Incidence and burden of illness at the Tokyo 2020 Paralympic Games held during the COVID-19 pandemic: a prospective cohort study of 66 045 athlete days

Abstract

ObjectiveTo describe the incidence and burden of illness at the Tokyo 2020 Paralympic Games, which was organised with strict COVID-19 countermeasures.MethodsDaily illnesses were recorded via the web-based injury and illness surveillance system (teams with their own medical staff; n=81), and local polyclinic services (teams without their own medical staff; n=81). Illness proportion, incidence and burden were reported for all illnesses and in subgroups by sex, age, competition period, sports and physiological system.Results4403 athletes (1853 female and 2550 male) from 162 countries were monitored for the 15-day period of the Tokyo Paralympic Games (66 045 athlete days). The overall incidence of illnesses per 1000 athlete days was 4.2 (95% CI 3.8 to 4.8; 280 illnesses). The highest incidences were in wheelchair tennis (7.1), shooting (6.1) and the new sport of badminton (5.9). A higher incidence was observed in female compared with male athletes (5.1 vs 3.6; p=0.005), as well as during the precompetition versus competition period (7.0 vs 3.5; p<0.0001). Dermatological and respiratory illnesses had the highest incidence (1.1 and 0.8, respectively). Illness burden was 4.9 days per 1000 athlete days and 23% of illnesses resulted in time loss from training/competition>1 day.ConclusionThe incidence of illness at the Tokyo 2020 Paralympic Games was the lowest yet to be recorded in either the summer or winter Paralympic Games. Dermatological and respiratory illnesses were the most common, with the burden of respiratory illness being the highest, largely due to time loss associated with COVID-19 cases. Infection countermeasures appeared successful in reducing respiratory and overall illness, suggesting implementation in future Paralympic Games may mitigate illness risk.

Incidence of injury and illness at the Beijing 2022 Paralympic Winter Games held in a closed-loop environment: a prospective cohort study of 7332 athlete days

“…Team sizes were determined by using the final master list of participating athletes in each team published by the IPC prior to the Games. The calculation of athlete days (total, precompetition and competition periods), injury proportion (IP) and incidence is consistent with the methodology of previous iterations of the Paralympic Injury and Illness Surveillance Studies and presented in supplementary file 2 2–6 17 18…”

Incidence and factor analysis for the heat-related illness on the Tokyo 2020 Olympic and Paralympic Games

“…Dermon et al 17 reported a higher incidence of heat-related illnesses in wheelchair athletes than in able-bodied athletes due to altered vasomotor control, large trunk area, proximity to the ground, high radiant heat and impaired body temperature control in disabled sports. Furthermore, the risk of heat-related illnesses is high both indoors and outdoors.…”

“…The following items were examined: (1) date, (2) venue, (3) event name, (4) time of occurrence, (5) continent of origin, (6) gender, (7) years by decade, (8) chief problem, (9) physician diagnosis, (10) severity classification, (11) vital signs at the initial visit, (12) treatment, (13) transportation methods (ambulance, other), (14) admissions to the medical facility, (15) transport to medical facilities, (16) whether transported to a medical facility, (17) hospitalisation and treatment at medical facilities, (18) outcome and (19) WBGT at the venue.…”

Response

“…On the other hand, studies in well-trained able-bodied athletes have shown that high T c values are common, well tolerated (i.e., no health complaints), and not strongly associated with performance loss (2–4). Data on EHI in para-athletes remain scarce, but the available studies suggest that para-athletes are not predisposed to an elevated EHI risk per se (5–7). During the Tokyo 2020 Paralympic and Olympic Games, only 0.4% of para-athletes and 0.7% of able-bodied athletes reported to medical services with (exertional) hyperthermia or heat illness (7,8).…”

“…Data on EHI in para-athletes remain scarce, but the available studies suggest that para-athletes are not predisposed to an elevated EHI risk per se (5–7). During the Tokyo 2020 Paralympic and Olympic Games, only 0.4% of para-athletes and 0.7% of able-bodied athletes reported to medical services with (exertional) hyperthermia or heat illness (7,8). In most cases, the illness did not affect subsequent training or competition availability, suggesting that illnesses were mild.…”