A 12-yr profile of medical injury and illness for the Twin Cities Marathon[1]
Summary
Prospective 12-year medical-encounter profile of the Twin Cities Marathon, 1982-1994 (81,277 entrants), a cool-weather October race (start temperatures -4 to 16 C). Finish-area encounter rates were 18.9 per 1,000 entrants and 25.3 per 1,000 finishers; 90% of encounters were mild. Presentation mix: exercise-associated collapse 59%, skin problems 21%, musculoskeletal 17%, other medical 3%. Only 112 runners received IV fluids and 30 were transferred to emergency facilities across 12 years; one death (1989). More than 99.9% of finishers left the finish area without hospital or ED care. Concludes that cool-conditions marathoning is safe and that an early-morning start contributes to the low injury rate.
So what
The benchmark encounter-rate dataset for cool-weather endurance events and the quantitative case for start-time as a medical intervention: the same race distance that produces mass heat casualties in warm climates yields 90%-mild presentations when run at 5-15 C in the early morning. The 59% exercise-associated-collapse fraction defines what a marathon finish-line unit must actually be built to treat, and the 18.9-25.3 per 1,000 rates are the planning denominators to set against hot-race series (Perron heat-index work) when arguing WBGT-based scheduling to organizers.
Key findings
- 81,277 entrants over 12 years: 18.9 encounters/1,000 entrants, 25.3/1,000 finishers
- 90% of finish-line encounters mild; EAC 59%, skin 21%, MSK 17%
- 112 IVs and 30 ED transfers in 12 years; 1 death; >99.9% of finishers need no hospital care
- Cool conditions + early start identified as the protective design factors
Read the paper
- Publisher (DOI) ↗may be paywalled
- PubMed ↗abstract · free