Nagaon Medical College Professor Collapses and Dies During Gym Workout: What Exercise-Related Cardiac Risks Mean for Adults

Table of Contents

1. Key Highlights:
2. Introduction
3. The Nagaon incident: timeline and immediate facts
4. How exertion can trigger cardiac events: basic physiology
5. Who faces higher risk?
6. How common are exercise-triggered deaths?
7. Signs and symptoms that should never be ignored
8. Immediate response: what saves lives
9. The role of gyms and fitness centers in safety
10. Screening and medical evaluation before high-intensity training
11. Designing safer training: principles for individuals and coaches
12. Drugs, supplements and hidden risks
13. Autopsy and medico-legal investigations: what families and institutions should expect
14. Lessons from past incidents: survival hinges on preparedness
15. Building a safer workout culture: recommendations for individuals, gyms and policymakers
16. Practical checklists: quick actions for safer exercise and emergency readiness
17. How healthcare workers and busy professionals can reduce risk
18. Reporting, transparency and community support after a death
19. Real-world examples of policy change after incidents
20. Preparing for uncertainty: realistic expectations about risk
21. FAQ

Key Highlights:

• Dr. Sahin Rahman, an associate professor at Nagaon Medical College, collapsed while exercising at a gym and was later declared dead; CCTV captured the incident and the official cause of death is pending.
• Exercise-induced cardiac events are uncommon but can occur, particularly among people with undiagnosed heart disease or those who suddenly undertake high-intensity workouts after a long period of inactivity.
• Practical steps — pre-exercise screening where appropriate, gradual training progression, symptom awareness, on-site emergency preparedness (CPR and AED) — reduce risk and increase chances of survival when an event occurs.

Introduction

A routine gym session ended in tragedy on the evening of August 27 when Dr. Sahin Rahman, an associate professor in Community Medicine at Nagaon Medical College and Hospital, collapsed during a workout and later died. The episode, captured by gym CCTV and now under official inquiry, has stirred grief across his professional and local communities and reopened a public conversation on the safety of vigorous exercise.

Exercise offers proven cardiovascular benefits, but brief periods of intense exertion can trigger serious medical events in vulnerable individuals. The line between health-promoting activity and dangerous strain hinges on individual risk factors, exercise intensity and the environment where exercise takes place. The circumstances of Dr. Rahman’s death underscore how preparedness, screening and rapid emergency response can determine outcomes. The following analysis synthesizes what is known about exertion-related cardiac events, translates medical guidance into practical steps, and outlines how individuals and fitness facilities can lower risk and respond effectively.

The Nagaon incident: timeline and immediate facts

Reports state Dr. Sahin Rahman lost consciousness at approximately 7:36 p.m. while exercising at a gym. CCTV footage reportedly recorded the moment he collapsed. He was transported for medical care but was declared dead on arrival. Authorities have not released a final cause of death; forensic examination and post-mortem results are awaited.

Colleagues, students and local residents expressed shock. Public reaction ranged from mourning to renewed debate on the obligations of fitness centers to have emergency equipment and trained personnel on site. The facts so far are straightforward: a sudden collapse during exercise, immediate medical attention, and a pending medico-legal determination. The unanswered question — why — requires clinical and forensic assessment. That assessment will consider heart disease, arrhythmia, structural cardiac conditions, exertional myocardial infarction, non-cardiac causes such as intracranial events, and non-medical contributors like stimulant use.

The incident is a reminder that sudden health crises can occur even among medically trained individuals. It also highlights the critical role of on-site preparedness: rapid recognition, early cardiopulmonary resuscitation (CPR) and early defibrillation are decisive factors in survival from sudden cardiac arrest.

How exertion can trigger cardiac events: basic physiology

Exercise increases heart rate, blood pressure and cardiac workload. For most people, the cardiovascular adaptations that follow repeated physical activity reduce long-term risk of heart attack, stroke and heart failure. Yet during the brief period of vigorous exertion, the sudden rise in heart rate and blood pressure imposes acute mechanical and electrical stress on the heart. That stress can precipitate life-threatening events when underlying vulnerabilities exist.

Common mechanisms by which exercise precipitates cardiac events include:

• Plaque rupture and thrombosis: Vigorous exertion can raise blood pressure and shear stress on coronary artery plaques. In people with atherosclerotic disease, this can trigger plaque rupture, forming a clot that occludes a coronary artery and causes a myocardial infarction.
• Arrhythmias: Exercise causes surges of sympathetic (adrenaline) activity. In hearts with an arrhythmogenic substrate — for example, scarring from prior infarction, inherited channelopathies, or cardiomyopathies — that surge can provoke ventricular tachycardia or ventricular fibrillation, which produce sudden cardiac arrest.
• Structural disorders: Conditions such as hypertrophic cardiomyopathy, dilated cardiomyopathy or anomalous coronary arteries create mechanical or ischemic vulnerabilities. While these often manifest in younger athletes, they can remain undiagnosed until a catastrophic event.
• Myocarditis: Viral or inflammatory injury to the heart muscle reduces electrical stability. Exercise during or shortly after myocarditis substantially increases risk of arrhythmia and sudden death.
• Non-cardiac causes: Pulmonary embolism, intracerebral hemorrhage, heat stroke, severe electrolyte imbalances and severe asthma exacerbations can also cause collapse during or after exercise.

These mechanisms explain why sudden collapse while exercising may stem from myocardial infarction, fatal arrhythmia, or other acute medical emergencies. Understanding the possible pathways helps guide screening, prevention and emergency response.

Who faces higher risk?

No exercise regimen is risk-free, but risk concentrates in identifiable groups. That matters when deciding who should pursue diagnostic testing before high-intensity activity and which safeguards gyms and workplaces should implement.

Risk factors that elevate the chance of an exertion-triggered cardiac event include:

• Age over 40 to 45: Risk from atherosclerotic coronary disease rises with age, especially in men. Women’s risk increases after menopause.
• Known coronary artery disease, prior heart attack or established heart failure.
• Uncontrolled hypertension, diabetes, high cholesterol and smoking — metabolic and vascular risk factors that accelerate atherosclerosis.
• Family history of premature coronary artery disease or sudden cardiac death.
• Symptoms during activity: chest pain, unexplained breathlessness, fainting or near-fainting episodes, palpitations.
• Prior diagnosis of cardiomyopathy, arrhythmic disorders, valvular disease or congenital heart disease.
• Recent viral illness, particularly if it involved fever or prolonged fatigue, which raises the possibility of myocarditis.
• Abrupt escalation of workout intensity after prolonged inactivity.
• Use of stimulants or certain pre-workout supplements that raise heart rate and blood pressure.

Young athletes face a different spectrum of risk: inherited structural or electrical heart diseases are more common precipitants of sudden cardiac death in that group. For middle-aged or older recreational exercisers, undiagnosed coronary artery disease tends to dominate.

Recognizing these risk factors allows targeted screening and tailored exercise prescriptions. For the general public, regular moderate exercise remains protective; the challenge lies in identifying the small subset for whom unmodified vigorous exertion could be dangerous.

How common are exercise-triggered deaths?

Exercise-related cardiac deaths are rare relative to the vast number of exercise sessions globally, but they carry high visibility because of their sudden and dramatic nature.

Key points to contextualize risk:

• Among young athletes, the incidence of sudden cardiac death is low — estimates vary but generally fall into single-digit cases per 100,000 athletes yearly. Many of these deaths stem from underlying structural or electrical heart conditions.
• Among middle-aged and older adults who exercise infrequently, the relative risk of an acute cardiac event transiently increases during high-intensity activity. The absolute risk, however, remains low for most people.
• Cardiovascular disease is the leading cause of death in India and worldwide; therefore, a non-negligible number of cardiac events will occur during activities of daily life, including exercise.
• Survival after out-of-hospital cardiac arrest depends heavily on immediate response: bystander CPR and early defibrillation can raise survival rates significantly. Cases where AEDs are available and used promptly demonstrate markedly better outcomes.

High-profile cases illustrate both the rarity and the potential for rescue. Footballer Christian Eriksen collapsed from cardiac arrest during a European Championship match in 2021 and survived after immediate CPR and defibrillation. Fabrice Muamba collapsed during a match in 2012; prolonged resuscitation and intensive care saved his life. These examples show how preparedness can save lives. They do not imply that collapse during exercise is common, but they demonstrate that rapid intervention is decisive.

Signs and symptoms that should never be ignored

Symptoms that suggest a person is at elevated risk during exercise require immediate evaluation and can provide crucial warning before catastrophic events.

Red-flag symptoms during or after exertion:

• Chest pain or pressure, particularly if it radiates to the jaw, neck, shoulder, back or arm.
• New or unexplained shortness of breath disproportionate to exertion level.
• Dizziness, lightheadedness, fainting (syncope) or near-syncope.
• Palpitations accompanied by galloping heartbeats, sustained or irregular.
• Sudden and severe fatigue, nausea, sweating or a sense of impending doom.
• A sudden inability to continue or complete a session because of unusual symptoms.

Any new or unexplained exertional chest discomfort or syncope should prompt immediate cessation of exercise and urgent medical assessment. Individuals with recurrent or persistent symptoms should not resume intense activity until a clinician has completed appropriate evaluation.

Immediate response: what saves lives

When cardiac arrest occurs, every minute without effective intervention reduces survival. Actions by bystanders before emergency medical services arrive determine outcomes more often than any other factor.

Immediate steps for a bystander:

• Call for emergency medical services immediately.
• Check for responsiveness and normal breathing. If unresponsive and not breathing normally, begin high-quality chest compressions with minimal interruptions: push hard and fast in the center of the chest at a rate of roughly 100–120 compressions per minute and a depth of about 5–6 cm in adults.
• If an automated external defibrillator (AED) is available, power it on immediately and follow voice prompts. Deliver a shock if indicated without delay. Early defibrillation is the single most effective intervention for many sudden cardiac arrests.
• If trained and able, provide rescue breaths in addition to compressions (30 compressions:2 breaths). If not trained or uncertain, compression-only CPR still substantially improves survival.
• Continue CPR until professional help takes over or the person shows signs of life.

Gyms, sports grounds and workplaces can multiply survival odds by placing AEDs in visible locations and ensuring staff are trained in CPR and AED use. A culture that encourages immediate action — rather than waiting for professionals — prevents fatal delays.

The role of gyms and fitness centers in safety

Fitness facilities are front-line settings for many exercise-related emergencies. Their responsibilities include creating a safe environment, reducing risks and providing timely response when something goes wrong.

Basic safety measures every gym should implement:

• Visible, accessible AEDs and staff trained to use them. The presence of an AED alone is not enough; regular maintenance checks and staff confidence matter.
• Staff trained and certified in basic life support (BLS) and CPR, with refresher courses scheduled.
• Clear emergency action plans with assigned roles, communication protocols, and maps showing how to access AEDs and call local emergency services.
• Screening and signposting: fitness centers should encourage new members, particularly those aged over 40 or with medical risk factors, to seek medical clearance before beginning intensive programs. Simple health questionnaires at registration help identify people who need evaluation.
• Equipment maintenance and supervision: a member undertaking heavy lifts or high-intensity training should be observed or spotter-assisted when necessary.
• Clear signage about the risks of stimulant supplements and recommended safe practices for high-intensity work.

Regulatory frameworks vary. Some countries require AEDs in public sports venues or provide strong recommendations. Until such mandates are universal, best practice within the industry should aim for widespread AED availability and staff training. The single-minded pursuit of performance must not supersede basic safety.

Screening and medical evaluation before high-intensity training

Not all exercisers require exhaustive medical testing. Screening should be risk-based and pragmatic.

Who should seek medical assessment before starting vigorous activity?

• People aged 40–45 or older who plan to begin high-intensity or competitive exercise and have cardiovascular risk factors.
• Anyone with symptoms suggestive of cardiovascular disease (chest pain, exertional breathlessness, syncope, persistent palpitations).
• Individuals with known coronary artery disease, structural heart disease, arrhythmias or prior cardiac events.
• Those with a significant family history of premature coronary disease or sudden cardiac death.
• People with medical conditions such as uncontrolled diabetes, severe hypertension or active inflammatory disease.

Basic pre-exercise evaluations commonly include:

• Clinical history and physical examination.
• Resting blood pressure and blood sugar control assessment.
• Review of medications.
• For selected individuals: resting ECG, exercise stress testing, echocardiography or referral to a cardiologist for more advanced testing.

Screening cannot eliminate all risk. It identifies many common problems that elevate danger and allows clinicians to provide tailored advice: whether to modify intensity, recommend cardiac rehabilitation-style programs, or proceed with unrestricted activity.

Designing safer training: principles for individuals and coaches

A sensible training plan reduces cardiac stress spikes and builds cardiovascular resilience. The same principles apply whether preparing for a race, returning after injury, or resuming training after long inactivity.

Practical training strategies:

• Progress gradually. Increase weekly training load by small increments rather than making abrupt jumps in intensity or volume.
• Warm up thoroughly before high-intensity work and cool down afterward. A progressive warm-up raises heart rate gradually and primes the circulation.
• Monitor intensity using perceived exertion scales (RPE) or heart rate zones based on individual fitness and, if available, data from a graded exercise test.
• Incorporate interval training judiciously. High-intensity intervals offer benefits but must be introduced progressively and with appropriate recovery.
• Maintain hydration and electrolyte balance, particularly in hot or humid conditions.
• Time intense sessions when rested and avoid doing maximal efforts immediately after prolonged inactivity, illness or heavy alcohol use.
• Reconsider stimulant-containing pre-workout supplements, especially if they contain high caffeine doses, synephrine, or other vasoconstrictors that raise heart rate and blood pressure.
• For older adults or those with chronic disease, supervised programs (cardiac rehab or medically supervised exercise) provide safer routes to improved fitness.

Coaches and trainers must individualize programs, screen for red flags, and create an environment where participants feel safe to report symptoms without stigma.

Drugs, supplements and hidden risks

Medications and over-the-counter supplements sometimes interact with exercise physiology in ways that increase risk.

Considerations include:

• Stimulant substances (including high-dose caffeine, pseudoephedrine, synephrine, amphetamines and certain “proprietary” supplements) raise heart rate and blood pressure and may provoke arrhythmias.
• Recreational substances, including cocaine and amphetamines, dramatically increase cardiovascular risk and should never be used in conjunction with exercise.
• Some prescription medications (decongestants, certain diet pills, and some antidepressants) alter heart rate and rhythm or blood pressure. Medical review is necessary to reconcile medication use with planned activity.
• Performance-enhancing drugs, including anabolic steroids and certain growth factors, can induce structural heart changes and increase arrhythmia risk.

Athletes and recreational exercisers should be transparent with healthcare providers about supplement and medication use. Labeling of supplements can be unreliable; independent verification and professional advice reduce the risk of inadvertently taking harmful compounds.

Autopsy and medico-legal investigations: what families and institutions should expect

When a sudden, unexpected death occurs in a public place, authorities typically conduct a medico-legal investigation. For families and institutions, transparency and timely communication are essential, even as investigations proceed.

Elements of a thorough investigation:

• External and internal examination by a forensic pathologist, including macroscopic inspection of the heart and other organs.
• Histological examination of cardiac tissue to identify myocarditis, cardiomyopathies, or arrhythmic substrates.
• Toxicology testing to detect medications, stimulants or illicit substances that might have contributed.
• Review of CCTV and witness statements to establish timing, preceding activity, and the response timeline.
• Correlation of clinical history and access to medical records for preexisting conditions.

Investigations provide the basis for cause-of-death conclusions and can inform preventive measures at the facility level. They also serve legal and administrative functions, including potential liability assessments and public health reporting.

Respecting the bereaved family’s privacy and ensuring accurate, non-speculative communication to the public are essential throughout the process.

Lessons from past incidents: survival hinges on preparedness

Global cases highlight how rapid intervention changes outcomes. When bystanders, teammates or staff perform effective CPR and deploy an AED within minutes, survival improves dramatically.

Notable instances:

• Christian Eriksen collapsed on the pitch during a high-profile international match. Immediate resuscitation and defibrillation permitted recovery and return to professional involvement in football after further evaluation and treatment.
• Fabrice Muamba, who collapsed during a football match, received prolonged and persistent resuscitation; intensive care eventually led to recovery, although he retired from professional sport.
• Numerous community examples demonstrate survival where AEDs and trained responders were present, underscoring the value of accessible defibrillation.

Lessons from these events for gyms and public places:

• Staff training and readily available AEDs save lives.
• Quick recognition and prompt bystander CPR prevent irreversible brain injury.
• Regular drills, clear roles and public awareness campaigns create environments where immediate action is the default.

Survival statistics improve with a chain of survival: immediate recognition and activation of emergency response, early CPR, rapid defibrillation, effective advanced life support and integrated post-resuscitation care.

Building a safer workout culture: recommendations for individuals, gyms and policymakers

A safer exercise environment results from aligned actions by individuals, fitness providers and public health authorities.

For individuals:

• Seek medical advice if you have risk factors or symptoms; do not ignore exertional chest pain or syncope.
• Start slowly, build intensity gradually, and respect rest and recovery.
• Avoid stimulant substances and disclose medication and supplement use to a healthcare professional.
• Learn basic CPR and AED use. Familiarity with emergency response empowers immediate action.

For gyms and fitness facilities:

• Install AEDs in accessible locations and display them prominently.
• Ensure staff hold current CPR and AED certifications and conduct regular emergency drills.
• Integrate a simple health questionnaire for new members and recommend medical clearance where indicated.
• Create an emergency action plan and make it visible to staff and members.
• Monitor equipment and facility safety; provide supervision for potentially hazardous activities.

For policymakers and public health authorities:

• Consider mandating AED availability in public sports and fitness venues or subsidizing AED distribution.
• Fund community-based CPR training and public awareness campaigns.
• Encourage occupational health screening in high-risk workplaces, including healthcare facilities where employees may defer personal health priorities.
• Support research and surveillance to better quantify exercise-related events and evaluate prevention strategies.

These recommendations reduce risk, improve emergency response and reassure communities that recreational and professional exercise can proceed safely.

Practical checklists: quick actions for safer exercise and emergency readiness

Simple, actionable checklists help embed safer behaviors.

Individual pre-exercise checklist:

• Have you had any chest pain, fainting, or unusual breathlessness with exertion? If yes, consult a physician.
• Are you starting training after a long period of inactivity or illness? Plan a gradual return.
• Have you reviewed medications and supplements with a clinician?
• Warm up for at least 10 minutes before intense work and cool down afterward.
• Stay hydrated and avoid extreme temperatures for high-intensity sessions.

Gym/operator checklist:

• Is an AED visible and operational? Check battery and pads monthly.
• Are at least some staff certified in CPR and AED use? Schedule periodic refreshers.
• Is there a written, tested emergency action plan with roles assigned for any shift?
• Do intake forms ask about cardiovascular symptoms and risk factors? Are high-risk patrons advised to have medical clearance?
• Are emergency numbers and AED location maps posted clearly?

Responder checklist (if someone collapses):

• Call emergency services and state location clearly.
• Check responsiveness and breathing. If absent or not normal, start chest compressions immediately.
• Send someone to retrieve the AED and instruct them on its location.
• Continue CPR and follow AED prompts.
• Provide emergency responders with any relevant history: symptoms before collapse, medications and known conditions.

These checklists translate policy into practice and improve outcomes when seconds matter.

How healthcare workers and busy professionals can reduce risk

Healthcare professionals often work long hours, face irregular schedules and deprioritize personal health. Their exposure to stressors and risk factors deserves special attention.

Strategies tailored to busy professionals:

• Schedule periodic health checks: short, focused occupational health assessments can detect hypertension, diabetes and other risk factors.
• Integrate short, moderate-intensity exercise into routines rather than sporadic maximal sessions.
• Prioritize sleep and recovery. Shift work and sleep deprivation worsen cardiovascular risk.
• Use workplace wellness programs that offer supervised exercise opportunities and medical clearance pathways.
• Encourage peer support and culture change that treats clinicians’ health as a professional responsibility, not a personal indulgence.

By embedding preventive care into professional life, clinicians can model safe behaviors and reduce the likelihood of unexpected events.

Reporting, transparency and community support after a death

When a sudden death occurs in a public place, institutions must balance transparency with respect for the bereaved. Clear communication, factual updates about investigations, and support for affected colleagues and patrons are essential.

Appropriate institutional actions:

• Provide timely, factual statements acknowledging the event while avoiding speculation about cause.
• Offer grief counseling and support services to staff, students and others affected.
• Cooperate with authorities and complete internal reviews of emergency response to identify improvements.
• Communicate changes implemented to prevent recurrence, such as AED installation or staff retraining.

Community support and professional solidarity reduce the secondary harms of such incidents and create momentum for safety improvements.

Real-world examples of policy change after incidents

Several jurisdictions adopted stricter safety measures after high-profile collapses in public settings. Examples vary from mandated AEDs in schools and sports stadiums to public CPR training campaigns. Legislation and policy often follow publicized incidents, but much can be accomplished proactively at the institutional level without waiting for regulatory mandates.

For instance, sports federations and major event organizers commonly require medical teams, resuscitation equipment and emergency action plans. Extending similar rigorous standards to community gyms and workplaces makes practical sense given the frequency of fitness participation and the proven value of rapid intervention.

Preparing for uncertainty: realistic expectations about risk

The goal is not to scare would-be exercisers away from physical activity. Regular, moderate exercise reduces cardiovascular morbidity and mortality across populations. The intent is to calibrate risk-awareness: recognize when higher intensity or certain personal factors elevate risk, and take steps accordingly. Awareness and preparation — not avoidance — protect health.

Individuals should weigh the benefits of exercise against individual risk and seek professional guidance when needed. Facilities should create systems that support safe participation and rapid response. Policymakers should prioritize interventions that demonstrate clear benefit, such as AED access and community CPR training.

FAQ

Q: How common are deaths during gym workouts? A: Deaths during exercise are uncommon compared with the number of exercise sessions that occur, but they do happen. Sudden cardiac events during vigorous exertion are more likely in people with underlying heart disease or specific risk factors. The absolute risk for most healthy people remains low.

Q: Should everyone get a cardiac clearance before starting gym workouts? A: Not everyone needs formal cardiac testing. Screening should be risk-based. People over middle age, those with cardiovascular risk factors (hypertension, diabetes, high cholesterol, smoking) or those with symptoms such as chest pain, breathlessness or syncope should seek medical evaluation before beginning high-intensity programs.

Q: Are AEDs necessary in gyms? A: AEDs significantly increase survival from sudden cardiac arrest when used promptly. Fitness centers, sports facilities and other public venues where strenuous activity occurs should have accessible AEDs and staff trained to use them.

Q: If I feel faint or dizzy during exercise, what should I do? A: Stop exercising immediately and sit or lie down. If symptoms resolve, seek medical assessment before resuming intense activity. If fainting occurs or symptoms persist, call emergency services.

Q: What if I witness someone collapse at the gym? A: Call emergency services immediately, check for responsiveness and breathing, and begin chest compressions if the person is unresponsive and not breathing normally. Send someone to fetch an AED and use it as soon as it is available. Continue CPR until help arrives.

Q: Can supplements cause problems during workouts? A: Some supplements contain stimulants and unregulated compounds that raise heart rate and blood pressure and may increase arrhythmia risk. Discuss any supplements with a healthcare professional and avoid products with undisclosed or high-dose stimulant ingredients.

Q: What precautions should older adults take when exercising? A: Older adults should start with moderate activity, progress gradually, and obtain medical review if they have chronic conditions or symptoms. Supervised programs and exercise prescriptions tailored to fitness level reduce risk and improve benefits.

Q: Will autopsy results tell the family what caused the collapse? A: A thorough autopsy, including histology and toxicology, often identifies the cause or contributing factors. Some cases require more complex testing or specialist cardiology and genetic analyses to reveal inherited conditions. Families should be prepared for a process that can take time.

Q: How can gyms improve safety without disrupting operations? A: Implement basic measures: place an AED in a prominent area, ensure staff hold CPR/AED certification, maintain clear emergency plans, and use intake questionnaires to identify members who need medical clearance. These steps are practical and minimally disruptive.

Q: Does vigorous exercise always increase heart attack risk? A: Vigorous activity transiently raises cardiac stress, which can increase the short-term risk of an event in those with underlying disease. Over the long term, regular training reduces cardiovascular risk. The balance favors exercise for most people when approached sensibly.

Q: Where can I learn CPR and AED use? A: Community-based providers such as the Red Cross, local hospitals, and certified training centers offer CPR and AED courses. Many organizations also provide workplace training. Learning these skills empowers individuals to act when seconds count.

Q: What should employers or institutions do after an on-site death? A: Cooperate with investigations, provide factual updates to stakeholders, offer grief support, review emergency protocols and implement improvements such as AED deployment and staff retraining. Transparent communication and practical change are critical.

This examination seeks to translate a tragic, specific incident into concrete lessons for prevention, preparedness and response. Sudden medical events during exercise can occur, but their consequences change dramatically when people and organizations prepare, recognize early warning signs and act swiftly. Practical, evidence-informed steps — screening where appropriate, gradual training progression, avoidance of risky substances, and universal basic emergency readiness — make exercise safer for everyone.