Over the last decades there has been a significant rise in the participation of endurance and ultra-endurance events. The socio-demographic and comorbidity profiles make endurance/ultraendurance exercisers a distinct population. Additionally, endurance/ultra-endurance events combine the risks of strenuous exercise with risks associated with remote locations and extreme conditions. Atopy is frequent in ultra-endurance athletes . Inducible forms of urticarias comprise 14% of chronic urticarias in athletes, cold-induced urticaria being the most common . Among participants of the 2012 London Marathon, a history of anaphylaxis was self-reported in 0.5% runners. Exercise-induced anaphylaxis is a rare but potentially fatal syndrome which occurs in conjunction with exercise or physical activity. In 2018, a survey of 1156 ULTRA participants demonstrated that ultra-marathon athletes sought medical support during the race for 240 different medical. Of these, 2.8% used epinephrine or antihistamines. Sudden deaths rate in marathoners ranges between 0.24-0.67 per 100,000.Therefore, health-related issues in endurance and ultra-endurance athletes are of great importance. It is now well-recognized that underlying cardiovascular disorders are the most common reason for sudden deaths during endurance/ultra-endurance events. However, the prevalence of anaphylaxis, in particular exercise-induced anaphylaxis, is underestimated and underdiagnosed in endurance/ultra-endurance athletes. Exercise-associated urticaria and anaphylaxis are important medical issues requiring increased awareness. Development of valid and reliable pre-race risk assessment tools is required to ensure an adequate medical support during the endurance/ultra-endurance events. However, current regulations differ between countries. A careful analysis of triggers and confounding factors related to a particular ultra-endurance competition is crucial for personalized recommendations. Task Force purposes include: to propose a pre-race risk assessment algorithm for recognition, management, and prevention of urticaria and anaphylaxis; to summarize knowledge gaps for research agenda; and to raise the awareness about urticaria and anaphylaxis in endurance and ultra-endurance athletes among medical professionals.

Chair: Elena Borzova
Secretary: Marcin Kurowski