Distance running is increasing in popularity, with many of these participants being older than 45 years (35% of all marathon participants in the USA in 2019 were older than 45 years). Older participants are at higher risk for acute medical complications during moderate to intense exercise, and have an increased prevalence of pre-existing chronic medical conditions such as atherosclerosis, hypertension and diabetes that might predispose them to medical complications. Leading organizations recommend pre-exercise screening regimes such as the administration of questionnaires, to identify those at risk, especially in masters (>50 years) athletes. The Comrades Marathon has for many years implemented a limited pre-race medical screening, in the form of two open-ended medical questions, which is voluntarily completed by runners at race entry. In a recently published study, data from these questions, along with race-day medical encounters data, were collected from 133 641 Comrades Marathon race entrants between 2014 and 2019. The aims of the study were to determine the prevalence of self-reported pre-race chronic medical conditions and allergies in race entrants and to explore if these are associated with an increased risk of race-day medical encounters. All medical encounters presented in this study were of at least ‘moderate’ severity which required the withdrawal of the athlete from the race. The study found that 7.4% of race entrants reported allergies and 6.9% of race entrants reported chronic medical conditions/medication use. About 30% of entrants had one or more risk factors for cardiovascular disease and 1 in 400 reported established cardiovascular disease. The risk of a race-day medical encounter during the Comrades Marathon was significantly associated with a self-reported special medical condition/medication use, or a history of allergies.  This information could assist the medical team on race day, should a runner require emergency medical assistance, and therefore the benefits of these screening questionnaires and subsequent interventions to reduce the risk of adverse events is advocated.

Reference for this article:

Stephan Brill, Martin Schwellnus, Nicola Sewry, Dina Christa Janse Van Rensburg, Audrey Jansen Van Rensburg, Marcel Jooste, Jordan Leppan, Jeremy Boulter, Ishen Seocharan & Esme Jordaan (2021): Pre-race self-reported medical conditions and allergies in 133 641 Comrades ultramarathon (90km) runners - SAFER XXIII, The Physician and Sportsmedicine, DOI: 10.1080/00913847.2021.2004080