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Acute in-competition medical care at the Tokyo 2020 Olympics: a retrospective analysis
  1. Hideharu Tanaka1,2,
  2. Shota Tanaka3,
  3. Hiroyuki Yokota2,4,
  4. Yasuhiro Otomo2,5,
  5. Tomohiko Masuno2,6,
  6. Kousuke Nakano2,7,
  7. Manabu Sugita2,8,
  8. Takahiko Tokunaga2,9,
  9. Katsuhiko Sugimoto2,10,
  10. Junichi Inoue2,11,
  11. Nagisa Kato2,12,
  12. Tomoya Kinoshi1,2,
  13. Syuji Sakanashi1,2,
  14. Hironori Inoue1,2,
  15. Hiroto Numata2,10,
  16. Koshi Nakagawa1,
  17. Tetsuya Miyamoto2,
  18. Takao Akama2,13
  1. 1 Graduate School of Emergency Medical System, Kokushikan University, Tama, Japan
  2. 2 Medical Services Department, The Tokyo Organizing Committee of the Olympic and Paralympic Games, Tokyo, Japan
  3. 3 Research Institute of Disaster Management and EMS, Kokushikan University, Tama, Japan
  4. 4 Graduate School of Health and Medical Science, Nippon Sport Science University, Setagaya-ku, Japan
  5. 5 Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
  6. 6 Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Japan
  7. 7 Emergency Department, Saitama City Hospital, Saitama, Japan
  8. 8 Graduate School of Medicine, Juntendo University, Bunkyo-ku, Japan
  9. 9 Emergency Life Saving Academy Tokyo, Tokyo, Japan
  10. 10 Department of Sports Medicine, Kokushikan University, Tama, Japan
  11. 11 Emergency and Critical Care Center, Yamanashi Prefectural Central Hospital, Yamanashi, Japan
  12. 12 Emergency and Critical Care Center, Tokyo Medical and Dental University Hospital, Bunkyo-ku, Japan
  13. 13 Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
  1. Correspondence to Shota Tanaka, Research Institute of Disaster Management and EMS, Kokushikan University, Tama, 206-8515, Japan; tanakamedical24{at}


Objective To analyse injuries and illnesses during the 2020 Tokyo Olympic Summer Games.

Methods This retrospective descriptive study included 11 420 athletes from 206 National Olympic Committees and 312 883 non-athletes. Incidences of injuries and illnesses during the competition period from 21 July to 8 August 2021 were analysed.

Results A total of 567 athletes (416 injuries, 51 non-heat-related illnesses and 100 heat-related illnesses) and 541 non-athletes (255 injuries, 161 non-heat-related illnesses and 125 heat-related illnesses) were treated at the competition venue clinic. Patient presentation and hospital transportation rates per 1000 athletes were 50 and 5.8, respectively. Marathons and race walking had the highest incidence of injury and illness overall (17.9%; n=66). The highest incidence of injury (per participant) was noted in boxing (13.8%; n=40), sport climbing (12.5%; n=5) and skateboarding (11.3%; n=9), excluding golf, with the highest incidence of minor injuries. Fewer infectious illnesses than previous Summer Olympics were reported among the participants. Of the 100 heat-related illnesses in athletes, 50 occurred in the marathon and race walking events. Only six individuals were transported to a hospital due to heat-related illness, and none required hospital admission.

Conclusion Injuries and heat-related illnesses were lower than expected at the 2020 Tokyo Olympic Summer Games. No catastrophic events occurred. Appropriate preparation including illness prevention protocols, and treatment and transport decisions at each venue by participating medical personnel may have contributed to these positive results.

  • Covid-19
  • Sports medicine

Data availability statement

No data are available.

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  • HT and ST contributed equally.

  • Contributors Conceptualisation—HT and ST. Formal analysis—KNakagawa. Clinical Investigation—HY, HT, YO, TM, KNakano, MS, TT, KS, JI, SS, HI, HN, TK and NK. Methodology—HT and HY. Project administration—HT. Supervision—TM and TA. Visualisation—HT and ST. Writing (original draft)—HT and ST. Writing (review and editing)—HT and ST. Guarantor—HT. HT and ST equally contributed.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Map disclaimer The inclusion of any map (including the depiction of any boundaries therein), or of any geographic or locational reference, does not imply the expression of any opinion whatsoever on the part of BMJ concerning the legal status of any country, territory, jurisdiction or area or of its authorities. Any such expression remains solely that of the relevant source and is not endorsed by BMJ. Maps are provided without any warranty of any kind, either express or implied.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

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

  • Author note In this paper, we focus on the injuries, non-heat-related illnesses and heat-related illnesses that occurred not only among athletes but also among staff, officials and venue personnel involved in the 2020 Tokyo Olympic Games, and extract data from medical records from the perspective of emergency medicine. The purpose of this report is to share as much accurate information as possible from the 2020 Tokyo Olympic Games regarding the impact of the international mass-gathering event on the emergency medical care system operating within possible future infection outbreaks. This report is based on information compiled by the Medical Services Department of the Tokyo Organizing Committee for the 2020 Olympic and Paralympic Games, and is therefore subject to change. Note that there may be differences in the reports from each venue.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.