The early reports out of this weekend's Chicago Marathon rang unsettlingly familiar to Honolulu Marathon Association president Jim Barahal's ears.

One runner was confirmed dead and hundreds had to be taken to the hospital as high heat and humidity wreaked havoc on a field of some 35,000 participants. Amid the swirl of accusations and denials that followed the cancellation of the race after 3 1/2 hours came anecdotal reports of drink shortages along the early stages of the course and overheated runners detouring into convenience stores looking for something to drink.

Critics accused Chicago Marathon officials of being unprepared for the unusually hot weather. Race officials, who admitted that they didn't anticipate runners using the drinks to pour on themselves, insisted that they had responded properly by increasing the number of drink servings at designated aid stations from 1.6 million to 1.8 million.

"The first thing my mind flashed to was our own marathon in 1995," Barahal said. "What we learned from that experience absolutely left a mark on all of us here."

Had Chicago Marathon authorities studied what happened that year in Honolulu, it's possible the catastrophic situation might have been resolved differently, Barahal said.

Honolulu Marathon officials had been closely tracking the weather conditions in the week prior to the 1995 race and had taken measures to ensure they could respond to heat-related emergencies on race day.

Because water for the aid stations was to be drawn from fire hydrants, runners were sure to have an ample supply of fluids, but the association also increased its order of the cups from which runners would drink to account for the greater demand. In addition, the association also chartered tour buses just in case large numbers of runners needed to be removed from the course.

The day unfolded just as Barahal and his officers had feared. The race started in the dark with a temperature of 84 degrees and rising. Within the first three hours of the 26.2-mile event, hundreds of runners had been waylayed by the heat and medical tents were filled with participants requiring treatment for dehydration and heat exhaustion.

The tour buses were dispatched, and staff and volunteers encouraged runners to either drop out or walk. On the long, exposed stretch of road along Kahala Avenue, race officials commandeered water hoses from private homes to spray runners as they entered the home stretch. Barahal checked on runners along Diamond Head Road, encouraging them to call it a day as they vomited at his feet.

"We used 171 IVs and a number of runners were sent to the hospital," Barahal recalled. "All you could hear were sirens."

Despite the warnings, most of the runners refused to quit. Barahal and other race officials convened at Kapi'olani Park to mull their options. If medical issues continued to arise at the same rate, they knew they might have to cancel the race. They decided to continue monitoring the situation, re-evaluating their course of action every few minutes.

There were several considerations at play: the safety of the runners, the logistics involved with stopping the race, the possibility that canceling the race would lead to ruinous legal consequences.

"We also had to weigh the moral and ethical question of how much responsibility do we assume and to what degree were runners responsible for making their own decisions about whether to continue," Barahal said. "It went directly to how we view society. Is someone else responsible for you at all times, or do you take responsibility for your own safety? That's what running is all about. It's about training and preparation and ultimately personal achievement."

But then something unexpected and, in Barahal's word, "miraculous" happened. With each advancing minute, fewer and fewer runners sought help. By the 5-hour mark, the crisis seemed well under control. By seven hours, everything was back to normal, despite the unchanging weather.

"If we had extrapolated out what was happening at 3 1/2 hours to 5 hours, we would have been completely wrong," Barahal said. "What carried it for us was that we had enough water and, after 3 1/2 hours, when things were most dire, the medical situation improved."

Barahal concluded that those who were most affected were competitive runners who were impacted by heat and humidity more because of the level of exertion at which they performed. Slower runners and walkers were less likely to suffer from dehydration and heat exhaustion because of their more moderate level of exertion.

"But who knows what would have happened if we ran out of water," Barahal said, referring to the Chicago situation.

Barahal said he is waiting to see what information emerges from the aftermath of the Chicago Marathon before forming any substantive judgments. Still, he wonders if popular concern over a condition known as hyponatremia, an electrolyte imbalance that can result from drinking too much water, played any role in Chicago Marathon organizers failing to provide enough water on the course.

The relatively rare condition received widespread attention after a runner reportedly died from it during the 2002 Boston Marathon. Several top marathons now include warnings about over-hydrating in their race packet materials and Barahal said he and other race officials have been urged by medical professionals to adopt such warnings.

However, Barahal, a physician, said the single study commonly referenced to support such warnings is inconclusive at best. To him, the risk that marathoners face in under-hydrating in hot race conditions far outweighs the much slimmer chance that they might overhydrate to the point of hyponatremia.

"For every runner that drinks too much, there are a hundred that don't drink enough," he said.

The example of the 1995 Honolulu Marathon would seem to bear that out, he said, noting that it is highly unlikely that a runner could consume enough fluid in 3 1/2 hours to induce such a condition. Runners who finish in seven our eight hours would be more prone to drinking water at such a volume over the course of the race.

Barahal also noted that runners who are concerned about hyponatremia should simply make sure they drink a sports drink that contains sodium and other electrolytes.

Gatorade, a sports drink that contains higher levels of sodium, will be available at aid stations in this year's Honolulu Marathon.

Reach Michael Tsai at mtsai@honoluluadvertiser.com.