Long-distance running is gaining popularity in Hong Kong and the number of participants in the Hong Kong Marathon increases every year. However, a study report reveals that from 2002 to 2012, nine participants suffered from seizure of cardiovascular diseases during the Hong Kong Marathon races and two of them failed resuscitation. Also, a 24-year-old participant died of cardiac arrest during the 10-kilometre race this year. In view of this, the Li Ka Shing Faculty of Medicine of the University of Hong Kong will conduct pre-participation screenings for subclinical cardiovascular diseases for first-time marathon participants free of charge for a period of three years with a view to reducing the morbidity and mortality of cardiovascular diseases among marathon participants. Regarding the safety arrangements for marathon races, will the Government inform this Council:
(1) whether it knows if the Hong Kong Amateur Athletic Association (HKAAA), organiser of the Hong Kong Marathon, compiled statistics in the past 10 years on participants suffering from seizure of cardiovascular diseases during the races; if HKAAA did, set out in a table the following information: (i) the number of persons receiving on-site first aid, (ii) the number of persons sent to hospitals for treatment, (iii) the number of persons injured (broken down by cause and age distribution) and (iv) the number of deaths (broken down by cause and age distribution); if not, of the reasons for that;
(2) given that there are views that marathon races have high demands on the physical fitness of runners and the organiser of marathon races should therefore set high thresholds for participation in the races, whether the authorities will (i) require HKAAA to raise the thresholds for participating in the races, including setting an age limit and the requirement to complete specified pre-participation training for participants, and (ii) encourage participants of full or half marathon races to undergo pre-participation screening for subclinical cardiovascular diseases to reduce the risk of seizures during the races; whether the authorities will provide free pre-participation screenings for subclinical cardiovascular diseases for participants from higher risk groups as well as step up publicity efforts to enhance participants’ awareness of the need to undergo appropriate physical check-up before the races; if they will, of the details; if not, the reasons for that; and
(3) whether it knows if HKAAA will enhance the first aid facilities and equipment currently provided during marathon races, including setting up additional first aid stations and deploying more healthcare personnel of various disciplines, as well as reviewing and making available on site more medical equipment with upgraded specifications; if HKAAA will, of the details; if not, the reasons for that?
Highly popular among the public, the Hong Kong Marathon (HK Marathon) organised by the Hong Kong Amateur Athletic Association (HKAAA) since 1997 is a sports event listed on the calendar of the International Association of Athletics Federations (IAAF). The 2016 HK Marathon, to be held on January 17 next year, has just been recognised by the IAAF as a Gold Label Road Race, a strong indication that the race has reached a very high international level. Given that the race results count towards athletes’ world rankings, many world-class runners come to compete for the championship, which helps enhancing our status as a sports events capital. As demonstrated by the year-on-year increase in the number of local participants, the race contributes significantly to the development of long-distance running in Hong Kong.
My reply to the various parts of the question is as follows:
(1) The HKAAA has kept statistical records of supports given to participants of the HK Marathon (including hospital admission, wound dressing, blister or cramp treatment, application of cold pack or turpentine oil). According to information provided by the HKAAA, the number of participants receiving supports in the 2015 event exceeded 9,000, which is lower when compared with the number of over 14,000 in 2013 and over 10,000 in 2014, with the majority requiring cramp treatment and turpentine oil application. Participants experiencing discomfort during or after the race will be delivered by the Organising Committee (OC) to the respective regional hospitals for treatment.
Since 2008, the accident and emergency information system (AEIS) of the Hospital Authority (HA) has maintained statistics on attendance by participants of the HK Marathon at the accident and emergency departments. Relevant figures are in Annex.
Statistical information about causes of patients’ injuries/deaths (including relevance with cardiovascular diseases) are currently not available in the AEIS operated by the HA. It is understood that the two participants died during the race, one each in the 2012 and 2015 event, were aged 26 and 24 respectively.
(2) As required by the IAAF, only persons aged 20 or above are eligible to participate in recognised marathon races, such as the HK Marathon. For safety reasons, the HKAAA requires that runners signing up for the full marathon must provide records of participation in and completion of 10-kilometre or longer races in the past three years before accepting their registrations.
To ensure that marathoners have adequate and appropriate pre-participation training, the HKAAA, in collaboration with the Leisure and Cultural Services Department, organises training courses every year on the full, half and 10-kilometre marathon for the public, with a view to providing participants with more comprehensive guidance and richer knowledge on running via such courses. The HKAAA anticipates that in the run-up to the event next year, over 70 training courses of different levels will be held for enrolment by more than 3,100 participants. Member clubs of the HKAAA also arrange relevant training courses.
On publicity, the OC uploaded onto the HK Marathon website a number of articles on training information written by doctors and professionals to remind participants to understand their physical condition. An electronic newsletter is also distributed regularly to participants to promulgate points to note for the race to reduce their risk of injury. In the terms and conditions, the OC alerts persons suffering from chronic illnesses, such as heart disease and hypertension, not to take part in the marathon. Moreover, the HKAAA frequently works cooperation with various groups and through different media channels to promote safety awareness in long-distance running and reminds participants of proper preparation.
Currently, there is no sufficient data from overseas and local studies to support that cardiovascular screening for general marathon participants can effectively reduce the onset risk and mortality rate. The Department of Health will keep in view the relevant studies, including the results of the Pre-participation Cardiovascular Screening Program for Hong Kong Marathon Runners launched for first-time participants by the University of Hong Kong in the second half of 2015, and make appropriate follow-ups accordingly.
In any case, members of the public are advised to consult their family doctors for an appropriate assessment if they have developed heart disease, experienced chest pain during physical activities or lost balance due to dizziness, or are currently on medication for blood pressure control or heart condition, or are suffering from other chronic illnesses such as diabetes, and take into account their physical health prior to marathon registration.
(3) According to the HKAAA, the OC will adjust medical support arrangements as required by the event of a particular year. Taking the 2015 HK Marathon as an example, the Auxiliary Medical Service (AMS) set up medical and first aid stations (a total of 30) equipped with automated external defibrillators at the starting and finishing points as well as various points at an average interval of 2.5 kilometres along the route; deployed nine ambulances, three ambulance-aid motorcycles and 17 first aid bicycles to provide necessary services; and deployed more than 800 doctors, nurses and first aiders on the event day to provide medical services at various stations. Apart from these stations, the OC arranged first aiders carrying convenient first-aid kits to render services for participants in need. To ensure effective response to unforeseen medical needs, AMS members were provided with radio communication equipment and emergency coordination centres were set up at the finishing points to coordinate and support medical care efforts.