Medical conditions treated at the ironman italy: from the epidemiology to the organization of a medical plan

Purpose: Triathlon popularity is rapidly increasing, and data about the associated medical conditions’ epidemiology are sparse and fragmented. The primary goal of this study was to describe the epidemiology of injuries at an international triathlon event. The study’s secondary objective was to quantify the resources and define some strategies for the organisation of medical support. Method: This study analysed the data from the medical reports gathered during three consecutive editions of the Ironman Italy, from 2017 to 2019, which included six triathlon races over a medium to long-distance. The data contained in the registration forms and medical reports were examined. We also analysed the data relative to the drugs and dressings used to treat any medical conditions and created a model according to Maurer’s algorithm. Results: This study covered a total of 94,611 triathlon-hours, including 80,478 h of long-distance, 10,336 of middle-distance and 3,797 of Olympic triathlon. Out of 10,653 race-starters9,165 males1,488 females, 3.35% required medical attention and suffered from 472 medical conditions. A significantly higher risk was found for females versus males (X2 = 9.78,p = 0.02) and in long-distance (IR: 4.09/1,000 h) rather than in Olympic/middle distance races (IR: 1.75/1,000 h). Most (68.4%) were systemic conditions, including muscular exhaustion, hypothermia, and dehydration, while only 10.2% were acute traumatic injuries. Acute and overuse injuries affecting the musculoskeletal system represented 15.2% (n = 72). They prevailed to the lower limbs, most being minor injuries such as abrasion, contusion, ankle sprain, muscle strain, and plantar fasciitis. A high percentage of skin conditions, 36% (n = 56), were treated. On a total of 357 triathletes requiring medical assistance, 8.1% were a candidate for hospitalisation. A requirement of 7 ambulances, 30 rescuers and two medical units was calculated for a triathlon event of the same size. Ten recommendations relative to optimise the organisation of the medical assistance to a triathlon event were also formulated. Conclusions: Although most injuries encountered in the triathlon series were minor, triathlon race organisers and medical personnel should be prepared at any time to cope with unpredictable eventualities, including the worst-case scenarios. Specifically, a reinforced surveillance plan in the swimming fraction and the preparation of specific prevention and rescue plans are recommended.