Background Nordic skiing consist of cross-country skiing (CC), ski jumping (SJ) and Nordic combined (NC). Only little injury and illness data from elite competitions in these sports are currently available. Objective To analyse injuries and illnesses during the FIS Nordic World Ski Championships 2021. Design Prospective cohort study. Setting FIS Nordic World Ski Championships in Oberstdorf, Germany, 23rd February to 7th March 2021. Participants All registered athletes (n=663). Main Outcome Measure Daily report of newly incurred injuries and illnesses according to the respective IOC consensus statement (2020) by the medical teams. Results About half of the nations (32/65), covering 51.6% of the registered athletes (n=342), participated in the study and returned 88.4% of the daily report forms. During the 12 championships days, 16 injuries were reported (incidence rate: 4.6%, 95%CI 2.4 to 6.9%), 12 in CC and 2 injuries each in NC and SJ. Six injuries affected the upper and 6 the lower extremities, 2 the lumbar-sacral spine/buttock and 2 the head. Most injuries occurred suddenly (n=13), 3 gradually. Eleven injuries (69%) were non-time-loss, Four injuries resulted in an estimated time-loss of 3-7 days, 1 in an estimated time-loss of 21 days (fracture of metacarpal bone). Out of the 16 illnesses (incidence rate: 4.6%, 95%CI 2.4 to 6.9%), 11 were reported in CC, 3 in NC and 2 in SJ.. Regarding etiology, 5 illnesses were environmental (4 exercise-related and 1 non-exercise related), 4 infectious, 3 allergic, 2 metabolic/nutritional, 1 degenerative/chronic and 1 unknown. Most illness occurred suddenly (n=10), 4 gradually and 2 had a mixed mode of onset. Twelve illnesses (75%) were non-time-loss. Three illnesses resulted in an estimated time-loss of 3 days, 1 in an estimated time-loss of 20 days (COVID-19 infection). Conclusion The injuries or illnesses incidence rate was lower than in Winter Olympic Games. The low illness rate might be due to COVID-19 hygiene measures.
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