Association between thermal responses, medical events, performance, heat acclimation and health status in male and female elite athletes during the 2019 Doha World Athletics Championships.

PURPOSE: To determine associations between thermal responses, medical events, performance, heat acclimation and health status during a World Athletics Championships in hot-humid conditions. METHODS: From 305 marathon and race-walk starters, 83 completed a preparticipation questionnaire on health and acclimation. Core (Tcore; ingestible pill) and skin (Tskin; thermal camera) temperatures were measured in-competition in 56 and 107 athletes, respectively. 70 in-race medical events were analysed retrospectively. Performance (% personal best) and did not finish (DNF) were extracted from official results. RESULTS: Peak Tcore during competition reached 39.6°C±0.6°C (maximum 41.1°C). Tskin decreased from 32.2°C±1.3°C to 31.0°C±1.4°C during the races (p<0.001). Tcore was not related to DNF (25% of starters) or medical events (p≥0.150), whereas Tskin, Tskin rate of decrease and Tcore-to-Tskin gradient were (p≤0.029). A third of the athletes reported symptoms in the 10 days preceding the event, mainly insomnia, diarrhoea and stomach pain, with diarrhoea (9% of athletes) increasing the risk of in-race medical events (71% vs 17%, p<0.001). Athletes (63%) who performed 5-30 days heat acclimation before the competition: ranked better (18±13 vs 28±13, p=0.009), displayed a lower peak Tcore (39.4°C±0.4°C vs 39.8°C±0.7°C, p=0.044) and larger in-race decrease in Tskin (-1.4°C±1.0°C vs -0.9°C±1.2°C, p=0.060), than non-acclimated athletes. Although not significant, they also showed lower DNF (19% vs 30%, p=0.273) and medical events (19% vs 32%, p=0.179). CONCLUSION: Tskin, Tskin rate of decrease and Tcore-to-Tskin gradient were important indicators of heat tolerance. While heat-acclimated athletes ranked better, recent diarrhoea represented a significant risk factor for DNF and in-race medical events.

Injury characteristics in male youth athletics: a five-season prospective study in a full-time sports academy.

OBJECTIVES: To describe the injury characteristics of male youth athletes exposed to year-round athletics programmes. METHODS: Injury surveillance data were prospectively collected by medical staff in a cohort of youth athletics athletes participating in a full-time sports academy from 2014-2015 to 2018-2019. Time-loss injuries (>1 day) were recorded following consensus procedures for athletics. Athletes were clustered into five event groups (sprints, jumps, endurance, throws and non-specialised) and the number of completed training and competition sessions (athletics exposures (AE)) were calculated for each athlete per completed season (one athlete season). Injury characteristics were reported overall and by event groups as injury incidence (injuries per 1000 AE) and injury burden (days lost per 1000 AE). RESULTS: One-hundred and seventy-eight boys (14.9±1.8 years old) completed 391 athlete seasons, sustaining 290 injuries. The overall incidence was 4.0 injuries per 1000 AE and the overall burden was 79.1 days lost per 1000 AE. The thigh was the most common injury location (19%). Muscle strains (0.7 injuries per 1000 AE) and bone stress injuries (0.5 injuries per 1000 AE) presented the highest incidence and stress fractures the highest burden (17.6 days lost per 1000 AE). The most burdensome injury types by event group were: bone stress injuries for endurance, hamstring strains for sprints, stress fractures for jumps, lesion of meniscus/cartilage for throws and growth plate injuries for non-specialised athletes. CONCLUSION: Acute muscle strains, stress fractures and bone stress injuries were identified as the main injury concerns in this cohort of young male athletics athletes. The injury characteristics differed between event groups.

Hydration and cooling in elite athletes: relationship with performance, body mass loss and body temperatures during the Doha 2019 IAAF World Athletics Championships.

PURPOSE: To characterise hydration, cooling, body mass loss, and core (Tcore) and skin (Tsk) temperatures during World Athletics Championships in hot-humid conditions. METHODS: Marathon and race-walk (20 km and 50 km) athletes (n=83, 36 women) completed a pre-race questionnaire. Pre-race and post-race body weight (n=74), Tcore (n=56) and Tsk (n=49; thermography) were measured. RESULTS: Most athletes (93%) had a pre-planned drinking strategy (electrolytes (83%), carbohydrates (81%)) while ice slurry was less common (11%; p<0.001). More men than women relied on electrolytes and carbohydrates (91%-93% vs 67%-72%, p≤0.029). Drinking strategies were based on personal experience (91%) rather than external sources (p<0.001). Most athletes (80%) planned pre-cooling (ice vests (53%), cold towels (45%), neck collars (21%) and ice slurry (21%)) and/or mid-cooling (93%; head/face dousing (65%) and cold water ingestion (52%)). Menthol usage was negligible (1%-2%). Pre-race Tcore was lower in athletes using ice vests (37.5°C±0.4°C vs 37.8°C±0.3°C, p=0.024). Tcore (pre-race 37.7°C±0.3°C, post-race 39.6°C±0.6°C) was independent of event, ranking or performance (p≥0.225). Pre-race Tsk was correlated with faster race completion (r=0.32, p=0.046) and was higher in non-finishers (did not finish (DNF); 33.8°C±0.9°C vs 32.6°C±1.4°C, p=0.017). Body mass loss was higher in men than women (-2.8±1.5% vs -1.3±1.6%, p<0.001), although not associated with performance. CONCLUSION: Most athletes' hydration strategies were pre-planned based on personal experience. Ice vests were the most adopted pre-cooling strategy and the only one minimising Tcore, suggesting that event organisers should be cognisant of logistics (ie, freezers). Dehydration was moderate and unrelated to performance. Pre-race Tsk was related to performance and DNF, suggesting that Tsk modulation should be incorporated into pre-race strategies.

Remote assessment in sport and exercise medicine (SEM): a narrative review and teleSEM solutions for and beyond the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic forces sport and exercise medicine (SEM) physicians to think differently about the clinical care of patients. Many rapidly implement eHealth and telemedicine solutions specific to SEM without guidance on how best to provide these services. AIM: The aim of this paper is to present some guiding principles on how to plan for and perform an SEM consultation remotely (teleSEM) based on a narrative review of the literature. A secondary aim is to develop a generic teleSEM injury template. RESULTS: eHealth and telemedicine are essential solutions to effective remote patient care, also in SEM. This paper provides guidance for wise planning and delivery of teleSEM. It is crucial for SEM physicians, technology providers and organisations to codesign teleSEM services, ideally involving athletes, coaches and other clinicians involved in the clinical care of athletes, and to gradually implement these services with appropriate support and education. CONCLUSION: teleSEM provides solutions for remote athlete clinical care during and after the COVID-19 pandemic. We define two new terms-eSEM and teleSEM and discuss guiding principles on how to plan for and perform SEM consultations remotely (teleSEM). We provide an example of a generic teleSEM injury assessment guide.

New MRI muscle classification systems and associations with return to sport after acute hamstring injuries: a prospective study.

OBJECTIVES: To determine agreement between modified Peetrons, Chan acute muscle strain injury classification and British Athletics Muscle Injury Classification (BAMIC) and to investigate their associations and ability to predict time to return to sport (RTS). METHODS: Male athletes (n=176) with acute hamstring injury and MRI (1.5T) ≤5 days were followed until RTS. MRIs were scored using standardised forms. RESULTS: For MRI-positive injuries there was moderate agreement in severity grading (κ = 0.50-0.56). Substantial variance in RTS was demonstrated within and between MRI categories. Mean differences showed an overall main effect for severity grading (p < 0.001), but post hoc pairwise comparisons for BAMIC (grade 0a/b vs. 1, p = 0.312; 1 vs 2, p = 0.054; 0a/b vs 2, p < 0.001; 1 vs 3, p < 0.001) and mean differences for anatomical sites (BAMIC a-c, p < 0.001 [a vs b, p = 0.974; a vs c, p = 0.065; b vs c, p = 0.007]; Chan anatomical sites 1-5, p < 0.077; 2A-C, p = 0.373; 2a-e, p = 0.008; combined BAMIC, p < 0.001) varied. For MRI-positive injuries, total explained RTS variance was 7.6-11.9% for severity grading and BAMIC anatomical sites. CONCLUSIONS: There was wide overlap between/variation within the grading/classification categories. Therefore, none of the classification systems could be used to predict RTS in our sample of MRI-positive hamstring injuries. KEY POINTS: • Days to RTS varied greatly within the grading and classification categories. • Days to RTS varied greatly between the grading and classification categories. • Using MRI classification systems alone to predict RTS cannot be recommended. • The specific MRI classification used should be reported to avoid miscommunication.

Strategies and factors associated with preparing for competing in the heat: a cohort study at the 2015 IAAF World Athletics Championships.

PURPOSE: Assess exertional heat illness (EHI) history and preparedness in athletes competing in a World Athletics Championships under hot/humid conditions and identify the factors associated with preparedness strategies. METHODS: Of the 207 registered national teams invited to participate in the study, 50 (24%) accepted. The 957 athletes (49% of all 1965 registered) in these teams were invited to complete a precompetition questionnaire evaluating EHI history, heat stress prevention (heat acclimatisation, precooling and hydration) and recovery. Responses from 307 (32%) athletes were separated in field events, sprints, middle-distance and long-distance running, and decathlon/heptathlon for analysis. RESULTS: 48% of athletes had previously experienced EHI symptoms and 8.5% had been diagnosed with EHI. 15% heat acclimatised (∼20 days) before the championships. 52% had a precooling strategy, ice slurry ingestion (24%) being the most prevalent and women using it more frequently than men (p=0.005). 96% of athletes had a fluid consumption strategy, which differed between event categories (p<0.001). The most common volumes planned on being consumed were 0.5-1 L (27.2%) and ≥2 L (21.8%), water being the most frequent. 89% of athletes planned on using at least one recovery strategy. Female sex (p=0.024) and a previous EHI diagnosis increased the likelihood of using all 3 prevention strategies (p<0.001). CONCLUSIONS: At a World Championships with expected hot/humid conditions, less than one-fifth of athletes heat acclimatised, half had a precooling strategy and almost all a hydration plan. Women, and especially athletes with an EHI history, were more predisposed to use a complete heat stress prevention strategy. More information regarding heat acclimatisation should be provided to protect athlete health and optimise performance at major athletics competitions in the heat.

Preparticipation predictors for championship injury and illness: cohort study at the Beijing 2015 International Association of Athletics Federations World Championships.

OBJECTIVES: To determine preparticipation predictors of injury and illness at a major Athletics championship. METHODS: A cohort study design was used. Before the 2015 International Association of Athletics Federations World Championships in Athletics, all 207 registered national teams were approached about partaking in a study of preparticipation health; 50 teams accepted. The athletes (n=957) in the participating teams were invited to complete a preparticipation health questionnaire (PHQ). New injuries and illnesses that occurred at the championships were prospectively recorded. Logistic regression analyses were performed with simple and multiple models using any in-championship injury and in-championship illness as outcomes. RESULTS: The PHQ was completed by 307 (32.1%) of the invited athletes; 116 athletes (38.3%) reported an injury symptom during the month before the championships, while 40 athletes (13%) reported an illness symptom. 20 (6.5%) of the participating athletes sustained a health problem during the championships. Endurance athletes were almost 10-fold more likely to sustain an in-championship illness than speed/power athletes (OR, 9.88; 95% CI 1.20 to 81.31; p=0.033). Participants reporting a preparticipation gradual-onset injury symptom were three times more likely (OR, 3.09; 95% CI 1.08 to 8.79; p=0.035) and those reporting an illness symptom causing anxiety were fivefold more likely (OR, 5.56; 95% CI 1.34 to 23.15; p=0.018) to sustain an in-championship injury. SUMMARY AND CONCLUSIONS: Analyses of preparticipation predictors of injury and illness at a major Athletics championship suggest that endurance athletes require particular clinical attention. Preparticipation symptoms causing anxiety are interesting predictors for in-championship health problems.

Sports injury and illness incidence in the Rio de Janeiro 2016 Olympic Summer Games: A prospective study of 11274 athletes from 207 countries.

OBJECTIVE: To describe the pattern of injuries and illnesses sustained during the Games of the XXXI Olympiad, hosted by Rio de Janeiro from 5 to 21 August 2016. METHODS: We recorded the daily incidence of athlete injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the Rio 2016 medical staff. RESULTS: In total, 11 274 athletes (5089 women, 45%; 6185 men, 55%) from 207 NOCs participated in the study. NOC and Rio 2016 medical staff reported 1101 injuries and 651 illnesses, equalling 9.8 injuries and 5.4 illnesses per 100 athletes over the 17-day period. Altogether, 8% of the athletes incurred at least one injury and 5% at least one illness. The injury incidence was highest in BMX cycling (38% of the athletes injured), boxing (30%), mountain bike cycling (24%), taekwondo (24%), water polo (19%) and rugby (19%), and lowest in canoe slalom, rowing, shooting, archery, swimming, golf and table tennis (0%-3%). Of the 1101 injuries recorded, 40% and 20% were estimated to lead to ≥1 and >7 days of absence from sport, respectively. Women suffered 40% more illnesses than men. Illness was generally less common than injury, with the highest incidence recorded in diving (12%), open-water marathon (12%), sailing (12%), canoe slalom (11%), equestrian (11%) and synchronised swimming (10%). Illnesses were also less severe; 18% were expected to result in time loss. Of the illnesses, 47% affected the respiratory system and 21% the gastrointestinal system. The anticipated problem of infections in the Rio Olympic Games did not materialise, as the proportion of athletes with infectious diseases mirrored that of recent Olympic Games (3%). CONCLUSION: Overall, 8% of the athletes incurred at least one injury during the Olympic Games, and 5% an illness, which is slightly lower than in the Olympic Summer Games of 2008 and 2012.

Muscle injury is the principal injury type and hamstring muscle injury is the first injury diagnosis during top-level international athletics championships between 2007 and 2015.

BACKGROUND: During top-level international athletics championships, muscle injuries are frequent. OBJECTIVE: To analyse the incidence and characteristics of muscle injuries and hamstring muscle injuries (hamstring injuries) occurring during top-level international athletics championships. METHODS: During 16 international championships held between 2007 and 2015, national medical team and local organising committee physicians reported daily all injuries on a standardised injury report form. Only muscle injuries (muscle tears and muscle cramps) and hamstring injuries have been analysed. RESULTS: 40.9% of all recorded injuries (n=720) were muscle injuries, with 57.5% of them resulting in time loss. The overall incidence of muscle injuries was higher in male athletes than female athletes (51.9±6.0 vs 30.3±5.0 injuries per 1000 registered athletes, respectively; RR=1.71; 95% CI 1.45 to 2.01). Muscle injuries mainly affected the thigh (52.9%) and lower leg (20.1%), and were mostly caused by overuse with sudden onset (38.2%) and non-contact trauma (24.6%). Muscle injury risk varied according to the event groups. Hamstring injuries represented 17.1% of all injuries, with a higher risk in male compared to female athletes (22.4±3.4 vs 11.5±2.6 injuries per 1000 registered athletes, respectively; RR=1.94; 95% CI 1.42 to 2.66). CONCLUSIONS: During international athletics championships, muscle injury is the principal type of injury, and among those, the hamstring is the most commonly affected, with a two times higher risk in male than female athletes. Athletes in explosive power events, male athletes and older male athletes, in specific were more at risk of muscle injuries and hamstring injuries. Injury prevention strategies should be sex-specific.

How much is too much? (Part 2) International Olympic Committee consensus statement on load in sport and risk of illness.

The modern-day athlete participating in elite sports is exposed to high training loads and increasingly saturated competition calendar. Emerging evidence indicates that inappropriate load management is a significant risk factor for acute illness and the overtraining syndrome. The IOC convened an expert group to review the scientific evidence for the relationship of load-including rapid changes in training and competition load, competition calendar congestion, psychological load and travel-and health outcomes in sport. This paper summarises the results linking load to risk of illness and overtraining in athletes, and provides athletes, coaches and support staff with practical guidelines for appropriate load management to reduce the risk of illness and overtraining in sport. These include guidelines for prescription of training and competition load, as well as for monitoring of training, competition and psychological load, athlete well-being and illness. In the process, urgent research priorities were identified.

How much is too much? (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury.

Athletes participating in elite sports are exposed to high training loads and increasingly saturated competition calendars. Emerging evidence indicates that poor load management is a major risk factor for injury. The International Olympic Committee convened an expert group to review the scientific evidence for the relationship of load (defined broadly to include rapid changes in training and competition load, competition calendar congestion, psychological load and travel) and health outcomes in sport. We summarise the results linking load to risk of injury in athletes, and provide athletes, coaches and support staff with practical guidelines to manage load in sport. This consensus statement includes guidelines for (1) prescription of training and competition load, as well as for (2) monitoring of training, competition and psychological load, athlete well-being and injury. In the process, we identified research priorities.

Mannheimia haemolytica and Bibersteinia trehalosi Serotypes Isolated from Merino Breed Lambs in Extremadura (Southwestern Spain).

Pneumonia caused by Mannheimia haemolytica is an important disease in ruminants. Because of its economic significance, several methods have been developed to study the pathogenicity and epidemiology of M. haemolytica. In this study, bacterial isolates of M. haemolytica and Bibersteinia trehalosi identified from the lungs of sheep were serotyped by means of indirect haemagglutination. Of the 598 lungs studied, 34 isolates were identified and serotyped. In decreasing order, M. haemolytica serotypes were: not typable (50 %), A1 (17.65 %), A7 (11.76 %), A6 (5.88 %), and A12, A2, A5 and A9 (each representing 2.94 %). The only B. trehalosi serotype was T4 (2.94 %). Serotypes A1, A6 and A7 of M. haemolytica were the most commonly isolated from pneumonic sheep producing greater changes in the lungs and having important implications for sheep production.

Sex differences in injury during top-level international athletics championships: surveillance data from 14 championships between 2007 and 2014.

BACKGROUND: Injury incidence has been reported for international athletics championships from 2007 to 2012. However, it is unclear whether male or female athletes differ in risk and/or characteristics of injuries. OBJECTIVE: To compare the incidences and characteristics of injuries that occurred during international athletics championships between female and male athletes. METHODS: The national medical team and the local organising committee physicians reported all injuries daily on a standardised injury report form during 14 international championships from 2007 to 2014. Relative risks (RR) of injury, 95% CI and magnitude thresholds were calculated. RESULTS: The rate of injuries per 1000 registered athletes was significantly higher in male (110.3±6.8) than in female (88.5±6.7) athletes (RR=1.25; 95% CI 1.13 to 1.37, small effect size). Male athletes incurred significantly more injuries in the thigh (RR=1.64; 95% CI 1.32 to 2.05, small), lower leg (RR=1.36; 95% CI 1.05 to 1.75, small) and hip/groin injuries (RR=2.26; 95% CI 1.31 to 3.88, moderate), more muscle strains (RR=1.64; 95% CI 1.33 to 2.04, small), cramps (RR=1.81; 95% CI 1.35 to 2.43, small), and especially more thigh strains (RR=1.66; 95% CI 1.25 to 2.19, small), but fewer stress fractures (RR=0.32; 95% CI 0.12 to 0.81, moderate) than female athletes. A higher injury risk of male than of female athletes was observed in sprints (RR=1.32; 95% CI 1.06 to 1.66, small), middle distance runs (RR=1.48; 95% CI 1.06 to 2.06, small), race walks (RR=2.55; 95% CI 1.27 to 5.10, moderate) and jumps (RR=2.13; 95% CI 1.53 to 2.97, moderate). No sex difference was found for cause and severity of injury. CONCLUSIONS: Injury risk during international athletics championships differed between female and male athletes for location, type and event groups. Injury prevention strategies should be sex-specific, regarding the differences in injury location and type.

Preparticipation injury complaint is a risk factor for injury: a prospective study of the Moscow 2013 IAAF Championships.

OBJECTIVES: To determine the health status of athletes before the start of an international athletics championship and to determine whether preparticipation risk factors predicted in-championship injuries. METHODS: At the beginning of the 2013 International Association of Athletics Federations (IAAF) World Championships, all registered athletes (n=1784) were invited to complete a preparticipation health questionnaire (PHQ) on health status during the month preceding the championships. New injuries that occurred at the championships were prospectively recorded. RESULTS: The PHQ was completed by 698 (39%) athletes; 204 (29.2%) reported an injury complaint during the month before the championships. The most common mode of onset of preparticipation injury complaints was gradual (43.6%). Forty-nine athletes in the study reported at least one injury during the championships. Athletes who reported a preparticipation injury complaint were at twofold increased risk for an in-championship injury (OR=2.09; 95% CI 1.16 to 3.77); p=0.014). Those who reported a preparticipation gradual-onset injury complaint were at an almost fourfold increased risk for an in-championship time-loss injury (OR=3.92; 95% CI 1.69 to 9.08); p=0.001). Importantly, the preparticipation injury complaint severity score was associated with the risk of sustaining an in-championship injury (OR=1.14; 95% CI 1.06 to 1.22); p=0.001). SUMMARY AND CONCLUSIONS: About one-third of the athletes participating in the study reported an injury complaint during the month before the championships, which represented a risk factor for sustaining an injury during the championship. This study emphasises the importance of the PHQ as a screening tool to identify athletes at risk of injuries before international championships.

Injury and illness surveillance during the 24th Men's Handball World Championship 2015 in Qatar.

BACKGROUND: The IOC encourages international federations to establish systematic athlete injury and illness surveillance programmes. OBJECTIVE: To describe pattern of injuries and illnesses during the 24th Men's Handball World Championship 2015 by implementing the IOC injury and illness surveillance protocol. METHODS: The medical staff of participating teams (n=24) were requested to report all new injuries and illnesses during matches and/or training on a daily basis throughout the event (15 January to 1 February, 2015). Exposure (number of player-hours) during all matches was calculated for all players (n=384) and for each of the 4 player positions (wing, back, line and goalkeeper). RESULTS: Medical staff of all teams submitted 96.7% (n=325) of the daily report forms. In total, 27.1% of the players were injured, and of the 132 injuries reported, 40% were time-loss injuries. The total incidence of injuries was 104.5 per 1000 player-hours. The highest risk of injury was found among line players, and more injuries occurred during the first half of the matches. The most frequent injury location was the ankle, followed by the thigh, knee and head/face. The majority of injuries were contusion, sprain or strain. In total, 10.9% of the players were affected by an illness during the event. Of the 42 cases recorded, 31 (73.8%) were reported as respiratory tract infection. CONCLUSIONS: The risk of injury in handball is high among Olympic sports. Preventive measures should focus on contusions, ankle sprains, and thigh muscle strains, as well as measures aimed to reduce upper respiratory tract infections.

Injuries in 13 international Athletics championships between 2007-2012.

BACKGROUND: The International Association of Athletics Federation has systematically surveyed all Athletics injuries in their competitions since 2007 in order to develop strategies for health protection of their athletes. AIMS: Analysis of frequency and characteristics of injuries during 13 international Athletics championships from 2007 to 2012 regarding different types of championships and discipline categories. METHODS: The team physicians and the Local Organizing Committee reported daily all injuries on a standardised injury report form during each championship. RESULTS: A total of 1470 injuries were reported, equivalent to 81.1±4.2 injuries per 1000 registrations of which 36.7±2.9 were expected to result in absence from sports. The incidence of time-loss injuries was significantly higher in competition (29.0±2.6) than in training (5.8±1.9), and in outdoor (46.4±4.0) than in indoor (23.7±6.2) or youth/junior championships (13.2±4.0). While most in-competition time-loss injuries were reported during short distance events (32.5%), combined events had the highest incidence of in-competition time-loss injuries (106±26.5). The most frequent diagnosis was thigh strain (28.2%), followed by lower leg strain and ankle sprain. Injury location varied between different discipline categories: in long distances the lower leg, in Marathon the foot and in throws the upper extremity were mainly affected. CONCLUSIONS: The incidence of injuries varied substantially between different types of Athletics championships and between discipline categories. Special attention should be paid to combined events, running disciplines and (thigh) strain to better understand the injury mechanisms and risk factors and develop related preventive measures.

Injury and illness definitions and data collection procedures for use in epidemiological studies in Athletics (track and field): consensus statement.

BACKGROUND: Movement towards sport safety in Athletics through the introduction of preventive strategies requires consensus on definitions and methods for reporting epidemiological data in the various populations of athletes. OBJECTIVE: To define health-related incidents (injuries and illnesses) that should be recorded in epidemiological studies in Athletics, and the criteria for recording their nature, cause and severity, as well as standards for data collection and analysis procedures. METHODS: A 1-day meeting of 14 experts from eight countries representing a range of Athletics stakeholders and sport science researchers was facilitated. Definitions of injuries and illnesses, study design and data collection for epidemiological studies in Athletics were discussed during the meeting. Two members of the group produced a draft statement after this meeting, and distributed to the group members for their input. A revision was prepared, and the procedure was repeated to finalise the consensus statement. RESULTS: Definitions of injuries and illnesses and categories for recording of their nature, cause and severity were provided. Essential baseline information was listed. Guidelines on the recording of exposure data during competition and training and the calculation of prevalence and incidences were given. Finally, methodological guidance for consistent recording and reporting on injury and illness in athletics was described. CONCLUSIONS: This consensus statement provides definitions and methodological guidance for epidemiological studies in Athletics. Consistent use of the definitions and methodological guidance would lead to more reliable and comparable evidence.

Analyses of Helsinki 2012 European Athletics Championships injury and illness surveillance to discuss elite athletes risk factors.

OBJECTIVE: To further analyze newly incurred injuries and illnesses (I&Is) during Athletics International Championships to discuss risk factors. DESIGN: Prospective recording of newly occurred injuries and illnesses. SETTING: The 2012 European Athletics (EA) Championships in Helsinki, Finland. PARTICIPANTS: National team and local organizing committee physicians and physiotherapists and 1342 registered athletes. MAIN OUTCOME MEASURES: Incidence and characteristics of new injuries and illnesses. RESULTS: Ninety-three percent of athletes were covered by medical teams, with a response rate of 91%. One hundred thirty-three injuries were reported (incidence of 98.4 injuries per 1000 registered athletes). Sixty-two injuries (47%) resulted in time loss from sport. The most common diagnosis was hamstring strain (11.4% of injuries and 21% of time-loss injuries). Injury risk was higher in males and increased with age. The highest incidences of injuries were found in combined events and middle- and long-distance events. Twenty-seven illnesses were reported (4.0 illnesses per 1000 athlete days). The most common diagnoses were upper respiratory tract infection (33.3%) and gastroenteritis/diarrhea (25.9%). CONCLUSIONS: During outdoor EA Championships, injury and illness incidences were slightly lower and injury characteristics were comparable with those during outdoor World Athletics Championships. During elite athletics Championships, gender (male), age (older than 30 years), finals, and some events (combined events and middle- and long-distance races) seem to be injury risk factors. Illness risk factors remain unclear. As in previous recommendations, preventive interventions should focus on overuse injuries, hamstring strains, and adequate rehabilitation of previous injuries, decreasing risk of infectious diseases transmission, appropriate event scheduling, sports clothes, and heat acclimatization.

Evaluation of the Potential Effect of Postbiotics Obtained from Honey Bees against Varroa destructor and Their Combination with Other Organic Products.

The Varroa destructor mite infests Apis mellifera colonies and causes significant harm. Traditional treatments have become less effective because of mite resistance development and can also generate residues inside beehives. This study aimed to gauge the efficacy of a beehive-derived postbiotic in reducing V. destructor viability and to explore its synergies with organic compounds. Four lactic acid bacteria (LAB) species, Leuconostoc mesenteroides, Lactobacillus helsingborgensis, Bacillus velezensis, and Apilactobacillus kunkeei, were isolated and tested in a postbiotic form (preparations of inanimate microorganisms and/or their components) via bioassays. L. mesenteroides, L. helsingborgensis, and B. velezensis notably reduced the mite viability compared to the control, and they were further tested together as a single postbiotic product (POS). Further bioassays were performed to assess the impact of the POS and its combinations with oxalic acid and oregano essential oil. The simple products and combinations (POS/Oregano, POS/Oxalic, Oregano/Oxalic, and POS/Oregano/Oxalic) decreased the mite viability. The most effective were the oxalic acid combinations (POS/Oregano/Oxalic, Oxalic/Oregano, POS/Oxalic), showing significant improvements compared to the individual products. These findings highlight the potential of combining organic products as a vital strategy for controlling V. destructor infection. This study suggests that these combinations could serve as essential tools for combating the impact of mites on bee colonies.