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Medical planning for mass-participation running events: a 3-year review of a half-marathon in Singapore.

Tan CM, Tan IW, Kok WL, Lee MC, Lee VJ - BMC Public Health (2014)

Bottom Line: Thirdly, more casualties presented at the race end-point as compared to the along the race routes.Conversely, being of an older age, being male, and running in a non-competitive event were each associated with lower casualty risk.The stable and intuitive casualty patterns detailed in this study provide a strong basis for further quantitative research on the medical aspects of running events, as well as for mass-participation sporting events in general.

View Article: PubMed Central - PubMed

Affiliation: Headquarters Medical Corps, Singapore Armed Forces, 701 Transit Road, Singapore 778910, Singapore. clivetan@gmail.com.

ABSTRACT

Background: Systematically planning appropriate medical coverage for mass-participation running events is a challenge that has received relatively little attention in the medical literature, despite its potentially severe consequences. In particular, the literature lacks quantitative information on running events that medical planners can utilize for decisions on medical resource allocation and deployment.

Methods: Using a case-study approach, this study provides a detailed quantitative medical services utilization profile for the Singapore Army Half-Marathon, constructed from participant and casualty data spanning three years and comprising over 80,000 data points. Casualty rates for participants of varying age and sex in different running events were also estimated using a multivariate logistic regression model. Qualitatively, planning processes and practices were described and discussed.

Results: The quantitative profile yielded three main findings. Firstly, the analysis reveals that the gross Medical Usage Rate had remained fairly stable at between 16.9 and 26.0 casualties per 10,000 participants over the three years. Secondly, comparing injury types, musculoskeletal and soft-tissue injuries were the most commonly-presented injuries. Thirdly, more casualties presented at the race end-point as compared to the along the race routes. The regression analysis showed that, of the four modeled variables, the longer event distance (21 km vs. 10 km) had the largest effect on the likelihood that a participant would become a casualty. Conversely, being of an older age, being male, and running in a non-competitive event were each associated with lower casualty risk.

Conclusions: The stable and intuitive casualty patterns detailed in this study provide a strong basis for further quantitative research on the medical aspects of running events, as well as for mass-participation sporting events in general. The qualitative aspects of this report may serve as a useful resource to medical planners for running events.

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Related in: MedlinePlus

Medical conditions by category for casualties (AHM 2010-2012).
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Fig2: Medical conditions by category for casualties (AHM 2010-2012).

Mentions: Number of casualties attended to in each year ranged from 65 to 90. Light casualties made up the majority of casualties, followed by intermediate and severe casualties. The MUR, defined as the number of casualties attended to per 10,000 participants, varied within a narrow band from 16 to 26.Casualty records were reviewed and analysed for the medical conditions that the casualties presented with (Figure 2). Musculoskeletal conditions [37.9%] (e.g. muscle cramps, joint sprains) were the most common medical condition seen at these events, closely followed by skin and soft tissue injuries [29.2%] (e.g. skin abrasions, blisters). Physical exhaustion [15.7%] was the third most common diagnosis category, followed by heat injury [6.4%].Figures 3 and4 jointly illustrate the pattern of casualty presentation. In Figure 3, the casualties’ time and location of presentation were plotted on a scatterplot grid for each of the three years under study, with colors depicting case severity. The black lines depict the running trajectory, with reference to the medical posts, of a participant running at a steady speed of 10 km/h.As illustrated in Figure 3, the 21 km race started at 5.15 am and the 10 km race started at 7.00 am. The highest number of casualties presented at MP1, which was situated at the start/end point. The greatest density of casualties was around 8 am, which was when most runners complete the 21 km and 10 km event. MPs providing support at various intermediate points in the running route see a lower rate of casualties compared to the MP at the start/end point. It should also be noted that a small number of casualties presented before 5.15 am – these were not runners, but were staff from the event organizers.Figure 4 shows the 21 km, 10 km and 5 km running route from the 2011 race event, and includes the geographical location of the MPs as well as the area covered by each MP. The MPs were evenly spaced between each other for efficient allocation of medical resources. Of note, the runners in the 10 km event did not pass by all the available MPs, and this is depicted by the dashed lines in Figure 3.Figure 2


Medical planning for mass-participation running events: a 3-year review of a half-marathon in Singapore.

Tan CM, Tan IW, Kok WL, Lee MC, Lee VJ - BMC Public Health (2014)

Medical conditions by category for casualties (AHM 2010-2012).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4232663&req=5

Fig2: Medical conditions by category for casualties (AHM 2010-2012).
Mentions: Number of casualties attended to in each year ranged from 65 to 90. Light casualties made up the majority of casualties, followed by intermediate and severe casualties. The MUR, defined as the number of casualties attended to per 10,000 participants, varied within a narrow band from 16 to 26.Casualty records were reviewed and analysed for the medical conditions that the casualties presented with (Figure 2). Musculoskeletal conditions [37.9%] (e.g. muscle cramps, joint sprains) were the most common medical condition seen at these events, closely followed by skin and soft tissue injuries [29.2%] (e.g. skin abrasions, blisters). Physical exhaustion [15.7%] was the third most common diagnosis category, followed by heat injury [6.4%].Figures 3 and4 jointly illustrate the pattern of casualty presentation. In Figure 3, the casualties’ time and location of presentation were plotted on a scatterplot grid for each of the three years under study, with colors depicting case severity. The black lines depict the running trajectory, with reference to the medical posts, of a participant running at a steady speed of 10 km/h.As illustrated in Figure 3, the 21 km race started at 5.15 am and the 10 km race started at 7.00 am. The highest number of casualties presented at MP1, which was situated at the start/end point. The greatest density of casualties was around 8 am, which was when most runners complete the 21 km and 10 km event. MPs providing support at various intermediate points in the running route see a lower rate of casualties compared to the MP at the start/end point. It should also be noted that a small number of casualties presented before 5.15 am – these were not runners, but were staff from the event organizers.Figure 4 shows the 21 km, 10 km and 5 km running route from the 2011 race event, and includes the geographical location of the MPs as well as the area covered by each MP. The MPs were evenly spaced between each other for efficient allocation of medical resources. Of note, the runners in the 10 km event did not pass by all the available MPs, and this is depicted by the dashed lines in Figure 3.Figure 2

Bottom Line: Thirdly, more casualties presented at the race end-point as compared to the along the race routes.Conversely, being of an older age, being male, and running in a non-competitive event were each associated with lower casualty risk.The stable and intuitive casualty patterns detailed in this study provide a strong basis for further quantitative research on the medical aspects of running events, as well as for mass-participation sporting events in general.

View Article: PubMed Central - PubMed

Affiliation: Headquarters Medical Corps, Singapore Armed Forces, 701 Transit Road, Singapore 778910, Singapore. clivetan@gmail.com.

ABSTRACT

Background: Systematically planning appropriate medical coverage for mass-participation running events is a challenge that has received relatively little attention in the medical literature, despite its potentially severe consequences. In particular, the literature lacks quantitative information on running events that medical planners can utilize for decisions on medical resource allocation and deployment.

Methods: Using a case-study approach, this study provides a detailed quantitative medical services utilization profile for the Singapore Army Half-Marathon, constructed from participant and casualty data spanning three years and comprising over 80,000 data points. Casualty rates for participants of varying age and sex in different running events were also estimated using a multivariate logistic regression model. Qualitatively, planning processes and practices were described and discussed.

Results: The quantitative profile yielded three main findings. Firstly, the analysis reveals that the gross Medical Usage Rate had remained fairly stable at between 16.9 and 26.0 casualties per 10,000 participants over the three years. Secondly, comparing injury types, musculoskeletal and soft-tissue injuries were the most commonly-presented injuries. Thirdly, more casualties presented at the race end-point as compared to the along the race routes. The regression analysis showed that, of the four modeled variables, the longer event distance (21 km vs. 10 km) had the largest effect on the likelihood that a participant would become a casualty. Conversely, being of an older age, being male, and running in a non-competitive event were each associated with lower casualty risk.

Conclusions: The stable and intuitive casualty patterns detailed in this study provide a strong basis for further quantitative research on the medical aspects of running events, as well as for mass-participation sporting events in general. The qualitative aspects of this report may serve as a useful resource to medical planners for running events.

Show MeSH
Related in: MedlinePlus