|dc.description.abstract||Background: The Ironman South Africa (IMSA) is one of 28 Ironman races worldwide
and is one of the most prominent events on the South African sports calendar. The 2014
event was held on the 6th of April in the city of Port Elizabeth in Nelson Mandela Bay.
Even though Ironman events are among the most popular long distance triathlons
worldwide, there is a need for ongoing data gathering regarding the injuries and illness
profiles of athletes during events. The importance of ongoing research is highlighted by
the fact that these ultra-distance athletes are exposed to environmental conditions and
physiological demands in excess of those that athletes participating in individual sporting
events of similar duration experience. Consequently such an event requires a wellorganised
medical and emergency system.
Aim:The aim of this study was to analyse the medical information of athletes that
received medical attention at the 2014 Ironman South Africa (IMSA) event (N=179).
Demographic information and medical histories of the athletes that participated in the
event were also collected. A detailed report of the weather conditions on race day was
included as additional information in this study. The IMSA medical plan was also reviewed
to analyse the treatment plans, medical resources and medical personnel that provided
care at the event.
Method: The study was a retrospective, cross-sectional study. Athletes that presented
for medical attention and their related medical notes recorded as standard procedure
during the 2014 IMSA event were included in this study. This study undertook to use the
information by transferring the data recorded in the medical notes to a data collection
form developed for this study. The captured data was then coded and analysed.
Descriptive statistics for the measures of central tendency presenting frequency,
percentages, means and averages were calculated.
Results and Recommendations: Of the 2331 athletes who started the race8%
required medical attention. This number is slightly lower than data documented for
recent previous IMSA events. At the 2014 event weather conditions were mild and likely
played a role in a somewhat lower incidence of injury and illness among the participants.
However, the incidence is comparative with international data documented for
international Ironman and other triathlon events. IMSA has seen a significant increase in participants and a 1% increase in female participation. Although analysis of the data did
not find a statistically significant difference for gender between the group of athletes that
did not require any medical attention on race day and the group of athletes that did
require medical attention, the trend of an increasing number of female participants needs
to be considered in future planning. A statistically significant difference was found for age
between the group of athletes requiring medical attention and those athletes that did not.
Younger athletes between the ages of 18 and24 years had the largest number of injuries
(15%), followed by athletes in the 25-29 year age group (13%). IMSA also recorded an
increase in novice participation in 2014 of almost 12% from the previous year. This
information, together with the incidence of injury among younger athletes found in this
study also deserves further consideration. Race participants, especially novice athletes,
should be clearly advised on conditions that may exacerbate heat illnesses such as
obesity, lower levels of fitness, dehydration, lack of acclimatisation, a previous history of
heat stroke, sleep deprivation, certain medications including diuretics and
antidepressants, and sweat gland dysfunction or sunburn.
Exercise/exertion related diagnoses were made in 64% of these athletes, with 72 cases of
Exercise Associated Collapse (EAC)/hypotension being diagnosed. This finding is
supported by literature in which EAC is consistently listed as one of the most commonly
encountered medical problems during Ironman and other endurance events. A significant
finding of this study also supports existing literature highlighting pre-existing injuries and
medical disorders as important factors in identifying the at-risk athlete with 19% of those
athletes that received medical attention during the race were on chronic medication. The
prevalent use of NSAIDs both before and during the event is another significant finding of
this study. This finding may highlight an important need for more comprehensive preparticipation
screening and continuous medical education among athletes. Specifically
pre-participation screening, the viability of pre-race seminars, and comprehensive medical
education by way of more effective and detailed communication with both medical
personnel and race entrants needs to be investigated.||en_ZA