only 42.93% strictly followed the requirements and underwent the examination.
According to runners, many participants currently forge physical examination certificates by modifying names through Photoshop and other means. Numerous 'help posts' and 'experience sharing posts' of this kind can be easily found online, with most people stating that they do this simply because they find the process cumbersome.
Regarding the purpose of participating in a marathon, 88.79% said it was for fitness, 8.28% participated to accompany friends or acquaintances, 8.79% joined to follow the trend and increase social conversation topics, and 15.8% said they participated on a whim to experience it.
This shows that many runners misunderstand the significance of marathon races and underestimate the difficulty of the competition. The essence of a marathon is a competitive race, not a fitness activity to improve physical fitness. It is an extreme test of both physical and mental endurance, accompanied by risks such as pain and injury, and is not suitable for everyone. Without extensive experience, participating rashly can cause irreversible damage or injury to the body.
(3) 50% of runners do not undergo regular physical examinations, and 30% have experienced heart discomfort but did not seek medical attention.
Not only do marathon events have hidden dangers such as participants not meeting physical fitness standards and passing physical examinations through deception, but this survey also found that 55.3% of general exercise enthusiasts rarely or never undergo physical examinations. Their physical condition, especially heart health, which is directly related to sudden death, is very concerning.
The survey found that 30% of respondents had experienced at least one symptom such as chest pain, chest tightness, dizziness, shortness of breath, or abnormal heartbeat while running, but only considered it exercise fatigue and did not undergo timely physical examinations or seek medical attention.
These symptoms can more or less reflect heart health. For example, chest pain could be a precursor to a heart attack; persistent dizziness during exercise, accompanied by excessive sweating and confusion, could indicate nervous system, blood pressure, or heart valve diseases; sudden shortness of breath could be caused by heart failure, asthma, or heart disease; and abnormal heartbeat is generally a symptom of arrhythmia, possibly atrial fibrillation. Doctors recommend stopping exercise immediately and seeking medical attention if these symptoms occur.
(4) Nearly half of the runners lack knowledge of safe exercise practices and urgently need education on heart rate knowledge.
In the multiple-choice question 'What are the causes of exercise injuries?' we set four very obvious options, including not warming up and stretching, incorrect exercise posture, cardiovascular diseases, and excessive exercise intensity. However, the selection rates for these options ranged from 50% to 75%, indicating that 25% to 50% of runners still do not have a comprehensive understanding of safe exercise practices.
Secondly, when asked to choose the factor that most affects exercise effectiveness, only 38.71% chose the correct option 'heart rate,' while 20.18% chose exercise duration, 4.45% believed the amount of sweat determined exercise effectiveness, and a significant number chose pace (the time it takes to complete 1 kilometer), ranking third at 18.47%.
Ignoring one's heart's capacity and blindly pursuing speed is also a common mistake among many marathon runners. In the survey, nearly 10% (9.52%) of runners chose to sprint at full speed near the finish line, a habit that poses certain dangers in marathon races. Looking at the tragic sudden deaths in marathons over the past four years, 15 out of 22 cases occurred within about four kilometers of the finish line.
(5) 90% of people know that sudden death is related to the heart, but only 5% of runners wear heart rate monitoring devices.
92.08% of respondents believe that sudden death during exercise is caused by heart overload, but in real life, people do not pay much attention to heart rate changes. Only 5% of exercisers use heart rate monitoring devices to observe their heart rate.
According to the '2017 National Runner Survey Report' released by Running USA, 18% of American exercisers wear heart rate monitoring devices. In comparison, the penetration rate of heart rate devices in China is less than one-third of that in the United States.
In China, 60.6% of people do not know how to calculate their maximum heart rate, nearly 50% of runners rely solely on their physical sensations to gauge heart rate changes, 30.52% said they would not pay attention unless their heart felt particularly uncomfortable, and 16.23% never pay attention to their heart rate.
(6) The high price and inconvenience of heart rate devices are the main obstacles to their widespread use.
We also surveyed why domestic exercisers do not use professional devices to monitor their heart rate. The high price and inconvenience of heart rate devices ranked first and second, respectively.
If the price of heart rate devices is not considered, nearly 50% (45.84%) of respondents would most like to use heart rate earphones, which are not only convenient to wear but also meet the needs of heart rate monitoring and listening to music during exercise. 35.63% would like to use heart rate watches. The lowest proportion, only 5.64%, chose heart rate belts, which is also related to the inconvenience and discomfort of wearing heart rate belts.
In recent years, under the strong promotion of the 'National Fitness' initiative, the number, duration, and age diversity of exercisers in China have made significant progress. However, a lack of correct exercise knowledge and blind exercise can bring hidden dangers and even tragedies to individuals and society—exercise injuries and sudden deaths are frequently reported in the news, which is regrettable.
With the approach of the Beijing Winter Olympics, it is believed that the nationwide exercise craze will become even more intense. Codoon released this report at this time to draw attention from all sectors of society to scientific and safe exercise and to promote a rational understanding of marathon events. Only safe exercise is sustainable; only by following scientific exercise methods can we avoid the pitfalls of ineffective exercise, allowing more people to fall in love with exercise and enjoy healthy bodies.