Reducing the hazards in Sydney's the Sun City-to-Surf runs, 1971 to 1979.

The hazards experienced by fun runners in Sydney's The Sun City-to-Surf run are principally physical, environmental and medical. The organizers of the event, advised by a representative of the Australian Sports Medicine Federation (N.S.W.), have progressively increased the implementation of the recommendations which were made after the inaugural run in 1971 in the areas of improved organization, competitor education, medical support, recording of competitor data, and conducting the event in cool weather. To ensure the maximum safety of the runners, the number of whom has increased from approximately 1650 in 1971 to 16200 in 1979, additional measurees have been taken. These were (i) the introduction of "spotters" with experience in sports medicine to identify and advise exhausted runners before they collapse; (ii) staffing the run's medical centre with medical and nursing specialists in intensive care; (iii) improved management of heat exhaustion; and (iv) conducting education seminars after the run to make recommendations for improving subsequent events. Since 1971, there has been a progressive reduction in the number of casualties. The incidence of casualties treated in the medical centre fell from 1.76% in 1971 to 0.1% in 1979; and the incidence of those requiring further treatment in hospital fell from 0.42% in 1971 to 0.01% in 1979. None of the participants had suffered severe complications of heat exhaustion. Improvements in the management of heat exhaustion (the most common cause of collapse) which made the use of iced water (hiterto traditional method of cooling casualties with hyperthermia) unnecessary have reduced the risk of using electrical equipment in wet surroundings. The over-all reduction in the incidence and morbidity of collapse casualties is due to a combination of factors. These factors and possibilities of further reduction of hazards are discussed.