Climate Crisis Threatens Runners: Rising Temperatures Could Turn Deadly

Carolyn Baker, decked out in a bright neon pink top and complementary sunglasses, was all smiles as she participated in the Falmouth Road Race along Cape Cod’s scenic coastline. She eagerly looked for familiar faces as she approached the race’s conclusion, an event she had successfully completed on numerous previous occasions.

However, unexpectedly, Baker’s body succumbed to the strain. On that sunny day in August, her internal temperature skyrocketed due to the intense physical exertion, reaching nearly 107 degrees Fahrenheit (41.6 Celsius). Medical volunteers immediately intervened, immersing her in a tub of ice water to rapidly bring down her temperature.

Baker’s family first realized something was amiss when they noticed her location moving backward on their tracking app, indicating she had been taken to the medical tent. Her husband, who had finished earlier and was socializing with friends, was shocked when he received a call from his daughter informing him of the incident, prompting him to rush to the medical tent.

The severe heatstroke that struck Baker is increasingly becoming a lethal threat, exacerbated by climate change which has led to more frequent dangerously hot days across the continental U.S.

Exertional heatstroke occurs when the body overheats during physical activity, failing to cool itself adequately, which can lead to serious central nervous system issues such as fainting or even blacking out. Although rapid cooling can treat the condition effectively, many race events lack the necessary resources or knowledge. Moreover, the prevailing culture among runners that values endurance and tolerance of discomfort can lead runners to overlook dangerous symptoms.

Such overheating can cause muscle breakdown, releasing proteins harmful to the kidneys, weaken the digestive system’s lining allowing bacteria to leak, or even lead to the death of brain cells. The consequences can be dire, damaging organs and potentially leading to death.

The Falmouth race tends to see a high incidence of heatstroke given its 7-mile length, which is sufficient to significantly raise body temperature yet short enough that many participants push their limits. With over 11,000 participants, some of whom may not be adequately acclimatized to the heat or might start the race dehydrated, the risks are increased. Plus, some individuals are naturally more susceptible than others.

Falmouth, however, is better equipped than many locations for dealing with heatstroke. With ample personnel, equipment, and experience, they are prepared to manage numerous cases. Medical director John Jardine has documented nearly 500 cases of heatstroke over two decades, attracting the interest of researchers.

Yet, according to Douglas Casa, director of the University of Connecticut’s Korey Stringer Institute—named after the Minnesota Vikings lineman who succumbed to heatstroke during a training camp in 2001—many races lack adequate medical facilities and expertise. Casa highlighted the contrast with smaller local 5K races, which might have minimal medical support, if any.

Ensuring Runner Safety

Placing victims into ice water baths is the most effective and rapid method for cooling. Prompt diagnosis and treatment on-site are crucial, and it’s important for medical staff to use rectal thermometers for accurate temperature readings since external skin temperature can be misleading.

Casa, with his extensive experience tracking over 3,000 heatstroke cases, notes that if a person’s temperature is reduced below 104 degrees within 30 minutes of heatstroke onset, there have been no fatalities. He also suggests that governing bodies for races should issue heat-related safety guidelines, though he acknowledges that race care has generally improved over the years.

Race directors face the complex task of organizing events for a diverse range of participants, balancing security, logistics, runner tracking, and medical provisions. Dave McGillivray, who directs the Boston Marathon and advises other race directors, stressed that runners also have a responsibility to be cautious. He recalls urging runners at the 2012 Boston Marathon to moderate their pace due to extreme heat, a difficult message for those committed to achieving their personal bests.

Despite the challenges that day, where over 2,000 participants required medical attention and around 200 were hospitalized, no lives were lost, demonstrating the importance of adequate preparation and resources. McGillivray pointedly remarked, “If you don’t have the resources, then you shouldn’t be firing the gun.”

Experiences from Two Athletes

Evan Hauptmann, a high school multisport athlete, decided to tackle the Falmouth race at 17 with the goal of finishing in under an hour. Despite feeling fine for most of the race, a challenging hill near the end made him lightheaded. He pushed through, spurred by his competitive spirit, only to collapse from a record-high temperature of 112.8 degrees Fahrenheit (44.9 Celsius) soon after crossing the finish line.

Immediate cooling measures were successful, and although initial tests showed concerning protein levels indicative of muscle damage, Hauptmann recovered without lasting harm and resumed his football activities two weeks later. His experience made him more conscious of the risks of heat and the importance of hydration and listening to his body.

In contrast, Zoë Wallis’s encounter with heatstroke occurred before she even started college, during a pre-season 5-mile run with her basketball team. Despite never having run that distance, she was pushed to continue even as she began to feel unwell. The ordeal ended with her collapsing and sustaining injuries, leading to temporary organ failure and a subsequent lawsuit against the school.

Wallis’s recovery took three months, and the psychological impact of the heatstroke ultimately led her to leave the team and lose her scholarship. It took years of therapy for her to recover from the trauma.

Run Wisely and Take Precautions

While risks exist, running and participating in races generally contribute positively to one’s health. Dr. Aaron Baggish emphasized that runners have a lower risk of cardiac arrest and other heart-related conditions than non-runners.

As for Baker, she experienced a swift recovery. Just a week after her collapse, she returned to the same spot in her neon outfit to complete the last mile of the Falmouth race, a testament to her resilience and determination to overcome her ordeal.

This year, she returned to the race and finished without incident, proving not only her physical recovery but also her mental resolve.