Hospital-based event medical support for the Baltimore Marathon, 2002-2005

We present a four-year, cross-sectional epidemiologic description of injuries and illnesses among Baltimore Marathon participants and the evaluation, treatment, and disposition of those conditions by an on-site event medical team led by physicians and staff from an urban, academic emergency department.

We analyzed data from injuries encountered during the marathon. Subjects presenting to a medical aid station along the course route or at the finish line were defined as "injured or ill" and were prospectively divided into two groups: 1) a brief-encounter group and 2) an extended-encounter group. Data collected included gender, presenting complaint(s), assessment, treatment(s), and disposition.

Three percent (N=1,144) of approximately 33,700 total participants over four years presented to medical aid stations during the Baltimore Marathon between 2002 and 2005. Most participants (66%) did not require a full clinical evaluation. Common complaints encountered were dehydration (32%), musculoskeletal injuries (25%), and cutaneous wounds (20%). Transport to the hospital was required for 4% of all injured participants, and 61% returned to the race.

Most injuries/illnesses encountered at the Baltimore Marathon in 2002-2005 were minor, although some were serious enough to require transport to a hospital. The year with the highest average race-day temperature had the highest observed injury rates and the highest number of hospital transports. These results help to improve understanding of the types, severity, and distribution of injuries commonly sustained by marathon participants and may guide decisions regarding the appropriate distribution of emergency medical resources at such events.