Medical Emergencies During a Half Marathon Race – The Influence of Weather

Carlström, Eric; Börjesson, Mats; Palm, Gunnar; Khorram‐Manesh, Amir; Lindberg, Fredrik; Holmer, Björn; Berner, Andreas; Örninge, Per; Luning, Hampus; Nilson, Finn; Gelang, Carita; Thorsson, Sofia

doi:10.1055/a-1090-0995

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…Previous studies have shown that heat (there are various measures of heat including WBGT and PET) has an effect on MEs, specific MEs, and other outcomes such as notfinishing a race. 23,24 In our study, we show that dehydration, which was the most common specific ME, had the highest incidence in the year with the lowest WBGT. Although there are many other factors that could be confounders (eg age, gender, race route etc.…”

Section: Discussionsupporting

confidence: 48%

Medical Encounters in a 90-km Ultramarathon Running Event: A 6-year Study in 103 131 Race Starters—SAFER XVII

Sewry

Schwellnus

Boulter³

et al. 2021

Clinical Journal of Sport Medicine

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Objective: To determine the incidence and nature of illness-related medical encounters (MEs) at a 90-km, ultramarathon, mass, community-based, endurance running event. Design: Retrospective, descriptive epidemiological study. Setting: Comrades Marathon (90 km), South Africa. Participants: One lakh three thousand one hundred thirty-one race starters over 6 years (2014)(2015)(2016)(2017)(2018)(2019). Independent Variables: Incidence of moderate and serious/life-threatening MEs. Main Outcome Measures: All MEs were recorded by race medical doctors on race day each year. Medical encounters were recorded by severity, organ system, and final specific diagnosis (2019 consensus statement definition on mass community-based events). Incidences (I: per 1000 starters; 95% confidence intervals) were calculated for MEs. Results: There were 1971 illness-related MEs, with an overall incidence of 19.1 (range, 18.3-20.0). The incidence for serious/life-threatening MEs was 1.8 (range, 1.6-2.1). Incidences of MEs by organ systems affected were as follows: fluid/electrolyte (8.8; 8.3-9.4), central nervous system (4.0; 3.7-4.5), and gastrointestinal system (2.9; 2.6-3.2). Dehydration (I 5 7.5: 7.0-8.1) and exercise-associated muscle cramping (I 5 3.2: 2.9-3.6) were the 2 most common specific diagnoses. Conclusion: The incidence of MEs in the 90-km Comrades Marathon was one of the highest incidences of MEs reported in an endurance running event (1 in 52 starters and 1 in 556 starters for serious/life-threatening MEs). Preventative measures to reduce MEs are needed, and further investigations into the risk factors associated with MEs could assist in managing the risk and better prepare athletes, race organizers, and medical directors.

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Section: Discussionsupporting

confidence: 48%

Medical Encounters in a 90-km Ultramarathon Running Event: A 6-year Study in 103 131 Race Starters—SAFER XVII

Sewry

Schwellnus

Boulter³

et al. 2021

Clinical Journal of Sport Medicine

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“…The specific risk factors responsible for the association between the outcomes (such as adverse events, did‐not‐finish, and medical encounters) and the risk stratification categories found in this cohort should also be further investigated. We acknowledge that further potential external factors unrelated to health status could influence the AE/ME/DNF rates in risk categories (such as environmental conditions) 33 and should be further explored in future studies.…”

Section: Discussionmentioning

confidence: 99%

Pre‐race screening and stratification predicts adverse events—A 4‐year study in 29585 ultra‐marathon entrants, SAFER X

Sewry

Schwellnus

Börjesson

et al. 2020

Scandinavian Med Sci Sports

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Background Pre‐race screening and risk stratification in recreational endurance runners may predict adverse events (AEs) during a race. Aim To determine if pre‐race screening and risk stratification predict AEs during a race. Methods A total of 29 585 participants (Male 71.1%, average age = 42.1 years; Female 28.9%, average age = 40.2 years) at the Two Oceans ultra‐marathon races (56 km) completed a pre‐race medical screening questionnaire and were risk stratified into four pre‐specified groups [very high risk (VHR; existing cardiovascular disease–CVD:3.2%), high risk (HR; risk factors for CVD:10.5%), intermediate risk (IR; existing other chronic disease, medication use or injury:53.3%), and low risk (LR:33.0%)]. Race starters, finishers, and medical encounters (ME) were recorded. Did‐not‐start (DNS) rate (per 1000 entrants that did‐not‐start), did‐not‐finish (DNF) rate (per 1000 starters that did‐not‐finish), AE rate [per 1000 starters that either DNF or had an ME], and ME rate (per 1000 starters with an ME) were compared across risk categories. Results Adverse events were significantly higher (per 1000 starters; 95%CI) in the VHR (68.9; 52.4‐89.9:P = .0407) compared with the LR (51.3; 46.5‐56.7). The DNS rate was significantly different between the IR (190.3; 184.0‐196.9) and LR (207.4; 199.2‐216.0: P = .0011). DNF rates were not different in the VHR (56.4; 41.9‐75.9) compared to LR (44.2; 39.7‐49.1: P = .1295), and ME rate was also not different between risk categories, however, VHR (12.9; 7.0‐23.9) was approaching significance compared to LR (6.9; 5.2‐9.1: P = .0662). Conclusion Pre‐race medical screening and risk stratification may identify athletes at higher risk of AEs. Further studies should be performed in larger cohorts to clarify the role of pre‐race medical screening in reducing AEs in endurance runners.

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“…For instance, road closures along and around events, as well as the provision of public, active, or 'green' transport options for spectators and officials, may help reduce pollution levels at the event whilst Kosaka et al (2018) suggested that increased shading along the Tokyo marathon route may reduce the likelihood of heat stress related medical incidents (Morici et al 2020). This is especially so when research has highlighted the positive relationship between increased temperatures, associated medical incidents and the total number of 'did not finish' participations (Carlstrom et al 2019;Khorram-Manesh et al 2020;Schwabe et al 2014).…”

Section: Summary and Practical Applicationsmentioning

confidence: 99%

The Diamond League athletic series: does the air quality sparkle?

2021

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Urban air pollution can have negative short- and long-term impacts on health, including cardiovascular, neurological, immune system and developmental damage. The irritant qualities of pollutants such as ozone (O3), nitrogen dioxide (NO2) and particulate matter (PM) can cause respiratory and cardiovascular distress, which can be heightened during physical activity and particularly so for those with respiratory conditions such as asthma. Previously, research has only examined marathon run outcomes or running under laboratory settings. This study focuses on elite 5-km athletes performing in international events at nine locations. Local meteorological and air quality data are used in conjunction with race performance metrics from the Diamond League Athletics series to determine the extent to which elite competitors are influenced during maximal sustained efforts in real-world conditions. The findings from this study suggest that local meteorological variables (temperature, wind speed and relative humidity) and air quality (ozone and particulate matter) have an impact on athletic performance. Variation between finishing times at different race locations can also be explained by the local meteorology and air quality conditions seen during races.

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Medical Emergencies During a Half Marathon Race – The Influence of Weather

Cited by 6 publications

References 15 publications

Medical Encounters in a 90-km Ultramarathon Running Event: A 6-year Study in 103 131 Race Starters—SAFER XVII

Medical Encounters in a 90-km Ultramarathon Running Event: A 6-year Study in 103 131 Race Starters—SAFER XVII

Pre‐race screening and stratification predicts adverse events—A 4‐year study in 29585 ultra‐marathon entrants, SAFER X

The Diamond League athletic series: does the air quality sparkle?

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