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Athlete health and safety at large sport events: the development of consensus-driven guidelines
  1. Margo Mountjoy1,2,
  2. Jane Moran2,3,
  3. Hosny Ahmed4,
  4. Stephane Bermon5,
  5. Xavier Bigard6,
  6. Dominik Doerr7,
  7. Alain Lacoste8,
  8. Stuart Miller9,
  9. Alexis Weber10,
  10. Jeremy Foster11,
  11. Richard Budgett12,
  12. Lars Engebretsen12,
  13. Louise M Burke13,
  14. Vincent Gouttebarge14,
  15. Marie-Elaine Grant15,
  16. Brian McCloskey16,
  17. Paul Piccininni17,
  18. Sebastien Racinais18,
  19. Mark Stuart19,
  20. David Zideman20
  1. 1Bureau—Sport Medicine Liaison, McMaster University Michael G DeGroote School of Medicine, Hamilton, Ontario, Canada
  2. 2Medical and Scientific Commission—Games Group—Sport Medicine, International Olympic Committee, Lausanne, Vaud, Switzerland
  3. 3Medical Commission, International Skating Union, Victoria, British Columbia, Canada
  4. 4ADU, International Handball Federation, Basel, Switzerland
  5. 5Sports Medicine, World Athletics, Monaco
  6. 6Sport Medicine, Union Cycliste Internationale, Aigle, Vaud, Switzerland
  7. 7International Weightlifting Federation (IWF), Budapest, Hungary
  8. 8Sports Medicine, World Rowing, Lausanne, Vaud, Switzerland
  9. 9Science & Technical Department, International Tennis Federation, Roehampton, UK
  10. 10Medicine & Science, FIFA, Zürich, Switzerland
  11. 11Association of Summer Olympic International Federations (ASOIF), Lausanne, Switzerland
  12. 12Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
  13. 13Nutrition Working Group, International Olympic Committee, Lausanne, Vaud, Switzerland
  14. 14Mental Health Working Group, International Olympic Committee, Lausanne, Vaud, Switzerland
  15. 15Medical and Scientific Commission Games Group—Physiotherapy, International Olympic Committee, Lausanne, Vaud, Switzerland
  16. 16Medical and Scientific Commission—Games Group—Public Health, International Olympic Committee, Lausanne, Vaud, Switzerland
  17. 17Medical and Scientific Commission—Dental, International Olympic Committee, Lausanne, Vaud, Switzerland
  18. 18Medical and Scientific Commission—Games Group Sport Science: adverse weather impact, International Olympic Committee, Lausanne, Vaud, Switzerland
  19. 19Medical and Scientific Commission Games Group—Pharmacy, International Olympic Committee, Lausanne, Vaud, Switzerland
  20. 20Medical and Scientific Commission—Games Group Anaesthesiologist and Emergency Pre-Hospital Care Consultant, International Olympic Committee, Lausanne, Vaud, Switzerland
  1. Correspondence to Dr Margo Mountjoy, Bureau - Sport Medicine Liaison, McMaster University Michael G DeGroote School of Medicine, Hamilton, Canada; mountjm{at}


All sport events have inherent injury and illness risks for participants. Healthcare services for sport events should be planned and delivered to mitigate these risks which is the ethical responsibility of all sport event organisers. The objective of this paper was to develop consensus-driven guidelines describing the basic standards of services necessary to protect athlete health and safety during large sporting events. By using the Knowledge Translation Scheme Framework, a gap in International Federation healthcare programming for sport events was identified. Event healthcare content areas were determined through a narrative review of the scientific literature. Content experts were systematically identified. Following a literature search, an iterative consensus process was undertaken. The outcome document was written by the knowledge translation expert writing group, with the assistance of a focus group consisting of a cohort of International Federation Medical Chairpersons. Athletes were recruited to review and provide comment. The Healthcare Guidelines for International Federation Events document was developed including content-related to (i) pre-event planning (eg, sport medical risk assessment, public health requirements, environmental considerations), (ii) event safety (eg, venue medical services, emergency action plan, emergency transport, safety and security) and (iii) additional considerations (eg, event health research, spectator medical services). We developed a generic standardised template guide to facilitate the planning and delivery of medical services at international sport events. The organisers of medical services should adapt, evaluate and modify this guide to meet the sport-specific local context.

  • elite performance
  • health
  • injury prevention
  • public health
  • illness
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  • Contributors MM: first author, substantial contributions to conception and design, drafting and revising the manuscript and approval of the final version to be published. RB, LE, JM, LMB, VG, M-EG, BMcC, PP, SR, MS and DZ: members of the expert working group who provided expert-related content, revised the manuscript and approved the final version. HA, SB, ZB, DD, AL, SM and AW: members of the focus group who reviewed and revised the manuscript, and approved the final version. JF: substantial contribution to design and proofing of the final version.

  • 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.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Research ethics approval was not required as this project is a knowledge translation initiative.

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

  • 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.

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