Trail Running Safety: A Review of Serious Adverse Events Reported in Online News Articles

Trail running is an endurance sport that entails running outdoors on natural terrain. Scientific literature provides minimal information on serious adverse events that occur during trail running. The objectives of this review were to identify and summarize the available information published in online worldwide news articles and to categorize the results in fatal, missing, and catastrophic events in trail running. Over a 14-wk period, online news articles were searched using Google Advanced Search and DuckDuckGo for reports on serious adverse events during trail running. Data were extracted and summarized from online news articles that met the inclusion criteria. Ninety-four online news articles reported on 127 runners involved in serious adverse events during trail running. Among the serious adverse events reported in this review, 82% (n = 104) were fatal trail running events; 29% (n = 37) were related to missing events, of which 54% (n = 20) of the missing events resulted in death; and 6% (n = 6) were catastrophic injuries. Most runners were males (73%) aged 16 to 75 y (41.5 ± 12.6 y). The most common intrinsic causes of death were cardiac arrest (58%) and collapse (38%), whereas the most common extrinsic causes of death were cold weather resulting in potential hypothermia (40%) and blunt trauma following falling/slipping (25%). Almost half the runners who went missing (41%) were found. The 6 runners involved in catastrophic events (6%) suffered severe burn wounds, brain damage, and frostbite. Serious adverse events in trail running seem to be rare. This review reports multiple serious adverse events during trail running. Although these events are rare, they highlight the need for further research and improved reporting. These findings can assist in developing future prevention strategies for trail running events and guide medical staff during race-day medical planning.