I had a situation where my server went down for an hour when I clicked "Check users for spam" while there were over 100-200--500+ email addresses listed and not deleted yet. (There was a gap between my subscription renewal, so the spammy users built up for a while). The pattern seems to be having way more emails listed than you have concurrent SQL connections allowed, plus the forum already being busy.
Looking at the logs the server admin gave me, mysqld ran out of connections with massive numbers of "Waiting for table level lock" events (over 100 "Waiting for table level lock" piled up and clogged/deadlocked). For security reasons I can't publicly share the logs here, but a lot of deadlocked (waiting for table level lock) "INSERT INTO XXXXXXXbb_confirm" lines.
I could still ssh in so I found a workaround by "killall --user USERID" via ssh without needing to reboot the server (took a long time for me to figure this workaround out to kill all processes specific to the discussion forum, without needing to call my host sysadmin for emergency root access).
Then I clicked the "Check users for spam again" -- and right on cue (within 1-2 minutes) mysqld jammed completely, bringing down all mysql-dependant servers on my dedicated server.
Now I'll only check a few users at a time, but you might want to add some code to throttle the rate of queries to prevent unusual numbers of multithreaded "Waiting for table level lock" events.
If your forum has plenty of users, a lot of spammers, and you're a bit behind in executing a manual check (e.g. right after reactivating a subscription) -- I just wanted to let you know that Cleantalk phpbb plugin can cause 100% dedicated non-VPS Xeon server mysqld to go down for the count (without manual intervention) if you click "Check users for spam again" with over 100+ listed and keeping that textbox blank.
Temporary Workaround: Manually check only a few emails at a time -- and do it during off hours.
Permanent Workaround: Clealktalk phpbb plugin should code for gentler database access in a situation of being very far behind in spammer check in a "subscription-reactivation" manual-check situation.