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Incidence rate and burden of illness at the Pyeongchang 2018 Paralympic Winter Games
  1. Wayne Derman1,2,
  2. Phoebe Runciman1,2,
  3. Esme Jordaan3,4,
  4. Martin Schwellnus2,5,
  5. Cheri Blauwet6,
  6. Nick Webborn7,
  7. Jan Lexell8,
  8. Peter van de Vliet9,
  9. James Kissick10,
  10. Jaap Stomphorst11,
  11. Young-Hee Lee12,
  12. Keun-Suh Kim13
  1. 1 Institute of Sport and Exercise Medicine, Division of Orthopaedics, Department of Surgery, Stellenbosch University, Cape Town, South Africa
  2. 2 IOC Research Centre South Africa, South Africa
  3. 3 Biostatistics Unit, Medical Research Council, Cape Town, South Africa
  4. 4 Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
  5. 5 Sport, Exercise Medicine and Lifestyle Institute, University of Pretoria, Faculty of Health Sciences, Pretoria, South Africa
  6. 6 Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
  7. 7 Centre for Sport and Exercise Science and Medicine, University of Brighton, Eastbourne, UK
  8. 8 Department of Neuroscience, Rehabilitation Medicine, Uppsala Universitet, Uppsala, Sweden
  9. 9 Medical and Scientific Department, International Paralympic Committee, Bonn, Germany
  10. 10 Carleton University Sport Medicine Clinic, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
  11. 11 Department of Sports Medicine, Isala Klinieken, Zwolle, The Netherlands
  12. 12 Rehabilitation Medicine, Wonju College of Medicine, Yonsei University, Wonju, The Republic of Korea
  13. 13 Yonsei Institute of Sports Science and Exercise Medicine, Yonsei University, Seodaemun-gu, The Republic of Korea
  1. Correspondence to Professor Wayne Derman, Institute of Sport and Exercise Medicine, Division of Orthopaedics, Department of Surgery, Stellenbosch University, Stellenbosch, 7602, South Africa; ewderman{at}


Objective To describe the incidence rate (IR) and illness burden (IB) at the Pyeongchang 2018 Paralympic Winter Games.

Methods A total of 567 athletes from 49 countries were monitored for 12 days over the Pyeongchang 2018 Games (6804 athlete days). Illness data were obtained daily from teams with (41 teams, 557 athletes) and teams without (8 teams, 10 athletes) their own medical support, through electronic data capturing systems.

Results There were 87 illnesses reported, with an illness IR of 12.8 illnesses per 1000 athlete days (95% CI 10.2 to 16.0) and IB of 6.8 days lost per 1000 athlete days (95% CI 3.4 to 13.5). The highest IR was reported for Para snowboard (IR of 19.7 [95% CI 12.0 to 32.2]). Illnesses in the respiratory system (IR of 4.1 [95% CI 2.9 to 5.9]; IB of 1.4 [95% CI 0.6 to 3.0]), skin and subcutaneous system (IR of 2.5 [95% CI 1.5 to 4.1]; IB of 0.6 [95% CI 0.1 to 2.9]), and eye and ocular adnexa (IR of 1.6 [95% CI 0.9 to 3.1]; IB of 0.5 [95% CI 0.1 to 3.3]) were the most common.

Conclusion This is the first study to report both the IR and IB in this setting. There was a high IR of illness in the new sport of Para snowboard. The respiratory system had both the highest IR and IB.

  • disability
  • illness
  • athlete

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  • Twitter The burden of #athlete #illness at the #PyeongChang2018 @Paralympics

  • Contributors All authors have contributed to the development, application and write-up of the current study.

  • Funding Funding for this study was provided by the IOC Research Centre South Africa grant and International Paralympic Committee research support.

  • Competing interests All authors have declared competing interests.

  • Patient consent Not required.

  • Ethics approval Research ethical approval was granted by the University of Brighton (FREGS/ES/12/11) and Stellenbosch University (N16/05/067) research ethics committees before research activities were conducted. During the registration process, consent was obtained from all athletes for the use of de-identified medical data gathered during the Games.

  • Provenance and peer review Not commissioned; externally peer reviewed.