Key result
Greater apparent temperature variability linked to ~6.6-fold higher marathon sudden cardiac arrest per 1 °C increase.
Why the study?
Climate change has increased extreme weather events, raising concerns about temperature-related sudden cardiac arrests during marathon events, with recent rises in SCAs at the Taipei Marathon.
Does short-term apparent temperature variability increase the incidence of sudden cardiac arrest in marathon runners?
Observational (n=316,446)
No
Does short-term apparent temperature variability increase the incidence of sudden cardiac arrest in marathon runners?
Greater short-term apparent temperature variability in the days preceding a marathon is strongly associated with an increased risk of sudden cardiac arrest on race day.
Answers are grounded in this paper and cite their sources.
Temperature variability was associated with higher marathon sudden cardiac arrest rates; leaves open whether monitoring or mitigation alters outcomes.
Background: Climate change has led to a discernible increase in the intensity of extreme weather events, contributing to growing public health concerns regarding temperature-related mortality and morbidity. Recently, there has been an increase in the number of sudden cardiac arrests (SCAs) occurring during annual Taipei Marathon events compared with previous years. This study aimed to explore the correlation between weather conditions and SCA risk in runners. Methods: This retrospective observational study used data from the Taipei Marathon event held between 2013 and 2024 in Taiwan. We examined the relationship between the SCAs and weather conditions for each year using a Poisson regression model. Results: Among the 95,866 full- and 220,580 half-marathoners, all SCAs occurred in Taiwanese runners. There were three SCAs in male marathoners (median age, 50 years). In half-marathon runners, 10 SCAs occurred (median age, 30 years), including nine males and one female. Each 1 °C increase in the standard deviation of apparent temperature (AT) over the 7-day time window (lag 0-6) was associated with an SCA incidence rate that was 6.63 times as high on race day (IRR = 6.63, 95% profile likelihood CI 1.85-52.11; LRT p < 0.001). The incidence rate was significantly higher during half-marathons than during full marathons (4.53 versus 3.13 per 100,000 participants) and among men than among women (5.17 versus 1.18 per 100,000). The highest proportion of SCA (61.5%) occurred in the final quarter of the race. Bystander-administered cardiopulmonary resuscitation (CPR) was provided in all SCA events (100%). Automated external defibrillator shocks were delivered to 11 of 13 runners (84.6%). All 13 runners (100%) achieved return of spontaneous circulation in the field. Conclusion: Greater short-term AT variability was associated with a higher incidence of SCA during Taipei Marathon events, suggesting that temperature variability over several days preceding and including race day may be associated with SCA occurrence. Runners should remain highly vigilant and take proactive measures under cold/high-risk weather conditions. The on-site presence of trained first responders to initiate CPR is mandatory at these events. A well-planned model of in-event emergency medical services is of vital importance in scenarios such as marathon events.
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Lin et al. (2026) conducted an observational in Sudden cardiac arrest (n=316,446). Standard deviation of apparent temperature (AT) vs. Per 1 °C lower standard deviation of AT was evaluated on Incidence rate of sudden cardiac arrest (SCA) on race day (IRR 6.63, 95% CI 1.85-52.11, p=<0.001). Each 1 °C increase in the standard deviation of apparent temperature over a 7-day window was associated with a 6.63-fold higher incidence of sudden cardiac arrest during marathon events.
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