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Attachment1:

China Triathlon Sports Association

Physical Examination Guidelines for Athletes

1. Necessity of Physical Examination

(I) Triathlon is characterized by long course, high intensity and unstable environment. The stimulation to the human body is intense and serious, and various acute injuries and diseases will inevitably occur, mainly the stimulation or damage to the cardiovascular, respiratory, central nervous system, gastrointestinal tract and the motor (bone and muscle) system, and the serious cases can be life-threatening.

(II) Due to the unpredictable nature of acute injuries and illnesses, it is very important and necessary to provide athletes with a comprehensive physical examination, monitoring and control of symptomatic systems, active prevention and treatment of injuries and illnesses, and the establishment of health records. Good physical condition is the foundation of triathlon, and performing triathlon in a condition of injury or illness increases the risk of health and safety for athletes.

(III) In order to maximize the health and safety of participating athletes, this guideline for medical examination is formulated. Athletes who fail to undergo the required physical examination or whose results do not meet the following requirements shall not be allowed to participate in the competition.

2. Comprehensive Requirements

(1) Pre-match physical examination: Athletes must keep abreast of their own health and physical condition, and go to a "Class II A" or above hospital for a physical examination before the match (no more than six months before the match).

(2) Self-monitoring: If the result of a single physical examination before the competition is normal, it only indicates the physical health status reflected by the selected physical examination items. Due to the limitations of physical examination methods and items, potential physical risks cannot be completely ruled out; due to the "variability of human physical conditions", it cannot be proved that athletes are fully capable of completing the competition safely. Therefore, every participating athlete must do:

1. Before the game, take the initiative to ensure that you are in good condition and do not have colds, fevers, viral or bacterial tonsillitis, pharyngitis, gastroenteritis, or other acute or chronic injuries.

2. Athletes should always monitor their physical conditions during the competition. If they experience chest tightness, chest pain, palpitation, nausea, difficulty breathing, abnormal fatigue, etc., they should stop the competition immediately and seek help from the nearest medical point or event staff.

3. Physical Examination Items

The following physical examination items are designed based on common acute injuries in triathlon:

I. General Internal Medicine and Surgery Examination (All Athletes) Focus on asking and identifying whether the athletes have the following conditions:

1. Cardiovascular system diseases, such as hypertension, valvular disease, coronary heart disease, and cardiomyopathy;

2. Central nervous system diseases, such as epilepsy and severe neurasthenic syndrome;

3． Family history of sudden death;

4． Past history of sports stress or acute injury;

5. Respiratory diseases, such as allergic bronchial asthma, acute or chronic respiratory tract infections;

6． Gastrointestinal diseases, such as active peptic ulcers.

II. Blood pressure check (only for athletes over 13 years old)

1. Athletes under 50 years old: systolic blood pressure ≤ 130mmHg (17.3KPa), diastolic blood pressure ≤ 85mmHg (11.3KPa);

2. Athletes over 50 years old (including 50 years old): systolic blood pressure ≤140mmHg (18.6KPa), diastolic blood pressure ≤90mmHg (12KPa).

III. Electrocardiogram examination (all athletes)

The electrocardiogram report must be diagnosed by a physician, and the evaluation standards are as follows:

1. Normal electrocardiogram (confirmed by the hospital to have no obvious abnormalities):

(1) Sinus rhythm;

(2) The heart rate of adults is 40 to 100 beats/min (the heart rate of professional athletes can be lower than 40 beats/min).

2. Abnormal electrocardiograms that do not meet the competition requirements include but are not limited to:

(1) Sinus tachycardia, adult heart rate >100 beats/min; ventricular tachycardia;

(2) Frequent sinus arrhythmia;

(3) Sinus arrest; atrial, junctional, ventricular premature contractions or escape beats;

(4) Sick sinus syndrome;

(5) Sinoatrial, atrioventricular, left bundle branch block, etc. of degree II or above;

(6) Preexcitation syndrome;

(7) Myocardial ischemia, ST segment ischemic type reduction (including horizontal type, sagging type, arched type, sunken type, approximate ischemic type), T wave changes (including flat, bidirectional, inverted), Q-T Interval prolongation, U wave inversion, arrhythmia, etc.;

(8) Other ECG abnormalities, such as atrial fibrillation.

IV. Full blood biochemistry (can be performed as appropriate) to determine the liver and kidney function, blood sugar and blood lipids, serum ions, myocardial enzyme spectrum, etc.

V. Color echocardiography (can be performed as appropriate) to determine the condition of the ventricles, atria, valves, myocardium and its movement (contractility and compliance), ejection fraction and cardiac output, and to avoid cardiac structural disorders.