Racing in Rising Global Temperatures: A Scoping Review of Heat-related Illnesses in Endurance Running

• Published in: Disaster medicine and public health preparedness Vol. 19; p. e206
• Main Authors: Görgens, Sophia, Hertelendy, Attila J, Issa, Fadi, Fernandez, David, Alshadad, Ahmad, Davis, Lindsay, Franc, Jeffrey M, Kung, Janice, Woodward, Christina Ann, Voskanyan, Amalia, Ciottone, Greg
• Format: Journal Article
• Language: English
• Published: United States 24.07.2025
• Subjects: Heat Stress Disorders - epidemiology; Heat Stress Disorders - etiology; Heat Stroke - etiology; Hot Temperature - adverse effects; Humans; Physical Endurance - physiology; Running - injuries; Running - physiology; Running - statistics & numerical data; exertional heat stroke; prehospital medicine; heat-related illnesses; event medicine; climate change
• ISSN: 1938-744X
• DOI: 10.1017/dmp.2025.10135

As temperatures globally continue to rise, sporting events such as marathons will take place on warmer days, increasing the risk of exertional heat stroke (EHS). The medical librarian developed and executed comprehensive searches in Ovid MEDLINE, Ovid Embase, CINAHL, SPORTDiscus, Scopus, and Web of Science Core Collection. Relevant keywords were selected. The results underwent title, abstract, and full text screening in a web-based tool called Covidence, and were analyzed for pertinent data. A total of 3918 results were retrieved. After duplicate removal and title, abstract, and full text screening, 38 articles remained for inclusion. There were 22 case reports, 12 retrospective reviews, and 4 prospective observational studies. The races included half marathons, marathons, and other long distances. In the case reports and retrospective reviews, the mean environmental temperatures were 21.3°C and 19.8°C, respectively. Discussions emphasized that increasing environmental temperatures result in higher incidences of EHS. With rising global temperatures from climate change, athletes are at higher risk of EHS. Early ice water immersion is the best treatment for EHS. Earlier start times and cooling stations for races may mitigate incidences of EHS. Future work needs to concentrate on the establishment of EHS prevention and mitigation protocols.