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Illness and injury in athletes during the competition period at the London 2012 Paralympic Games: development and implementation of a web-based surveillance system (WEB-IISS) for team medical staff
  1. Wayne Derman1,2,
  2. Martin Schwellnus1,2,
  3. Esme Jordaan3,
  4. Cheri A Blauwet4,5,
  5. Carolyn Emery6,7,
  6. Pia Pit-Grosheide5,
  7. Norma-Angelica Patino Marques5,8,
  8. Oriol Martinez-Ferrer5,9,
  9. Jaap Stomphorst5,10,
  10. Peter Van de Vliet5,11,
  11. Nick Webborn12,
  12. Stuart E Willick5,13
  1. 1Department of Human Biology, UCT/MRC Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
  2. 2International Olympic Committee (IOC) Research Centre, Cape Town, South Africa
  3. 3Biostatistics Unit, Medical Research Council, Parow, South Africa
  4. 4Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, USA
  5. 5International Paralympic Committee (IPC) Medical Committee, Bonn, Germany
  6. 6Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Canada
  7. 7International Olympic Committee (IOC) Research Centre, Calgary, Canada
  8. 8National Center of Medicine and Sports Sciences, National Commission of Physical Culture and Sport in the Mexican Paralympic Centre, MexicoCity, Mexico
  9. 9Blanquerna Faculty of Sport Sciences, Ramon Llull University, Barcelona, Spain
  10. 10Sports Medicine Department, Isala Klinieken, Zwolle, the Netherlands
  11. 11Faculty of Kinesiology and Recreation Management, Health, Leisure and Human Performance Research Institute, University of Manitoba, Winnipeg, Canada
  12. 12Sussex Centre for Sport and Exercise Medicine, University of Brighton, Eastbourne, UK
  13. 13Physical Medicine and Rehabilitation, Orthopaedic Center, University of Utah, Salt Lake City, Utah, USA
  1. Correspondence to Professor Wayne Derman, UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, 3rd Floor Sports Science Institute of South Africa Boundary Road, Newlands, Cape Town 7700, South Africa; ewderman{at}


Background In this study we describe (1) the implementation of a novel web-based injury and illness surveillance system (WEB-IISS) for use by a team of physicians at multisport events and (2) the incidence and characteristics of injuries and illness in athletes during the London 2012 Paralympic Games.

Methods Overall, 3565 athletes from 160 of the 164 participating countries were followed daily over a 14-day period, consisting of a precompetition period (3 days), and a competition period (11 days) (49 910 athlete-days). Daily injury and illness data were obtained from teams with their own medical support (78 teams, 3329 athletes) via the WEB-IISS, and without their own medical support through the London Organising Committee of the Olympic Games and Paralympic Games database (82 teams and 236 athletes).

Results There were no differences between incidence rates (IR) of injury and illness, or between the precompetition and competition periods. The IR of injury during the competition period was 12.1/1000 athlete-days, with an incidence proportion (IP) of 11.6% (95% CI 11.0% to 13.3%). Upper limb injuries (35%), particularly of the shoulder (17%) were most common. The IR of illness during the competition period was 12.8/1000 athlete-days (95% CI 12.18 to 1421), with an IP of 10.2%. The IP was highest in the respiratory system (27.4%), skin (18.3%) and the gastrointestinal (14.5%) systems.

Conclusions During the competition period, the IR and IP of illness and injury at the Games were similar and comparable to the observed rates in other elite competitions. In Paralympic athletes, the IP of upper limb injuries is higher than that of lower limb injuries and non-respiratory illnesses are more common.

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