January 20, 2019
Health Concerns Facing Olympic Athletes

Health Concerns Facing Olympic Athletes

by Peter Jaret  

Sports medicine expert Cindy J. Chang, MD, served as head team physician for University of California, Berkeley’s 27 athletic teams from 1995 to 2008. She was Chief Medical Officer for the USA delegation at the 2007 Parapan Am Games in Rio, the 2008 Summer Paralympic Games in Beijing, and most recently the 2012 Olympics in London. Dr. Chang spoke with Berkeley Wellness about the 2016 Olympics in Brazil—and how athletes at all levels can stay healthy while training and competing during the summer months.

Zika virus is a big worry. What should athletes know about the virus and how to protect themselves?

It’s true that the Zika virus can pose a serious threat to some individuals more than others, for example, to female athletes who may be pregnant or want to get pregnant soon. But it’s just one of several potentially serious illnesses transmitted by mosquitoes. There’s also concern about Dengue fever in South and Central America and West Nile virus in parts of the US. In many parts of the world, malaria is a threat. Athletes should always protect themselves by using an insect repellent, for example, ones with DEET. Wear long sleeves and long pants. Try to avoid training outdoors during times whenever mosquitoes are out. Most mosquitoes are active at dusk, but the mosquitoes that transmit the Zika virus are also active during the daytime.

In places where the Zika virus is prevalent, athletes and others should consider using mosquito nets at night. In addition, you can use towels or duct tape to seal up any openings around windows, air conditioning units, or doors where mosquitoes can get into your room.

Will heat and humidity also pose a hazard for Olympic competitors?

Most elite athletes, including Olympic competitors, know how to manage heat and humidity. They very rarely run into trouble. Novice athletes, those just starting out, are much more likely to overdo it and become dehydrated or suffer heat exhaustion. Obviously, you can exercise during the cooler parts of the day. And it’s important to hydrate well—not just during exercise but also during the prior 24 hours. Some athletes sweat more than others. If you lose a lot of sweat while exercising or competing, you may need to replenish electrolytes. One convenient source is a sports drink.

What about air quality? Do athletes need to be concerned about smog and particulates?

Absolutely. In Beijing in 2008, there was tremendous concern about air quality. Athletes with respiratory conditions like asthma are especially vulnerable. They need to be sure to have ample supplies of any medications they take for their condition. Smog and pollutant levels vary during the day. So one option, if you train outside, is to choose times of the day when pollution levels are low. That’s not always easy, however. If possible, train indoors on days when the air quality is poor.

Recent headlines warned about water pollution in and around Rio. What should athletes do to protect themselves?

Our open water swimmers, rowers, and sailors can catch bacterial or viral illnesses from polluted water. It’s not always possible to avoid swallowing water. Our swimmers and triathletes may want to do more of their pre-competition training in pools to avoid getting ill before their events. If a competitive rower, make sure your water bottle in the boat is sealed in a plastic bag so it isn’t splashed with contaminated water. In many parts of the world, you can’t assume that the water coming out of the tap is safe. So it’s wise to drink only bottled water if you have any doubts. And to avoid bacterial skin infections, always thoroughly clean all clothing and equipment like oars and goggles after every exposure to the water. And don’t wait. Promptly clean your hands and your entire body.

What about the sun?

Obviously, ultraviolet radiation is a big concern during the summer. But athletes who train or compete outside should really protect themselves year round. I don’t think most athletes take the risk seriously enough. Ultraviolet radiation ages the skin and increases the risk of skin cancer. Out of 14 cancers, only melanoma has a higher incidence in physically active people. But even in the short-term, a sunburn can impair performance, as there is greater heat gain and an increased perception of effort because the responsiveness and capacity of sweat glands decreases.

Hopefully the advice is familiar by now. Cover up as much skin as possible with UV protection clothing and apply a broad-spectrum SPF-30 sunscreen. Some athletes don’t like to apply sunscreen to their faces, especially on their foreheads, because they don’t want it to sweat into their eyes. I’d recommend wearing a sweatband, or a cap during training if possible. Athletes sometimes worry that they won’t get enough vitamin D. But even with sunscreen, your skin still absorbs enough UVB rays to manufacture enough vitamin D. And if you’re worried, you can always take a supplement, if approved by your health care provider.

What are the most common injuries and complaints among athletes in the summer?

Athletes competing in the Olympics and Paralympics are obviously in peak physical shape. So we don’t tend to see the kind of overuse injuries we see in amateur athletes. Instead, we tend to see acute injuries like ankle or knee sprains, concussions, and less often fractures. In terms of non-elite athletes, the big problem is overdoing it. People can overtrain, especially in those parts of the US when summer finally comes around, and it is so great to be outdoors. There’s a risk of getting overuse injuries or even heat exhaustion. Again, the advice is to use common sense. Start slowly. Ramp up your training. Listen to your body, and give your body time to recover between workouts.

This opinion does not necessarily reflect the views of the UC Berkeley School of Public Health or of the Editorial Board at BerkeleyWellness.com.