Air Pollution Impairs Marathon Performance: A Cross-Sectional Analysis of 2.7 Million Finishers Across Six World Marathon Majors.
Donaldson JA, Cai S, Hey JV, Hansell AL, Yates T, Ng GA et al. · Sports medicine - open · 2026
Background: Ambient air pollution impairs respiratory and cardiovascular function during exercise, yet evidence on its effects across the full spectrum of endurance performance remains limited.
Objectives: To quantify the association between race-day ambient air pollution and marathon finishing time across six World Marathon Majors, and to determine whether effects vary by sex, age group, and performance level.
Methods: We analysed 2,756,553 net finishing times from six World Marathon Majors (Berlin, Boston, Chicago, London, New York City, and Tokyo) for editions held between 2010 and 2024. Race-day nitrogen dioxide (NO₂) and fine particulate matter (PM₂.₅) concentrations were obtained from the Copernicus Atmosphere Monitoring Service (CAMS) global reanalysis dataset. Linear mixed-effects models with random intercepts for each of 75 marathon-year events estimated pollution effects on finishing time, adjusting for heat index, wind speed, and temporal trends. Stratified analyses were conducted among 1,815,188 runners with available age data.
Results: Of the pollutants examined, NO₂ showed the stronger association with finishing time. Each 1 µg/m 3 increase was associated with 1.43 min slower finishing time in men (95% confidence interval [CI] 0.66 to 2.21) and 1.56 min in women (95% CI 0.63 to 2.48). PM₂.₅ effects were not statistically significant: -0.13 min per µg/m 3 in men (95% CI -0.67 to 0.40) and -0.14 min per µg/m 3 in women (95% CI -0.76 to 0.49). Recreational runners experienced NO₂ effects approximately six-fold larger than elite runners (2.12 vs 0.34 min per µg/m 3 ); expressed as a percentage of mean finishing time, this gradient persisted (0.67% vs 0.18%). Younger runners (18-29 years) showed larger effects than older runners (2.17 vs 1.32 min per µg/m 3 for ≥60 years). Kolmogorov-Smirnov tests confirmed that higher NO₂ was associated with rightward shifts across the entire finishing time distribution.
Conclusions: Ambient air pollution, particularly NO₂, is associated with impaired marathon performance in a dose-dependent manner, with the largest effects among recreational runners. These
Findings: have implications for race management and public health policy regarding outdoor physical activity in urban environments.