Abstract
This review highlights two intersecting environmental phenomena that have significantly impacted the Tokyo Summer Olympic and Paralympic Games: infectious disease outbreaks and anthropogenic climate change. Following systematic searches of five databases and the gray literature, 15 studies were identified that addressed infectious disease and climate-related health risks associated with the Summer Games and similar sports mega-events. Over two decades, infectious disease surveillance at the Summer Games has identified low-level threats from vaccine-preventable illnesses and respiratory conditions. However, the COVID-19 pandemic and expansion of vector-borne diseases represent emerging and existential challenges for cities that host mass gathering sports competitions due to the absence of effective vaccines. Ongoing threats from heat injury among athletes and spectators have also been identified at international sports events from Asia to North America due to a confluence of rising Summer temperatures, urban heat island effects and venue crowding. Projections for the Tokyo Games and beyond suggest that heat injury risks are reaching a dangerous tipping point, which will necessitate relocation or mitigation with long-format and endurance events. Without systematic change to its format or staging location, the Summer Games have the potential to drive deleterious health outcomes for athletes, spectators and host communities.
Research funding: Authors state no funding involved.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent is not applicable.
Ethical approval: The conducted research is not related to either human or animal use.
References
1. Intergovernmental Panel on Climate Change. Climate change 2013 – the physical science basis. Available from: https://www.ipcc.ch/report/ar5/wg1/.Search in Google Scholar
2. World Health Organization. Technical documents for novel Coronavirus (COVID-19). Available from: https://www.who.int/health-topics/coronavirus.Search in Google Scholar
3. Marketing Intelligence Sports; Kingdom United. Global sports impact (GSI) report. London: Sportcal Global Communications Ltd.; 2017.Search in Google Scholar
4. Liberati, A, Altman, DG, Tetzlaff, J, Mulrow, C, Gotzche, P, Loannidis, J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 2009;6:1–34. https://doi.org/10.1371/journal.pmed.1000100.Search in Google Scholar
5. Bramer, WM, Rethlefsen, ML, Kleijnen, J, Franco, OH. Optimal database combinations for literature searches in systematic reviews: a prospective exploratory study. Syst Rev 2017;6:245. https://doi.org/10.1186/s13643-017-0644-y.Search in Google Scholar
6. Griffith, MM, Fukusumi, M, Kobayashi, Y, Matsui, Y, Nishiki, S, Shimbashi, R, et al. Epidemiology of vaccine-preventable diseases in Japan: considerations for pre-travel advice for the 2019 Rugby World Cup and 2020 Summer Olympic and Paralympic Games. Western Pac Surveill Response J 2018;9:26. https://doi.org/10.5365/wpsar.2017.8.4.002.Search in Google Scholar
7. McCloskey, B, Endericks, T, Catchpole, M, Zambon, M, McLauchlin, J, Shetty, N, et al. London 2012 Olympic and Paralympic Games: public health surveillance and epidemiology. Lancet 2014;383:2083–9. https://doi.org/10.1016/s0140-6736(13)62342-9.Search in Google Scholar
8. Rodriguez-Valero, N, Luengo Oroz, M, Cuadrado Sanchez, D, Vladimirov, A, Espriu, M, Vera, I, et al. Mobile based surveillance platform for detecting Zika virus among Spanish Delegates attending the Rio de Janeiro Olympic Games. PloS One 2018;13:1–11. https://doi.org/10.1371/journal.pone.0201943.Search in Google Scholar
9. Shimatani, N, Sugishita, Y, Sugawara, T, Nakamura, Y, Ohkusa, Y, Yamagishi, T, et al. Enhanced surveillance for the sports festival in Tokyo 2013: Preparation for the Tokyo 2020 Olympic and Paralympic Games. Jpn J Infect Dis 2015;68:288–95. https://doi.org/10.7883/yoken.jjid.2014.233.Search in Google Scholar
10. Jones, J, Lawrence, J, Hallström, LP, Mantero, J, Kirkbride, H, Walsh, A, et al. International infectious disease surveillance during the London Olympic and Paralympic Games 2012: process and outcomes. Euro Surveill 2013;18:205–54. https://doi.org/10.2807/1560-7917.es2013.18.32.20554.Search in Google Scholar
11. Liang, X, Lan, L, Chen, W, Zhang, A, Lu, C, Lu, Y, et al. Disease distribution and medical resources during the Beijing 2008 Olympic and Paralympic Games. Chin Med J 2011;124:1031–6.Search in Google Scholar
12. Economopoulou, A, Kinross, P, Domanovic, D, Coulombier, D. Infectious diseases prioritisation for event-based surveillance at the European Union level for the 2012 Olympic and Paralympic Games. Euro Surveill 2014;19:207–70. https://doi.org/10.2807/1560-7917.es2014.19.15.20770.Search in Google Scholar
13. Yanagisawa, N, Wada, K, Spengler, JD, Sanchez-Pina, R. Health preparedness plan for dengue detection during the 2020 Summer Olympic and Paralympic Games in Tokyo. PLoS Negl Trop Dis 2018;12:1–14. https://doi.org/10.1371/journal.pntd.0006755.Search in Google Scholar
14. Severi, E, Kitching, A, Crook, P. Evaluation of the health protection event-based surveillance for the London 2012 Olympic and Paralympic Games. Euro Surveill 2014;19:208–32. https://doi.org/10.2807/1560-7917.es2014.19.24.20832.Search in Google Scholar
15. Petersen, E, Wilson, ME, Touch, S, McCloskey, B, Mwaba, M, Osman, D, et al. Rapid spread of Zika virus in the Americas-implications for public health preparedness for mass gatherings at the 2016 Brazil Olympic Games. Int J Infect Dis 2016;44:11–5. https://doi.org/10.1016/j.ijid.2016.02.001.Search in Google Scholar
16. Mizumoto, K, Chowell, G. Temporary fertility decline after large Rubella Outbreak, Japan. Emerg Infect Dis 2020;26:11–22. https://doi.org/10.3201/eid2606.181718.Search in Google Scholar
17. Watanabe, M. The COVID-19 Pandemic in Japan. Surg Today 2020;50:787–93. https://doi.org/10.1007/s00595-020-02033-3.Search in Google Scholar
18. World Health Organization. COVID-19 situation in the WHO Western Pacific Region. Available from: https://covid19.who.int/region/wpro/country/jp.Search in Google Scholar
19. Lurie, N, Saville, M, Hatchett, R, Halton, J. Developing COVID-19 vaccines at pandemic speed. N Engl J Med 2020;382:1969–73. https://doi.org/10.1056/nejmp2005630.Search in Google Scholar
20. Dai, L, Zheng, T, Xu, K, Han, Y, Xu, L, Huang, E, et al. A universal design of Betacoronavirus vaccines against COVID-19, MERS, and SARS. Cell 2020;182:722–33. https://doi.org/10.1016/j.cell.2020.06.035.Search in Google Scholar
21. Elachola, H, Gozzer, E, Zhuo, J, Memish, ZA. A crucial time for public health preparedness: Zika virus and the 2016 Olympics, Umrah, and Hajj. Lancet 2016;387:630–2. https://doi.org/10.1016/s0140-6736(16)00274-9.Search in Google Scholar
22. De Sá, TH, Reis-Santos, B, Rodrigues, LC. Zika outbreak, mega-events, and urban reform. Lancet Glob Health 2016;4:603. https://doi.org/10.1016/s2214-109x(16)30174-7.Search in Google Scholar
23. Poland, GA, Ovsyannikova, IG, Kennedy, RB. Zika vaccine development: current status. Mayo Clin Proc 2019;94:2572–86. https://doi.org/10.1016/j.mayocp.2019.05.016.Search in Google Scholar
24. Toresdahl, BG, Asif, IM. Coronavirus disease 2019 (COVID-19): considerations for the competitive athlete. Sports Health 2020;12:221–4. https://doi.org/10.1177/1941738120918876.Search in Google Scholar
25. Pereda, PC, de Oliveira Alves, DC. Climate impacts on dengue risk in Brazil: current and future risks. Climate Change and Health. New York: Springer; 2016:201–30 p.10.1007/978-3-319-24660-4_13Search in Google Scholar
26. Korzeniewski, K, Juszczak, D, Zwolińska, E. Zika: another threat on the epidemiological map of the world. Int Marit Health 2016;67:31–7. https://doi.org/10.5603/imh.2016.0007.Search in Google Scholar
27. Matsumoto, J, Fujibe, F, Takahashi, H. Urban climate in the Tokyo metropolitan area in Japan. J Environ Sci 2017;59:54–62. https://doi.org/10.1016/j.jes.2017.04.012.Search in Google Scholar
28. Kikumoto, H, Ooka, R, Arima, Y. A study of urban thermal environment in Tokyo in summer of the 2030s under influence of global warming. Energy Build 2016;114:54–61. https://doi.org/10.1016/j.enbuild.2015.07.033.Search in Google Scholar
29. Honjo, T, Seo, Y, Yamasaki, Y, Tsunematsu, N, Yokoyama, H, Yamato, H, et al. Thermal comfort along the marathon course of the 2020 Tokyo Olympics. Int J Biometeorol 2018;62:1407–19. https://doi.org/10.1007/s00484-018-1539-x.Search in Google Scholar
30. Herdt, AJ, Brown, RD, Scott-Fleming, I, Cao, G, MacDonald, M, Henderson, D, et al. Outdoor thermal comfort during anomalous heat at the 2015 Pan American games in Toronto, Canada. Atmosphere 2018;9:321–39. https://doi.org/10.3390/atmos9080321.Search in Google Scholar
31. Gerrett, N, Kingma, BR, Sluijter, R, Daanen, HA. Ambient conditions prior to Tokyo 2020 Olympic and Paralympic Games: considerations for acclimation or acclimatization strategies. Front Physiol 2019;10:414–27. https://doi.org/10.3389/fphys.2019.00414.Search in Google Scholar
32. Vanos, JK, Kosaka, E, Iida, A, Yokohari, M, Middel, A, Scott-Fleming, I, et al. Planning for spectator thermal comfort and health in the face of extreme heat: the Tokyo 2020 Olympic marathons. Sci Total Environ 2019;657:904–17. https://doi.org/10.1016/j.scitotenv.2018.11.447.Search in Google Scholar
33. Smith, KR, Woodward, A, Lemke, B, Otto, M, Chang, C, Mance, A, et al. The last Summer Olympics? Climate change, health, and work outdoors. Lancet 2016;388:642–4. https://doi.org/10.1016/s0140-6736(16)31335-6.Search in Google Scholar
34. Vanos, JK, Thomas, WM, Grundstein, AJ, Hosokawa, Y, Liu, Y, Casa, DJ. A multi-scalar climatological analysis in preparation for extreme heat at the Tokyo 2020 Olympic and Paralympic Games. Temperature 2020;1:191–214. https://doi.org/10.1080/23328940.2020.1737479.Search in Google Scholar
35. Kosaka, E, Iida, A, Vanos, J, Middel, A, Yokohari, M, Brown, R. Microclimate variation and estimated heat stress of runners in the 2020 Tokyo Olympic Marathon. Atmosphere 2018;9:192–204. https://doi.org/10.3390/atmos9050192.Search in Google Scholar
36. Kenney, WL, Craighead, DH, Alexander, LM. Heat waves, aging, and human cardiovascular health. Med Sci Sports Exerc 2014;46:1891–9. https://doi.org/10.1249/mss.0000000000000325.Search in Google Scholar
37. International Olympic Committee. International Olympic Committee announces plans to move Olympic Marathon and Race Walking to Sapporo. Available from: https://www.olympic.org/news/international-olympic-committee-announces-plans-to-move-olympic-marathon-and-race-walking-to-sapporo.Search in Google Scholar
38. Kakamu, T, Wada, K, Smith, DR, Endo, S, Fukushima, T. Preventing heat illness in the anticipated hot climate of the Tokyo 2020 Summer Olympic Games. Environ Health Prev Med 2017;22:68. https://doi.org/10.1186/s12199-017-0675-y.Search in Google Scholar
Supplementary Material
The online version of this article offers supplementary material (https://doi.org/10.1515/REVEH-2020-0141).
© 2021 Walter de Gruyter GmbH, Berlin/Boston
