Brill, StephanSchwellnus, Martin PeterSewry, Nicola AnnJanse van Rensburg, Dina ChristinaJansen van Rensburg, AudreyJooste, MarcelLeppan, JordanBoulter, JeremySeocharan, IshenJordaan, Esme2022-03-042023Brill, S., Schwellnus, M., Sewry, N. et al. 2023, 'Pre-race self-reported medical conditions and allergies in 133 641 Comrades ultramarathon (90km) runners - SAFER XXIII', The Physician and Sportsmedicine, vol. 51, no. 1, pp. 88-95, doi: 10.1080/00913847.2021.2004080.0091-3847 (print)2326-3660 (online)10.1080/00913847.2021.2004080http://hdl.handle.net/2263/84347OBJECTIVES : To determine the prevalence of self-reported pre-race chronic medical conditions and allergies in ultramarathon race entrants and to explore if these are associated with an increased risk of race-day medical encounters (MEs). METHODS : Data from two voluntary open-ended pre-race medical screening questions (Q1 – history of allergies; Q2 – history of chronic medical conditions/prescription medication use) were collected in 133641 Comrades Marathon race entrants (2014–2019). Race-day ME data collected prospectively over 6 years are reported as incidence (per 1000 starters) and incidence ratios (IR: 95%CI’s). RESULTS : Pre-race medical screening questions identified race entrants with a history of chronic medical conditions and/or prescription medication use (6.9%) and allergies (7.4%). The % entrants with risk factors for cardiovascular disease (CVD) was 30% and being older (>45 years) or male (27.5%) were the most frequent CVD risk factors. 0.3% of entrants reported existing CVD. The overall incidence of MEs was 20/1000 race starters. MEs were significantly higher in race entrants reporting a ‘yes’ to Q1 (allergies) (IR = 1.3; 1.1–1.5) (p = 0.014) or Q2 (chronic medical conditions and/or prescription medication use) (IR = 1.3; 1.1–1.5) (p = 0.0006). CONCLUSIONS : Voluntary completion of two open-ended questions identified chronic medical conditions and/or prescription medication use in 6.9% and allergies in 7.4% of ultramarathon race entrants. This is lower than that reported for other races that implemented compulsory completion of a more comprehensive pre-screening questionnaire. Despite potential under-reporting, a pre-race self-reported history of chronic medical conditions and allergies was associated with a higher risk of race-day MEs.en© 2021 Informa UK Limited, trading as Taylor & Francis Group. This is an electronic version of an article published in Physician and Sports medicine, vol. 51, no. 1, pp. 88-95, 2023. doi : 10.1080/00913847.2021.2004080. Physician and Sports medicine is available online at : http://www.tandfonline.comloi/tphy20.RunningPre-participation medical screeningCardiovascular disease (CVD)Chronic diseaseRisk factorsPostprint Article