The epidemiology of injuries and illnesses at the London 2012 Paralympic Games

Under the IPC Medical Code, the IPC is dedicated to improving the safety of Paralympic sport, and pursues multiple courses of actions to mitigate injury and illness risks. Among these initiatives, the IPC Medical Committee conducted an epidemiological study to monitor injury and illness in athletes competing at the London 2012 Paralympic Games.

All but 4 nations participated in the project by reporting athlete injury and illness on a daily basis in a web-based surveillance system. The period of data collection was 14 days, from 27 August through 9 September 2012 (11 days of the competition period and 3 days of the pre-competition period). The outcomes have recently been published in scientific journals (see references below).

Data have been captured from 3565 athletes from 160 delegations. The main findings can be summarized as follows:

• The incidence rate for injury (injury per 1000 athlete-days) was 12.7. The incidence rate for illness was 13.2. Rates are similar across gender. These rates are slightly higher compared to findings in able-bodied elite sportsmen participating in multisport settings.
• Illnesses are at least as prevalent as injuries during Paralympic Games.
• Most injuries are acute injuries at the Games, and mostly related to upper limb regions (shoulder, elbow, wrist and hand).
• The sports with the highest incidence rates are Football 5-a-side, Powerlifting, Goalball, Wheelchair Fencing and Wheelchair Rugby. Safest sports are Shooting, Rowing and Sailing.
• Most illnesses are reported for athletes competing in Equestrian, Powerlifting, and Athletics. Least vulnerable to illness are the athletes in Football 7-a-side, Shooting and Football 5-a-side.
• Mainly illnesses of respiratory, skin, digestive, nervous and genitourinary systems are reported.

It is the first time such large scale epidemiological study took place on (elite) athletes with an impairment. These data have direct clinical relevance. E.g., a team physician travelling to a 10-day event with 100 Paralympic athletes can anticipate seeing about 12–13 injuries, about half of which will be new onsets, acute injuries. If the team composition includes athletes participating in the higher risk sports listed above, it is likely that the team will incur more than 12–13 injuries. The team physician should be ready to diagnose and treat a high percentage of upper limb injuries, and anticipate a range of illnesses to deal with.

The IPC will replicate this project in the Sochi 2014 Paralympic Winter Games and beyond, while currently analysing data more in detail by sport and/or impairment type.

Original Publications (available from the IPC upon request):

• Derman, W., Schwellnus, M., Jordaan, E., Blauwet, C., Emery, C., Pit-Grosheide, P., Patino Marques, N.A., Martinez-Ferrer, O., Stomphorst, J., Van de Vliet, P., Webborn, N., & Willick, S. (2013). Illness and injury in athletes during the competition period at the London 2012 Paralympic Games – Development and implementation of a web-based surveillance system (web-IISS) for team medical staff. British Journal of Sports Medicine, 47, 420-425.
• Willick, S., Webborn, N., Emery, C., Blauwet, C., Pit-Grosheide, P., Stomphorst, J., Van de Vliet, P., Patino Marques, N.A., Martinez-Ferrer, O., Jordaan, E., Derman, W., & Schwellnus, M. (2013). The epidemiology of injuries at the London 2012 Paralympic Games. British Journal of Sports Medicine, 47, 426-432.
• Schwellnus, M., Derman, W., Jordaan, E., Blauwet, C., Emery, C., Pit-Grosheide, P., Patino Marques, N.A., Martinez-Ferrer, O., Stomphorst, J., Van de Vliet, P., Webborn, N., & Willick, S. (2013). Factors associated with illness in athletes participating in the London 2012 Paralympic Games – A prospective cohort study involving 49910 athlete days. British Journal of Sports Medicine, 47, 433-440.

For more detail, please contact the International Paralympic Committee
Ms. Cris Gomes, IPC Medical Manager, cris.gomes@paralympic.org