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PA 13-2-0532 Testing a novel method for identifying where serious medical encounters occur at marathons in order to improve medical preparedness and runners’ safety
  1. Finn Nilson1,
  2. Fredrik Lindberg2,
  3. Gunnar Palm2,
  4. Linnea Lundgren3,
  5. David Rayner2,
  6. Mats Börjesson4,5,
  7. Sofia Thorsson2,
  8. Amir Khorram-Manesh6,7,
  9. Eric Carlström6,8,9,10
  1. 1 Department of Environmental and Life Sciences, Karlstad University, Karlstad, Sweden
  2. 2 Department of Earth Sciences, University of Gothenburg, Gothenburg, Sweden
  3. 3 Institute of Civil Society Research, Ersta Sköndal Bräcke University College, Stockholm, Sweden
  4. 4 Department of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  5. 5 Dept of Food, Nutrition and Sport Science, Sahlgrenska University Hospital, Gothenburg, Sweden
  6. 6 Unit of Security and Preparedness, Gothenburg, Sweden
  7. 7 Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  8. 8 Unit of Prehospital Conduction, Gothenburg, Sweden
  9. 9 Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  10. 10 University College of Southeast Norway, Vestfold, Norway


During the last decade, an increasing global popularity of endurance events has been seen, with a particular increase in the number of both half and full city marathons. Although events that promote physical activity are important, particularly from a public health perspective, endurance events also lead to a considerable number of medical emergencies. Despite this, very little is known regarding where serious life-threatening medical encounters (SLTMEs) occur during a race. Also, it is not known if the locations coincide with where runners experience the race as the most exhausting.

Using the world’s largest half marathon (Gothenburg half marathon) as a case, SLTME data collected from the local ambulance provider (over 7 years), and data from runners’ experiences (n=237) is presented. Level of agreement tests are performed and, using the runners’ experiences as a template, specific high-risk clusters are presented.

SLTMEs are shown to be considerably more common towards the end of the race and in uphill sections. By asking runners where they found the race most exhausting, it is possible to identify places where the risk of SLTMEs will be greater and thereby where medical personnel should be stationed. From a practical perspective, using this method could considerably increase the safety of competitors as well as improving the cost-effectiveness of safety interventions at endurance races.

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