Preventing Severe Heat Injury in Runners: Suggestions from the 1979 Peachtree Road Race Experience

Abstract

Of an estimated 17632 participants of the 1979 Peachtree Road Race, a 10-km race held at 0800 on 4 July in Atlanta, Georgia, 29 had severe heat injury (collapse with altered mental status and rectal temperature of 39.7 degrees C or greater); all 29 recovered promptly. The temperature was 24.0 degrees C; the relative humidity, 83%; and the wet bulb-globe index, 23.0 degrees C. Compared with unaffected participants matched by age, sex, and predicted finishing time, case-runners were taller, had slower best recent 1.6-km and 10-km times, had run less in June, were more likely to achieve 89% of estimated maximum aerobic capacity during the race, less often splashed with water, were more likely to have underestimated their predicted finishing times based on their best recent 10-km times, and were more likely to live in Georgia. Height, sprinkler use, and underestimating predicted finishing times were each significant in the presence of the others. These observations suggest that participants of similar races, particularly those taller than 179.2 cm, should splash with water at least twice and base their predicted finishing times on their best recent 10-km times; adherence to these recommendations by runners at risk should reduce their severe heat injury risk at least 8.1 times.

Myoglobinuria, 1984

“…Also, in some military cases and many marathon cases, lack of training seemed to be exonerated. Among experienced runners, attacks seemed more likely to occur when the competitors set unrealistic expectations for speed or distance, and when they were exposed to high ambient temperatures (England et al, 1982). Dietary modifications in training did not seem important (Bank, 1977).…”

Prevention of sudden cardiac death in athletes, sportspersons and marathoners in India

“…The ischemia may get exacerbated by abrupt cessation of exercise that leads to reduced venous return, fall in blood pressure in a vasodilated state resulting in coronary hypoperfusion. The acute ischemia is further worsened by electrolyte imbalance, heat stroke36, 37 and excess circulating catecholamines 29 . This eventually causes malignant ventricular arrhythmias either at peak effort or immediate post exercise.…”

Distúrbios causados pelo frio e pelo calor durante corridas de longa distância

“…Todos os participantes devem ser advertidos no sentido de que as seguintes condições podem predispor a distúrbios induzidos pelo calor: obesidade [13][14][15] , baixo grau de aptidão fí-sica [16][17][18][19] , desidratação [19][20][21][22][23][24] , má aclimatação ao calor 15,25,26 , história prévia de colapso induzido pelo calor 15,27 , privação de sono 28 , alguns medicamentos, incluindo diuréticos e antidepressivos 25 e disfunção das glândulas sudoríparas ou estar queimado de sol 25 . Doenças que ocorram uma semana antes de um evento devem impedir a participação 29,30 , principalmente se envolverem febre, infecções do trato respiratório ou diarréia 31,32 .…”

“…Durante a fase aguda da exaustão pelo calor, o paciente se apresenta pálido, a pressão arterial está baixa e a freqüência cardíaca está elevada. A hipertermia pode se somar aos sintomas de exaustão pelo calor, mesmo em dias relativamente frios 16,44,[57][58][59][60][61][62] . Embora seja improvável que todos os casos de exaustão pelo calor possam ser evitados, os indivíduos mais suscetíveis são aqueles que se exercitam a um percentual maior da sua capacidade funcional, que estão desidratados, fisicamente inaptos e não aclimatados ao exercício no calor.…”