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ABSTRACT
Objective: International guidelines for pre-participation screening of masters/leisure athletes to identify those that require medical assessment exist, but have not been implemented in mass-community based sports events. We determined the prevalence of runners who, according to these guidelines, would require a medical assessment before participating in a distance running event.
Methods: Participants of the 2012 Two Oceans races (21.1 and 56 km) in South Africa (n = 15,778) completed an online pre-race medical screening questionnaire using European pre-participation screening guidelines. We determined the prevalence of runners that would require a pre-race medical assessment, based on risk factors, symptoms, and disease.
Results: The pre-participation “self assessment of risk” screening identified 4,941 runners (31.3%; 95% CI 30.6–32.0) that would need to undergo a full pre-participation medical assessment prior to running, if the current pre-participation screening guidelines are applied. Although musculoskeletal complaints and prescription medication use were the main triggers for a medical assessment, 16.8% (n = 2657) runners should undergo medical evaluation for suspected cardiac disease based on the questionnaire results: 3.4% (n = 538) reporting existing CVD (very high risk) and 13.4% (n = 2119) reporting multiple CVD risk factors (high risk). Other possible risk factors were reported as follows: history of chronic diseases (respiratory = 13.1%, gastro-intestinal = 4.3%, nervous system = 3.8%, metabolic/endocrine = 3.5%, allergies = 13.9%); chronic prescription medication = 14.8%, used medication before or during races = 15.6%; past history of collapse during a race = 1.4%.
Conclusions: Current guidelines identified that > 30% runners would require a full medical assessment before race participation – mainly linked to runners reporting musculoskeletal conditions. We suggest a revision of guidelines and propose that pre-race screening should be considered to identify runners with a “very high,” “high,” and “intermediate risk” for medical complications during exercise. Pre-race screening and educational intervention could be implemented to reduce medical complications during exercise.
Declaration of interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial relationships to disclose.
Data sharing statement
No additional data are available
Declaration of interest
No potential conflict of interest was reported by the authors.
Additional information
Funding
Notes on contributors
Karen Schwabe
Karen Schwabe study planning, data collection, data interpretation, manuscript editing
Martin Schwellnus
Martin Schwellnus principle investigator, responsible for the overall content as guarantor, study concept, study planning, data collection, data interpretation, manuscript (first draft), manuscript editing, facilitating funding
Sonja Swanevelder
Wayne Derman study concept, study planning, data collection, data interpretation, manuscript editing
Esme Jordaan
Sonja Swanevelder study planning, data analysis including statistical analysis, data interpretation, manuscript editing
Wayne Derman
Esme Jordaan study planning, data analysis including statistical analysis, data interpretation, manuscript editing
Andrew Bosch
Andrew Bosch data interpretation, manuscript editing