Abstract
Background:
Elite pediatric athletes face unique physiological and developmental challenges that influence their risk of injury and illness. Specifically, pediatric Paralympic athletes encounter additional barriers due to underlying impairments and, in some cases, the use of assistive devices. While epidemiological comparisons of non-pediatric Olympic and Paralympic athletes exist, there is limited understanding of potential differences in incidence between pediatric Olympic and Paralympic athletes.
Hypothesis:
To compare injury and illness incidence between pediatric Olympic and Paralympic Team USA athletes during the Paris 2024 Olympic and Paralympic Games.
Methods:
Team USA healthcare providers documented all injuries and illnesses that occurred among Team USA athletes (Overall n=862; Olympic n=635; Paralympic n=227) during the Paris Games within the USOPC Injury and Illness Surveillance System (IIS). The USOPC IIS records details of injuries and illnesses according to the 2020 IOC Consensus Statement for sport epidemiology. Athlete exposure was measured using the number of days an athlete was in Paris and summed to calculate athlete-days (AD). Pediatric athletes were defined as any athlete aged 21 or younger. Incidence rate (IR) with 95% confidence intervals [95%CI] per 1,000 ADs were calculated for both injuries and illnesses. Incidence rate ratios (IRR) were calculated to compare IR between pediatric Olympic and Paralympic athletes.
Results:
144 pediatric athletes (mean age, 19.7±1.5y, range 15-21y) competed for Team USA during the Paris Games, representing 16.7% of all Team USA athletes. Pediatric athletes sustained 32 injuries (12.7%) and 20 illnesses (12.6%). Injury IR in Team USA pediatric athletes was 12.8 [95%CI: 8.7, 18.0] per 1,000 AD. The injury IR in Olympic pediatric athletes was 12.5 [95% CI: 8.0, 18.6] per 1,000 AD, compared to 13.7 [95% CI: 5.9, 27.0] per 1,000 AD in Paralympic athletes. Illness IR in Team USA pediatric athletes was 8.0 [95%CI: 4.9, 12.3] per 1,000 AD. Illness IR in pediatric Olympic athletes was 6.8 [95%CI: 3.6, 11.6] per 1,000 AD and in Paralympic athletes was 12.0 [95%CI: 4.8, 24.7]. Paralympic pediatric athletes demonstrated a higher, though non-significant, illness IR relative to their Olympic peers (IRR [95%CI]: 1.7 [0.6-4.8]).
Conclusion:
Although not statistically significant, illness IR was higher in Paralympic athletes, which is consistent with findings in non-pediatric elite athlete populations. This difference may reflect a true disparity that our study was underpowered to detect. As pediatric participation in elite sport increases, continued surveillance and targeted prevention strategies are needed to address the distinct health profiles of pediatric Paralympic athletes.