Introduction: As temperatures globally continue to rise due to climate change, sporting events such as marathons will take place on warmer days, increasing the risk of exertional heat stroke (EHS). This is especially pertinent to sports that draw a large number of amateur athletes, such as endurance running. Methods: The medical librarian developed and executed comprehensive searches in Ovid MEDLINE, Ovid Embase, CINAHL, SPORTDiscus, Scopus, and Web of Science Core Collection on August 14, 2024. Relevant keywords were carefully selected. The remaining results underwent title, abstract, and full text screening in a web-based tool called Covidence. The included full texts were analyzed for pertinent data. Results: A total of 3918 results were retrieved, and when all duplicates were removed, 1698 results remained. After title, abstract, and full text screening, 38 articles remained for inclusion. There were 22 case reports, 13 retrospective reviews, and 4 prospective observational studies. The races included half marathons, marathons, and other long distances. In the 22 case reports, only five articles examined more than a single patient encounter, and the mean environmental and patient temperatures were 21.0°C and 40.5°C, respectively. In the retrospective reviews, the mean environmental and patient temperatures were 19.8°C and 40.7°C. Discussion points emphasized that increasing environmental temperatures result in higher incidences of EHS. Conclusion: With rising global temperatures from climate change, athletes are at higher risk of EHS. This scoping review reveals that younger, male patients are more often at risk, and early ice water immersion is the best treatment for EHS. Earlier race start times and cooling stations may mitigate incidences of EHS; however, data on event medicine preparation for hotter temperatures remains scarce. Future work needs to concentrate on universal reporting of illnesses in mass gathering events, as well as the establishment of heat-related illness prevention and mitigation protocols.
Görgens et al. (Sun,) studied this question.