Indepth knowledge of injury and illness epidemiology in circus arts is lacking. Comparing results across studies is difficult due to inconsistent methods and definitions. In 2020, the International Olympic Committee (IOC) consensus group proposed a standard method for recording and reporting epidemiological data on injuries and illnesses in sports and stated that sport-specific extension statements are needed to capture the context of each sport. This is the circus-specific extension to be used with the IOC consensus statement. International circus arts researchers in injury and illness epidemiology and performing arts medicine formed a consensus working group. Consensus statement development included a review of literature, creation of an initial draft by the working group, feedback from external reviewers, integration of feedback into the second draft and a consensus on the final document. This consensus statement contains circus-specific information on (1) injury definitions and characteristics; (2) measures of severity and exposure, with recommendations for calculating the incidence and prevalence; (3) a healthcare practitioner report form; (4) a self-report form capturing health complaints with training and performance exposure; and (5) a demographic, health history and circus experience intake questionnaire. This guideline facilitates comparing results across studies and enables combining data sets on injuries in circus arts. This guideline informs circus-specific injury prevention, rehabilitation, and risk management to improve the performance and health of circus artists.

BACKGROUND: Despite growing participation in circus arts, little is known about associated injuries. Understanding injury patterns is critical for developing interventions to decrease injury risk and guiding rehabilitation. OBJECTIVE: The purpose of this pilot prospective cohort study was to describe injury frequency and characteristics in adolescent and adult circus artists using a surveillance method derived from dance. METHODS: Participants included 14 adolescent [mean age 14.7 yrs (1.3); 100% female] and 10 adult circus artists [mean age 30.7 yrs (3.1); 60% female]. Circus training exposure (single session of one circus discipline) and injuries were tracked for 1 year using a dance-derived injury surveillance guideline. A regression analysis was run using total session exposures, age (in years), and years of circus experience as predictor variables for injury rate. RESULTS: Twenty-one of 24 participants completed the study. Forty-seven injuries were reported (53.2% time loss; 46.8% non-time loss). Joint injuries were most common for both groups. The injury rate per 1,000 exposures was 3 (95%CI 0.6–8.7) for adolescents and 13 (95%CI 6.9–22.01) for adults. The overall regression was significant (F(3,13)=6.66, p=0.006). The only significant predictor was age (beta=0.82, p=0.003). Total session exposures and years of circus experience had betas close to 0 (–0.11 and –0.04, respectively). CONCLUSION: This pilot study comparing injuries in adolescent and adult circus artists found age but not exposure was predictive of injury risk. Use of a standardized injury surveillance guideline in circus, similar to the one used in this study, will provide greater insight into injury patterns by allowing between-study comparison.

ObjectiveThis prospective cohort study quantified injury patterns related to specific circus discipline exposure in preprofessional and professional circus artists.MethodsCircus artists (n=201; ages 13–69; 172 female, 29 male assigned sex at birth) were enrolled in 10 cities across the USA. Participants were followed for 1 year from enrolment, completing a weekly training log and undergoing a physical therapist evaluation for injuries. The circus-specific extension of the International Olympic Committee 2020 consensus on recording injury and illness in sports was used to analyse injury patterns.ResultsThe study completion rate was 77% (n=155). Data were analysed by participant subgroup (age, professional status, sex at birth). The highest injury rates in participant subgroups were for males (5.69/1000 exposures) and related to discipline subgroups, were in aerial with ground elements (5.93/1000 exposures) and aerial (4.26/1000 exposures). Adults had more injuries related to aerial, whereas adolescents had more related to ground disciplines (χ2(2)=10.62, p=0.005) and non-time loss injuries (χ2(1)=5.45, p=0.02). Females had a higher proportion of repetitive injuries (70% vs 55%) than males (χ2(1) = 4.43, p=0.035). Individuals with an eating disorder history had more (p<0.004) injuries (mean 2.27±2.29) than those without (mean=1.48±0.96).ConclusionsThis study showed that intrinsic factors (age, sex at birth and history of eating disorder) and extrinsic factors (circus discipline exposure) affect injury risk. We need to account for the intersectionality of these factors to address risk management at an individual and group level.