Exercise In Pregnancy Acog

Responsibilities and Potential Liability

The sponsors and directors of an endurance event are reasonably safe from liability due to injury if they avoid gross negligence and willful misconduct, carefully inform the participants of hazards, and have them sign waivers before the race. However, a waiver signed by a participant does not totally absolve race organizers of moral and/or legal responsibility. It is recommended that race sponsors and directors: minimize hazards and make safety the first concern; describe inherent hazards potential course hazards, traffic control weather conditions in the race application; require all entrants to sign a waiver; retain waivers and records for yr; warn runners of the predisposing factors and symptoms of environmental illness; provide all advertised support services; legally incorporate the race or organizations involved; and purchase liability insurance.

Race directors should investigate local laws regarding Good Samaritan action. In some states physicians who do not accept remuneration may be classified as Good Samaritans. Race liability insurance may not cover physicians, therefore the malpractice insurance policy of each participating physician should be evaluated to determine if it covers services rendered at the race.

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Medical and race directors should postpone, reschedule, or cancel a race if environmental conditions warrant, even though runners and trained volunteers arrive at the site and financial sponsorship has been provided. Runners may not have adequate experience to make the decision not to compete; their safety must be considered. Downgrading the race to a fun run does not absolve race supervisors from their responsibility or decrease the risk to participants.

Background for This Position Stand

Dehydration is common during prolonged endurance events in both cold and hot environmental conditions because the average participant loses quarts liters of sweat-h-, and fluid replacement is usually insufficient. Runners may experience hyperthermia [body core temperature above.F] or hypothermia [body core temperature belowF], depending on the environmental conditions, caloric intake, fluid consumption, and clothing worn. Hyperthermia is a potential problem in warn and hot weather races when the body’s rate of heat production is greater than its heat dissipation. Indeed, on extremely hot days, it is possible that up to of the participants may require treatment for heat-related illnesses such as heat exhaustion and heatstroke. Hypothermia is more likely to occur in cold or cool-windy conditions. Scanty clothing may provide inadequate protection from such environments, particularly near the end of a long race when running speed and heat production are reduced. Frostbite can occur in low air temperature and especially when combined with high wind speed. The race and medical directors should anticipate the above medical problems and be capable of responding to a large number of patients with adequate facilities, supplies, and support staff. The four most common heat and cold illnesses during distance running are heat exhaustion, heatstroke, hypothermia, and frostbite.

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