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Protecting the health of Olympic athlete is the highest priority of the International Olympic Committee (IOC) Medical Commission.1 Emphasising this commitment, an injury surveillance system was established for all team sports during the 2004 Athens Olympic Games.2 This was followed by including individual sports in the IOC injury surveillance system, beginning with the 2008 Beijing games.3 For the 2010 Vancouver winter games, the surveillance system was expanded to include newly sustained illnesses.4
Challenging environmental conditions, including heat and humidity, cold, and altitude, pose particular risks to the health of athlete. As athletes must also contend with the unique physical requirements of their respective sport, universal safety guidelines do not always sufficiently address sport-specific injury and other clinical risks. The interaction between the demands of the sport and the environmental conditions – even with seemingly benign environments that represent limited danger to the general population under less intense and/or shorter recreational scenarios – can present a substantial potential hazard to the health of Olympic athlete or other elite athlete who is making an all-out effort for an extended period of time. For example, exertional heatstroke has been reported in a marathon runner recovering from a viral syndrome during a race held in a cool (6.1–9.4°C) but humid (62–99% relative humidity – RH) environment.5 Conversely, during a 21 km event in warm and humid conditions (WBGT 26.0–29.2°C), all runners finished the race without symptoms of exertional heat illness, despite body core temperature being >39°C for all of the 18 screened runners. Moreover, 10 of those asymptomatic screened finishers had a body core temperature >40°C, while two reached 41°C.6 Notably, a number of individual factors (eg, experience, recent health history and status, fitness, acclimatisation, physical and psychological make-up, nutritional and hydration status and sweat loss rate) each …
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