Athlete safety is a shared responsibility: insights from the RACE Paris Registry

This editorial refers to ‘Registry on acute cardiovascular events during endurance running races: the prospective RACE Paris registry’†, by B. Gerardin et al .on page 2531. Long-distance running (LDR) is among the oldest human pastimes. The ability to run at moderate intensity over long distances, primarily to hunt and to procure food, was at the core of our successful evolutionary history. In contemporary society, we no longer need to run, but many of us still do. Organized LDR races are held in every corner of the globe, and participation rates are steadily on the rise. The increasing popularity of LDR is multifactorial, with contributions including an increasing awareness of the health benefits of exercise, reliance on running as a means of socialization and recreation, and perhaps some subconscious countermeasures to combat our increasing tendency to be sedentary. Once an activity confined to elite male athletes, there is now more equal participation by men and women, with runners spanning the full spectra of age, medical complexity, and athletic prowess. However, as more people embrace LDR and participation in organized races soars, so too have concerns about risk. Safety concerns about LDR, based largely on case reports of sudden death during races, are genuine, valid, and an important topic of scientific inquiry that remain plagued by myths, anecdotes, and unanswered questions. In this issue of the journal, investigators representing the RACE Paris Registry present data characterizing life-threatening and fatal events among a small group of French distance races.1 Over a 7-year period, race participation and clinical data from five …