Assessing cognitive decline in the aging brain: lessons from rodent and human studies.

As life expectancy continues to increase worldwide, age-related dysfunction will largely impact our societies in the future. Aging is well established to promote the deterioration of cognitive function and is the primary risk factor for the development of prevalent neurological disorders. Even in the absence of dementia, age-related cognitive decline impacts specific types of memories and brain structures in humans and animal models. Despite this, preclinical and clinical studies that investigate age-related changes in brain physiology often use largely different methods, which hinders the translational potential of findings. This review seeks to integrate what is known about age-related changes in the brain with analogue cognitive tests used in humans and rodent studies, ranging from "pen and paper" tests to virtual-reality-based paradigms. Finally, we draw parallels between the behavior paradigms used in research compared to the enrollment into clinical trials that aim to study age-related cognitive decline.

Two step calibration method for ozone low-cost sensor: Field experiences with the UrbanSense DCUs.

Urban air pollution is a global concern impairing citizens' health, thus monitoring is a pressing need for city managers. City-wide networks for air pollution monitoring based on low-cost sensors are promising to provide real-time data with detail and scale never before possible. However, they still present limitations preventing their ubiquitous use. Thus, this study aimed to perform a post-deployment validation and calibration based on two step methods for ozone low-cost sensor of a city-wide network for air pollution and meteorology monitoring using low-cost sensors focusing on the main challenges. Four of the 23 data collection units (DCUs) of the UrbanSense network installed in Porto city (Portugal) with low-cost sensors for particulate matter (PM), carbon monoxide (CO), ozone (O3), and meteorological variables (temperature, relative humidity, luminosity, precipitation, and wind speed and direction) were evaluated. This study identified post-deployment challenges related to their validation and calibration. The preliminary validation showed that PM, CO and precipitation sensors recorded only unreliable data, and other sensors (wind speed and direction) very few data. A multi-step calibration strategy was implemented: inter-DCU calibration (1st step, for O3, temperature and relative humidity) and calibration with a reference-grade instrument (2nd step, for O3). In the 1st step, multivariate linear regression (MLR) resulted in models with better performance than non-linear models such as artificial neural networks (errors almost zero and R2 > 0.80). In the 2nd step, the calibration models using non-linear machine learning boosting algorithms, namely Stochastic Gradient Boosting Regressor (both with the default and post-tuning hyper-parameters), performed better than artificial neural networks and linear regression approaches. The calibrated O3 data resulted in a marginal improvement from the raw data, with error values close to zero, with low predictability (R2 ∼ 0.32). The lessons learned with the present study evidenced the need to redesign the calibration strategy. Thus, a novel multi-step calibration strategy is proposed, based on two steps (pre and post-deployment calibration). When performed cyclically and continuously, this strategy reduces the need for reference instruments, while probably minimising data drifts over time. More experimental campaigns are needed to collect more data and further improve calibration models.

Development of low-cost indoor air quality monitoring devices: Recent advancements.

The use of low-cost sensor technology to monitor air pollution has made remarkable strides in the last decade. The development of low-cost devices to monitor air quality in indoor environments can be used to understand the behaviour of indoor air pollutants and potentially impact on the reduction of related health impacts. These user-friendly devices are portable, require low-maintenance, and can enable near real-time, continuous monitoring. They can also contribute to citizen science projects and community-driven science. However, low-cost sensors have often been associated with design compromises that hamper data reliability. Moreover, with the rapidly increasing number of studies, projects, and grey literature based on low-cost sensors, information got scattered. Intending to identify and review scientifically validated literature on this topic, this study critically summarizes the recent research pertinent to the development of indoor air quality monitoring devices using low-cost sensors. The method employed for this review was a thorough search of three scientific databases, namely: ScienceDirect, IEEE, and Scopus. A total of 891 titles published since 2012 were found and scanned for relevance. Finally, 41 research articles consisting of 35 unique device development projects were reviewed with a particular emphasis on device development: calibration and performance of sensors, the processor used, data storage and communication, and the availability of real-time remote access of sensor data. The most prominent finding of the study showed a lack of studies consisting of sensor performance as only 16 out of 35 projects performed calibration/validation of sensors. An even fewer number of studies conducted these tests with a reference instrument. Hence, a need for more studies with calibration, credible validation, and standardization of sensor performance and assessment is recommended for subsequent research.

Quantifying indoor air quality determinants in urban and rural nursery and primary schools.

Poor indoor air quality can adversely affect children's health, comfort and school performance, but existing literature on quantifying indoor air pollutants (IAP) determinants' in nursery and primary schools is limited. Following previous studies, this study mainly aimed to quantify determinants of selected IAP, in nursery and primary schools from both urban and rural sites, accounting for seasonal variations. In 101 indoor microenvironments (classrooms, bedrooms and canteens) from 25 nursery and primary schools, CO2, CO, HCOH, NO2, O3, total volatile organic compounds, PM1, PM2.5, PM10, total suspended particles (TSP), and meteorological/comfort parameters were continuously sampled (occupancy and background levels), from at least 24 h to 9 consecutive days (not simultaneously) in each studied room; in some cases weekend was also considered. Children faced thermal discomfort and inadequate humidity, respectively in 60.1% and 44.1% of the studied classrooms. They were also exposed to high levels of IAP, namely PM2.5 and CO2 respectively in 69.0% and 41.3% of the studied classrooms, mostly in urban sites, depending on season and on occupancy and activity patterns (different amongst age groups). As PM2.5 and CO2 were the major concerning IAP, multivariate linear regression models were built to quantify (explained variability and relative importance) their main determinants, in both occupancy and non-occupancy (background) periods. Models for occupancy periods showed higher explained variability (R2 = 0.64, 0.57 and 0.47, respectively, for CO2, PM2.5 and PM10) than for non-occupancy. Besides background concentrations (43.5% of relative importance), relative humidity (21.1%), flooring material (17.0%), heating (6.7%) and age group of the occupants (5.3%), adjusted for season of sampling (6.4%) were predictors in CO2 occupancy model. In the cases of PM2.5 and PM10 occupancy concentrations, besides background concentrations (71.2% and 67.2% of relative importance, respectively for PM2.5 and PM10), type of school management (8.8% and 15.2%) and flooring material (13.9% and 13.9%), adjusted for season of sampling (6.1% and 3.8%), were the main predictors. These findings support the need of mitigation measures to reduce IAP levels, and prevention actions to avoid children's exposure. Reducing the time spent indoors in the same microenvironment by doing more and/or longer breaks, improving ventilation and cleaning actions, and avoiding or making a better maintenance hardwood flooring materials, chalkboard use and VOC emitting materials, are practices that should be implemented and their impacts quantified.

Changing rate of serious infections in biologic-exposed rheumatoid arthritis patients. Data from South American registries BIOBADABRASIL and BIOBADASAR.

OBJECTIVE: Most reports on serious infections (SI) in rheumatoid arthritis (RA) patients treated with biological disease-modifying antirheumatic drugs (bDMARDs) are from the USA and Western Europe. Data from other regions are largely missing. We report data from South American countries with different backgrounds and health-care systems but similar registries. METHODS: We merged 2010-2016 data from two registries, BIOBADABRASIL (Brazil) and BIOBADASAR (Argentina), which share the same protocol, online platform and data monitoring process. Patients with active RA were included when they began the first bDMARD or a conventional synthetic DMARD (csDMARD, control group). The SI incidence rate (IR) per 1000 patient/years and adjusted IR ratio (aIRR) were estimated for bDMARDs and csDMARDs. RESULTS: Data were analysed for 3717 RA patients with an exposure of 13,380 patient/years. The 2591 patients treated with bDMARDs (64% tumour necrosis factor-α inhibitors (TNFi)) had a follow-up of 9300 years, and the 1126 treated with csDMARDs had an exposure of 4081 patient/years. The SI IR was 30.54 (CI 27.18-34.30) for all bDMARDs and 5.15 (CI 3.36-7.89) for csDMARDs. The aIRR between the two groups was 2.03 ([1.05, 3.9] p = 0.034) for the first 6 months of treatment but subsequently increased to 8.26 ([4.32, 15.76] p < 0.001). The SI IR for bDMARDs decreased over time in both registries, dropping from 36.59 (28.41-47.12) in 2012 to 7.27 (4.79-11.05) in 2016. CONCLUSION: While SI remains a major concern in South American patients with RA treated with bDMARDs, a favourable trend toward a reduction was observed in the last years.Key Points• New comprehensive data on biologic drugs safety from international collaboration in South America.• First proposal for national registries data merging in South America.• Serious infections remain a major concern in RA patients treated with biologics.• A significant reduction of serious infections in RA patients exposed to biologics was observed over a 7 years period.

The effect of hypoxia and flow decrease in macroinvertebrate functional responses: A trait-based approach to multiple-stressors in mesocosms.

River ecosystems are most often subject to multiple co-occurring anthropogenic stressors. Mediterranean streams are particularly affected by water scarcity and organic loads that commonly lead to a simultaneous reduction in flow and increasing depletion of dissolved oxygen. In the present study, the single and combined effects of water scarcity (flow velocity reduction) and dissolved oxygen depletion were used to evaluate alterations of drifting macroinvertebrates on a channel mesocosm system, by employing a multiple trait-based approach. Our main findings confirmed that the impact of the two combined stressors can be implicated in alterations of ecosystem functions as result of the changes in proportions of biological traits. Overall, our results showed that, individually, flow velocity reduction and a severe oxygen depletion promoted a shift in community traits. In more detail, biological traits describing the dispersal of organisms and their respiration showed the strongest responses. The respiration mode responded to low flow with drift increase of gill breathers and decrease of individuals with tegument, whereas dispersal was clearly affected by the combination of stressors. Resistance through eggs was higher with the single effect of flow reduction, while swimmers´ relative abundance increased in individuals that drift after exposure to the combination of stressors. Thus, while flow reduction alone is expected to specifically filter out the gill breathers and the egg producers, the combination of stressors will impact more drastically organism's dispersal and swimmers. Such changes in biological traits can result in variations in ecosystem functioning through, for example, local changes in biomass, secondary production, stream metabolism as well as resulting in biodiversity losses or alterations of its distribution patterns.

Toxicity of the amphetamine metabolites 4-hydroxyamphetamine and 4-hydroxynorephedrine in human dopaminergic differentiated SH-SY5Y cells.

Amphetamine (AMPH) is a psychostimulant used worldwide by millions of patients in the clinical treatment of attention deficit hyperactivity disorder, narcolepsy or even obesity, and is also a drug of abuse. 4-Hydroxynorephedrine (4-OHNE) and 4-hydroxyamphetamine (4-OHAMPH) are two major metabolites known to persist in the brain longer than AMPH. The contribution of AMPH metabolites for its neurotoxicity is undetermined. We evaluated the toxicity of AMPH and its metabolites 4-OHNE and 4-OHAMPH, obtained by chemical synthesis, in human dopaminergic differentiated SH-SY5Y neurons. Cells were exposed to AMPH (concentration range 0-5mM) or 4-OHAMPH or 4-OHNE (concentration range 0-10mM) for 24 or 48h, and the viability was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) and lactate dehydrogenase (LDH) leakage assays. Results showed that for both AMPH and the metabolites a concentration-dependent toxicity was observed. The toxic concentration 50% (TC50) for AMPH and 4-OHNE following 24h exposure was circa 3.5mM and 8mM, respectively. For 4-OHAMPH the TC50 was not reached in the tested concentration range. N-acetyl cysteine, cycloheximide, l-carnitine, and methylphenidate were able to reduce cell death induced by AMPH TC50. Acridine orange/ethidium bromide staining showed evident signs of late apoptotic cells and necrotic cells following 24h exposure to AMPH 3.50mM. The 4-OHAMPH metabolite at 8.00mM originated few late apoptotic cells, whereas 4-OHNE at 8.00mM resulted in late apoptotic cells and necrotic cells, in a scenario similar to AMPH. In conclusion, the AMPH metabolite 4-OHNE is more toxic than 4-OHAMPH, nonetheless both are less toxic than the parent compound in vitro. The most toxic metabolite 4-OHNE has longer permanence in the brain, rendering likely its contribution for AMPH neurotoxicity.

Hyperthermia Severely Affects the Vascular Effects of MDMA and Metabolites in the Human Internal Mammary Artery In Vitro.

3,4-Methylenedioxymethamphetamine (MDMA or "ecstasy") is a recreational drug used worldwide for its distinctive psychotropic effects. Although important cardiovascular effects, such as increased blood pressure and heart rate, have also been described, the vascular effects of MDMA and metabolites and their correlation with hyperthermia (major side effect of MDMA) are not yet fully understood and have not been previously reported. This study aimed at evaluating the effects of MDMA and its main catechol metabolites, alpha-methyldopamine (α-MeDA), N-methyl-alpha-methyldopamine (N-Me-α-MeDA), 5-(glutathion-S-yl)-alpha-methyldopamine [5-(GSH)-α-MeDA] and 5-(glutathion-S-yl)-N-methyl-alpha-methyldopamine [5-(GSH)-N-Me-α-MeDA], on the 5-HT-dependent vasoactivity in normothermia (37 °C) and hyperthermia (40 °C) of the human internal mammary artery (IMA) in vitro. The results showed the ability of MDMA, α-MeDA and N-Me-α-MeDA to exert vasoconstriction of the IMA which was considerably higher in hyperthermic conditions (about fourfold for MDMA and α-MeDA and twofold for N-Me-α-MeDA). The results also showed that all the compounds may influence the 5-HT-mediated concentration-dependent response of IMA, as MDMA, α-MeDA and N-Me-α-MeDA behaved as partial agonists and 5-(GSH)-α-MeDA and 5-(GSH)-N-Me-α-MeDA as antagonists. In conclusion, MDMA abuse may imply a higher cardiovascular risk associated both to MDMA and its metabolites that might be relevant in patients with underlying cardiovascular diseases, particularly in hyperthermia.

Cortical bone analysis in a predialysis population: a comparison with a dialysis population.

This study was designed to characterize cortical bone by histomorphometry in a predialysis population, to correlate turnover, mineralization, and volume between cortical and trabecular bone, and to compare the findings with those in patients treated with maintenance dialysis. We evaluated cortical bone by histomorphometry in 16 patients with stage 3 or stage 4 chronic kidney disease and in 16 dialysis patients. Dual-energy X-ray absorptiometry (DXA) of the distal end of the forearm was performed in seven predialysis patients, and the findings correlated with histologic parameters. Predialysis patients compared with dialysis patients showed increased cortical bone thickness (p = 0.027) and decreased osteonal bone formation rate (p = 0.020) and adjusted apposition rate (p = 0.018), mainly for external cortical bone. In this predialysis population, trabecular bone volume positively correlated with external cortical porosity (r = 0.723, p = 0.003), external cortical thickness (r = 0.569, p = 0.034), and external osteonal accumulation (osteonal osteoid thickness, r = 0.530, p = 0.05; osteonal osteoid volume to bone volume ratio, r = 0.921, p < 0.001; and osteonal osteoid surface to bone surface ratio, r = 0.631, p = 0.016). These correlations were not observed in the internal cortical bone. Cortical osteonal mineralization surface negatively correlated with DXA Z and T scores and bone mineral density for the distal end of the forearm. The osteonal bone formation rate of both internal cortical bone and external cortical bone correlated with Z score (r = -0.975, p = 0.005 and r = -0.880, p = 0.021 respectively). We found no significant correlations between cortical thickness or porosity and DXA parameters for either external cortical bone or internal cortical bone. Our results suggest that a greater degree of kidney disease is associated with thinner cortices, eventually contributing to the higher fracture rate observed in the chronic kidney disease population. In predialysis patients, parathyroid hormone seems to have a modulating effect on both trabecular bone and cortical bone, particularly in external cortical bone.

Asthma prevalence and risk factors in early childhood at Northern Portugal.

Asthma is the commonest and most important chronic non-infectious disease in childhood and it has become more prevalent in recent years. There is a shortage of studies in relation to early childhood and so, as part of the INAIRCHILD project, this cross-sectional study aimed to assess the prevalence of asthma and its associated risk factors, namely demographic, environmental, psychosocial and clinical factors for infants and preschoolers living in Northern Portugal. Data concerning asthma prevalence were collected through questionnaires based on those from the International Study of Asthma and Allergies in Childhood (ISAAC-derived), the questionnaires were distributed to 1042 children attending the 17 nurseries involved in the INAIRCHILD project (10 in urban and suburban context, and 7 in rural context). The response rate was 48%. Prevalence of asthma based on symptomatology and odds ratio was calculated. Around 52% of the studied children presented at least one of the respiratory symptoms investigated (wheeze, dyspnea and cough) in the absence of upper respiratory infections. The prevalence of asthma was 10.7%, comparable to the figures for Portuguese schoolchildren (6-7 years old) reported by the national Directorate-General of Health, thus showing that an early diagnosis might be possible and helpful for the mitigation of childhood asthma. Environmental context (urban, suburban or rural), gender and family asthma history showed clear associations with asthma prevalence, namely non-rural location, male gender, and having an asthmatic parent were found to be risk factors.

Gaseous pollutants on rural and urban nursery schools in Northern Portugal.

Indoor air quality in nursery schools is different from other schools and this has been largely ignored, particularly in rural areas. Urban and rural nursery schools have different environmental characteristics whose knowledge needs improvement. Thus, this study aimed to evaluate continuously the concentrations of CO2, CO, NO2, O3, CH2O and total VOC in three rural nursery schools and one urban, being the only one comparing urban and rural nurseries with continuous measurements, thus considering occupation and non-occupation periods. Regarding CO2, urban nursery recorded higher concentrations (739-2328 mg m(-3)) than rural nurseries (653-1078 mg m(-3)). The influence of outdoor air was the main source of CO, NO2 and O3 indoor concentrations. CO and NO2 concentrations were higher in the urban nursery and O3 concentrations were higher in rural ones. CH2O and TVOC concentrations seemed to be related to internal sources, such as furniture and flooring finishing and cleaning products.

Children's exposure to indoor air in urban nurseries--Part II: Gaseous pollutants' assessment.

This study, Part II of the larger study "Children's exposure to indoor air in urban nurseries", aimed to: (i) evaluate nursery schools' indoor concentrations of several air pollutants in class and lunch rooms; and (ii) analyse them according to guidelines and references. Indoor continuous measurements were performed, and outdoor concentrations were obtained to determine indoor/outdoor ratios. The influence of outdoor air seemed to be determinant on carbon monoxide (CO), nitrogen dioxide (NO2) and ozone (O3) indoor concentrations. The peak concentrations of formaldehyde and volatile organic compounds (VOC) registered (highest concentrations of 204 and 2320 µg m(-3) respectively), indicated the presence of specific indoor sources of these pollutants, namely materials emitting formaldehyde and products emitting VOC associated to cleaning and children's specific activities (like paints and glues). For formaldehyde, baseline constant concentrations along the day were also found in some of the studied rooms, which enhances the importance of detailing the study of children's short and long-term exposure to this indoor air pollutant. While CO, NO2 and O3 never exceeded the national and international reference values for IAQ and health protection, exceedances were found for formaldehyde and VOC. For this reason, a health risk assessment approach could be interesting for future research to assess children's health risks of exposure to formaldehyde and to VOC concentrations in nursery schools. Changing cleaning schedules and materials emitting formaldehyde, and more efficient ventilation while using products emitting VOC, with the correct amount and distribution of fresh air, would decrease children's exposure.

Radon Levels in Nurseries and Primary Schools in Bragança District-Preliminary Assessment.

Lung cancer has been associated with radon concentration even at low levels such as those found in dwellings. This study aimed to (i) determine radon diurnal variations in three nurseries and one primary school in the Bragança district (north of Portugal) and (ii) compare radon concentrations with legislated standards and assess the legislated procedures. Radon was measured in three nurseries and a primary school in a rural area with nongranite soil. Measurements were performed continuously to examine differences between occupation and nonoccupation periods. Indoor temperature and relative humidity were also measured continuously. A great variability was found in radon concentrations between the microenvironments examined. Radon concentrations surpassed by severalfold the recommended guidelines and thresholds, and excessive levels of health concern were sporadically found (361.5-753.5 Bq m(-3)). Thus, it is of importance to perform a national campaign on radon measurements and to reduce exposure.

Children's exposure to indoor air in urban nurseries-part I: CO2 and comfort assessment.

Indoor air quality (IAQ) in nurseries is an emerging case-study. Thus, this study, as the Part I of the larger study "Children's exposure to indoor air in urban nurseries", aimed to: i) evaluate nurseries' indoor concentrations of carbon dioxide (CO2), a global IAQ indicator, in class and lunch rooms; ii) assess indoor comfort parameters-temperature (T) and relative humidity (RH); and iii) analyse them according to guidelines and references for IAQ, comfort and children's health. Indoor continuous measurements were performed. Non-compliances with guidelines were found in comfort parameters, which could cause discomfort situations and also microbial proliferation. Exceedances in CO2 concentrations were also found and they were caused by poor ventilation and high classroom occupation. More efficient ventilation and control of comfort parameters, as well as to reduce occupation by reviewing Portuguese legislation on that matter, would certainly improve IAQ and comfort in nurseries and consequently safeguard children's health.

Particulate matter in rural and urban nursery schools in Portugal.

Studies have been showing strong associations between exposures to indoor particulate matter (PM) and health effects on children. Urban and rural nursery schools have different known environmental and social differences which make their study relevant. Thus, this study aimed to evaluate indoor PM concentrations on different microenvironments of three rural nursery schools and one urban nursery school, being the only study comparing urban and rural nursery schools considering the PM1, PM2.5 and PM10 fractions (measured continuously and in terms of mass). Outdoor PM2.5 and PM10 were also obtained and I/O ratios have been determined. Indoor PM mean concentrations were higher in the urban nursery than in rural ones, which might have been related to traffic emissions. However, I/O ratios allowed concluding that the recorded concentrations depended more significantly of indoor sources. WHO guidelines and Portuguese legislation exceedances for PM2.5 and PM10 were observed mainly in the urban nursery school.

The microenvironmental modelling approach to assess children's exposure to air pollution - A review.

Exposures to a wide spectrum of air pollutants were associated to several effects on children's health. Exposure assessment can be used to establish where and how air pollutants' exposures occur. However, a realistic estimation of children's exposures to air pollution is usually a great ethics challenge, especially for young children, because they cannot intentionally be exposed to contaminants and according to Helsinki declaration, they are not old enough to make a decision on their participation. Additionally, using adult surrogates introduces bias, since time-space-activity patterns are different from those of children. From all the different available approaches for exposure assessment, the microenvironmental (ME) modelling (indirect approach, where personal exposures are estimated or predicted from microenvironment measurements combined with time-activity data) seemed to be the best to assess children's exposure to air pollution as it takes into account the varying levels of pollution to which an individual is exposed during the course of the day, it is faster and less expensive. Thus, this review aimed to explore the use of the ME modelling approach methodology to assess children's exposure to air pollution. To meet this goal, a total of 152 articles, published since 2002, were identified and titles and abstracts were scanned for relevance. After exclusions, 26 articles were fully reviewed and main characteristics were detailed, namely: (i) study design and outcomes, including location, study population, calendar time, pollutants analysed and purpose; and (ii) data collection, including time-activity patterns (methods of collection, record time and key elements) and pollution measurements (microenvironments, methods of collection and duration and time resolution). The reviewed studies were from different parts of the world, confirming the worldwide application, and mostly cross-sectional. Longitudinal studies were also found enhancing the applicability of this approach. The application of this methodology on children is different from that on adults because of data collection, namely the methods used for collecting time-activity patterns must be different and the time-activity patterns are itself different, which leads to select different microenvironments to the data collection of pollutants' concentrations. The most used methods to gather information on time-activity patterns were questionnaires and diaries, and the main microenvironments considered were home and school (indoors and outdoors). Although the ME modelling approach in studies to assess children's exposure to air pollution is highly encouraged, a validation process is needed, due to the uncertainties associated with the application of this approach.

Injuries and illnesses during the 2011 Paris European Athletics Indoor Championships.

This study aimed to record and analyse incidence and characteristics of injuries and illnesses incurred during the Indoor Athletics Championships. During the 2011 European Indoor Athletics Championships in Paris, incidence and characteristics of new injuries and illnesses were recorded prospectively by physicians and physiotherapists from national teams and local organizing committee in 631 registered athletes. Around 70% of athletes were covered by the medical teams (response rate: 84%). Thirty injuries, including eight time-loss injuries, were reported, representing an incidence of 47.5 injuries and 29.4 time-loss injuries per 1000 registered athletes. Injury and time-loss injury risk were highest in heptathlon and hurdles. Three-quarters of injuries affected the lower extremity. Thigh strain was the most common diagnosis (n = 7; 23%). Noncontact trauma (n = 9; 30%) was the predominant cause. A total of 18 illnesses were reported. Incidence of illnesses was 28.5 per 1000 registered athletes, with 17% resulting in time lost from sport. Upper respiratory tract infection was the most common diagnosis (n = 8; 44%) followed by upper respiratory tract allergy (n = 3; 17%) and gastroenteritis (n = 3; 17%). Injury and illness incidence and severity were lower during the 2011 European Indoor Athletics Championships than during outdoor championships, probably due to the shorter duration, the fewer number of events, and shorter sprint distances.