Existential threats to the summer olympic and paralympic games? A review of emerging environmental health risks

Michael Annear*, Tetsuhiro Kidokoro, Yasuo Shimizu

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

2 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)159-166
Number of pages8
JournalReviews on Environmental Health
Issue number2
Publication statusPublished - 2021 Jun 1


  • COVID-19
  • Climate change
  • Infectious disease
  • Sports mega-event

ASJC Scopus subject areas

  • Health(social science)
  • Pollution
  • Public Health, Environmental and Occupational Health


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