Mass participation in athletic events can lead to significant medical issues such as hypoglycaemia and heat stroke, particularly in participants with inadequate prior food and fluid intake.
Sydney's inaugural “City-to-Surf” race was held on September 5, 1971. It was modelled on the “Bay-to-Breakers” race in San Francisco. The race attracted 2,005 entrants, of whom 1,521 completed the 9-4 mile course in less than 100 minutes. The concept of the race was to create community awareness of participation in physical activity and to “increase the goodwill link between the sister cities of Sydney and San Francisco”. One hundred and fifty-seven competitors were treated for minor complaints during the race, 29 collapsed and were treated for hypoglycaemia and heat stroke, and 7 required hospitalization. Detailed investigations were carried out on 6 of the 7 hospitalized competitors. The majority of those hospitalized had had negligible food and fluid intake in the 12 to 16 hours preceding the race. Two competitors complained of chest pain, but results of ECGs were normal. SGOT and hydroxybutyric dehydrogenase (HBDH) levels were elevated for several days in one of these subjects and also in an asymptomatic and otherwise normal competitor. The HBDH level was elevated at the end of the race in 7 of 8 subjects tested. Elevations in serum Cortisol, growth-hormone and uric acid levels were noted in these subjects, together with a depression of serum insulin, glucose and bicarbonate levels. A series of recommendations is put forward to enable the “City-to-Surf” race to continue as an important annual event encouraging community activity, but minimizing potential hazards.
Sutton et al. (Sat,) studied this question.