Prerace medical screening and education reduce medical encounters in distance road races: SAFER VIII study in 153 208 race starters.

Abstract

To examine the efficacy and feasibility of an online prerace medical screening and educational intervention programme for reducing medical complications in long-distance races. This was an 8-year observational study of medical encounter rates among 153 208 Two Oceans race starters (21.1 and 56 km) in South Africa. After the first 4-year control (CON) period, we introduced an online prerace medical screening (based on European pre-exercise screening guidelines) and an automated educational intervention programme. We compared the incidence of medical encounters (per 1000 starters; all and serious life threatening) in the CON versus the 4-year intervention (INT) period. In comparison to the CON period (2008-2011: 65 865 starters), the INT period (2012-2015: 87 343 starters) had a significantly lower incidence (adjusted for age group, sex, race distance) of all medical encounters by 29% (CON=8.6 (7.9-9.4); INT=6.1 (5.6-6.7), p<0.0001), in the 21.1 km race by 19% (CON=5.1 (4.4-5.9); INT=4.1 (3.6-4.8), p=0.0356) and in the 56 km race by 39% (CON=14.6 (13.1-16.3); INT=9.0 (7.9-10.1), p<0.0001). Serious life-threatening encounters were significantly reduced by 64% (CON=0.6 (0.5-0.9); INT=0.2 (0.1-0.4); p=0.0003) (adjusted for age group and sex). Registration numbers increased in the INT period (CON=81 345; INT=106 743) and overall % race starters were similar in the CON versus INT period. Wet-bulb globe temperature was similar in the CON and INT periods. All medical encounters and serious life-threatening encounters were significantly lower after the introduction of a prescreening and educational intervention programme, and the programme was feasible.