Schwabe, KarenSchwellnus, Martin PeterSwanevelder, SonjaJordaan, EsmeDerman, WayneBosch, Andrew2018-09-132018Karen Schwabe, Martin Schwellnus, Sonja Swanevelder, Esme Jordaan, Wayne Derman & Andrew Bosch (2018): Leisure athletes at risk of medical complications: outcomes of pre-participation screening among 15,778 endurance runners - SAFER VII, The Physician and Sportsmedicine, 46(4):405-413, DOI: 10.1080/00913847.2018.1505569.0091-3847 (print)2326-3660 (online)10.1080/00913847.2018.1505569http://hdl.handle.net/2263/66554OBJECTIVE : International guidelines for pre-participation screening of masters/leisure athletes to identify those that require medical assessment exist, but have not been implemented in mass-community based sports events. We determined the prevalence of runners who, according to these guidelines, would require a medical assessment before participating in a distance running event. METHODS : Participants of the 2012 Two Oceans races (21.1 and 56 km) in South Africa (n = 15,778) completed an online pre-race medical screening questionnaire using European pre-participation screening guidelines. We determined the prevalence of runners that would require a pre-race medical assessment, based on risk factors, symptoms, and disease. RESULTS : The pre-participation “self assessment of risk” screening identified 4,941 runners (31.3%; 95% CI 30.6–32.0) that would need to undergo a full pre-participation medical assessment prior to running, if the current pre-participation screening guidelines are applied. Although musculoskeletal complaints and prescription medication use were the main triggers for a medical assessment, 16.8% (n = 2657) runners should undergo medical evaluation for suspected cardiac disease based on the questionnaire results: 3.4% (n = 538) reporting existing CVD (very high risk) and 13.4% (n = 2119) reporting multiple CVD risk factors (high risk). Other possible risk factors were reported as follows: history of chronic diseases (respiratory = 13.1%, gastro-intestinal = 4.3%, nervous system = 3.8%, metabolic/endocrine = 3.5%, allergies = 13.9%); chronic prescription medication = 14.8%, used medication before or during races = 15.6%; past history of collapse during a race = 1.4%. CONCLUSIONS : Current guidelines identified that > 30% runners would require a full medical assessment before race participation – mainly linked to runners reporting musculoskeletal conditions. We suggest a revision of guidelines and propose that pre-race screening should be considered to identify runners with a “very high,” “high,” and “intermediate risk” for medical complications during exercise. Pre-race screening and educational intervention could be implemented to reduce medical complications during exercise.en© 2018 Informa UK Limited, trading as Taylor & Francis Group. This is an electronic version of an article published in Physician and Sportsmedicine, vol. 46, no. 4, pp. 405-413, 2018. doi : 10.1080/00913847.2018.1505569. Physician and Sportsmedicine is available online at : http://www.tandfonline.comloi/tphy20.Cardiovascular diseaseChronic diseasePre-participation medical screeningRisk factorsRunningPostprint Article