November 28, 2022
Recently researchers at the University of Pretoria’s Sport, Exercise Medicine and Lifestyle Institute (SEMLI) with collaborators in the Netherlands, set out to document the incidence of all medical encounters (of at least of moderate severity), as well as the serious/life-threatening medical encounters during the 2017 – 2019, 10 mile (16.1km) Dam tot Damloop race.
This was a very large study of 94 033 participants of the race, which is the largest mass community-based running event in the Netherlands. They found that the overall incidence of medical encounters over this period was 2.8 per 1000 starters, and the incidence of serious/life-threatening medical encounters was 1.2 per 1000 starters. The most common encounter was related to heat-related illnesses (hypothermia and hyperthermia), and serious/life-threatening medical encounters was surprisingly high at 44% of all medical encounters. This equates to a 4x higher risk for serious/life threatening medical encounters as compared to other races, of any distance.
Although the study was not specifically designed to ascertain the reasons behind the high incidence of serious/life-threatening medical encounters, the researchers speculate that it may be due to a higher “risk profile” of participants, lack of experience/training and environmental conditions that participants are not acclimatized to. The higher risk population could result from the popularity in businesses entering teams to run the race. These are often people with a higher prevalence of risk factors for cardiovascular disease or other chronic diseases.
They may also be less regular runners and untrained, yet under the impression that the shorter distance is manageable. The main take-home message from this study was that serious/life-threatening medical encounters accounted for a large percentage of all medical encounters, emphasizing the need for interventions and prevention strategies to be implemented in this event by specialized medical practitioners. Race organizers should take rapidly changing environmental conditions into account when planning races; and runner education, particularly for relatively inexperienced runners, should form part of a preventative strategy to reduce the risk of heat illness.
Medical Encounters Among 94,033 Race Starters During a 16.1-km Running Event Over 3 Years in the Netherlands: SAFER XXVI. N Sewry, T Wiggers, M Schwellnus. Sports Health, 2022. DOI: 10.1177/19417381221083594