Background The influence of different weather conditions on injury risk has only been scarcely investigated.
Objective The objective was to study the influence of climate type on injury epidemiology in men's professional football in Europe.
Design Prospective cohort study.
Setting Men's professional football from nine European football associations.
Participants 24 clubs followed over a varying number of seasons from 2001/2002 to 2008/2009.
Assessment of risk factors The assessed risk factor was the climate type according to the Köppen-Geiger Climate Classification System. This system is divided into five climate types based on the average monthly temperature and precipitation. The dominating climate types in Europe are the Mediterranean, the Marine West Coast (MWC), the Humid Continental, and the Subarctic types.
Main outcome measurements The main outcome measure was the difference in time-loss injury incidence between clubs with Mediterranean (MED) and MWC climate types expressed as a rate ratio (RR) with 95% CI.
Results Excluding one club belonging to the Humid Continental climate type, there were 16 clubs in MWC group (61 team-seasons) and seven clubs in the MED group (40 team-seasons). The MED group had significantly lower incidence of training (3.5 vs 4.4/1000 h, RR 0.79, 95% CI 0.72 to 0.86) and match (25.5 vs 29.1/1000 h, RR 0.88, 95% CI 0.81 to 0.94) injuries. There were no differences for severe injuries (RR 0.95, 95% CI 0.82 to 1.09), strains (RR 1.05, 95% CI 0.95 to 1.15) or sprains (RR 0.89, 95% CI 0.78 to 1.02). However, the incidence of anterior cruciate ligament (ACL) injury was higher (0.087 vs 0.042/1000 h, RR 2.07, 95% CI 1.10 to 3.90) in the MED group, especially for non-contact ACL injuries (0.083 vs 0.012/1000 h, RR 6.72, 95% CI 2.53 to 17.83).
Conclusion Clubs with a Mediterranean climate type had lower injury risk in general, but a substantially higher risk of non-contact ACL injury.
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