Elite athletes travelling to international destinations >5 time zone differences from their home country have a 2–3-fold increased risk of illness
- Martin P Schwellnus1,2,
- Wayne Elton Derman1,2,
- Esme Jordaan3,
- Tony Page4,
- Mike Ian Lambert1,2,
- Clint Readhead5,
- Craig Roberts5,6,
- Ryan Kohler7,
- Robert Collins8,9,
- Stephen Kara10,
- Michael Ian Morris11,
- Org Strauss12,
- Sandra Webb13
- lDepartment of Human Biology, Faculty of Health Sciences, UCT/MRC Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Newlands, South Africa
- 2International Olympic Committee Research Centre, Cape Town, South Africa
- 3Biostatistics Unit, Medical Research Council, Parow, South Africa
- 4Sports Medicine Department, Olympic Park Sports Medicine Centre, Melbourne, Australia
- 5Medical and Scientific Department, South African Rugby Union, Cape Town, South Africa
- 6Discipline of Sports Science, Faculty of Health Sciences, University of Kwazulu-Natal, Durban, South Africa
- 7Sports Medicine Department, Australian Institute of Sport, Canberra, Australia
- 8Sports Medicine Department, Golden Lions Rugby Union, Johannesburg, South Africa
- 9Section Sports Medicine, University of Pretoria, Pretoria, South Africa
- 10Sports Medicine Department, Blues Super Rugby Franchise, Auckland, New Zealand
- 11Sports Medicine Department, Cheetahs Rugby Union, Bloemfontein, South Arica
- 12Sports Medicine Department, Blue Bulls Rugby Union, Pretoria, South Africa
- 13Highlanders, Dunedin, New Zealand
- Correspondence to
Professor Martin Schwellnus, Department of Human Biology, Faculty of Health Sciences, UCT/MRC Research Unit for Exercise Science and Sports Medicine, 3rd Floor Sports Science Institute of South Africa, Boundary Road, Newlands, Cape Town 7700, South Africa; ,
- Accepted 28 June 2012
- Published Online First 8 August 2012
Background Illness accounts for a significant proportion of consultations with a team physician travelling with elite athletes.
Objective To determine if international travel increases the incidence of illness in rugby union players participating in a 16-week tournament.
Setting 2010 Super 14 Rugby Union tournament.
Participants 259 elite rugby players from eight teams were followed daily over the 16-week competition period (22 676 player-days).
Assessment Team physicians completed a logbook detailing the daily squad size and illness in any player (system affected, final diagnosis, type and onset of symptoms, training/match days lost and suspected cause) with 100% compliance. Time periods during the tournament were divided as follows: located and playing in the home country before travelling (baseline), located and playing abroad in countries >5 h time zone difference (travel) and located back in the home country following international travel (return).
Main outcome measurement Incidence of illness (illness per 1000 player-days) during baseline, travel and return.
Results The overall incidence of illness in the cohort was 20.7 (95% CI 18.5 to 23.1). For all teams, the incidence of illness according to location and travelling was significantly higher in the time period following international travel (32.6; 95% CI 19.6 to 53.5) compared with the baseline (15.4; 95% CI 8.7 to 27.0) or after returning to their home country (10.6; 95% CI 6.1 to 18.2).
Conclusions There is a higher incidence of illness in athletes following international travel to a foreign country that is >5 h time difference and this returns to baseline on return to the home country.
Funding IOC Research Center: 2009-09-07, partial support.
Competing interest None.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.