World Triathlon PPE Certification 2021


Pre-Participation Examination (PPE) requirements

 According to World Triathlon competition guidelines, all the athletes have to undergo a Periodic Health Evaluation (PHE) and a Pre-Participation Evaluation (PPE) prior to engaging in competitive sport.

As of 1st January 2017, an annual PPE is mandatory for all Junior athletes competing in junior category of any ITU event. From 2018, all athletes competing in the ITU competitions in Youth, Junior, U23, Elite and Elite paratriathlon categories must have completed a pre-competition health screening which includes a questionnaire, a physical examination and an ECG following the IOC’s recommended procedure.

Thereafter, all Youth, Junior, U23, Elite and Elite paratriathlon athletes, competing in ITU competitions, must complete the medical questionnaire and undergo a medical examination each year, and, in addition, must undergo a resting ECG every two years. For all other triathlete age groups this screening is strongly recommended.

The screening takes place in three steps:

  1. Answer the Medical Questionnaire - this questionnaire is strictly confidential and must given

to the responsible team doctor before the medical examination. The medical questionnaire will

be available to be downloaded from the ITU website.

  1. Physical Examination by the doctor following the IOC recommendations published in the

“Lausanne Recommendations” about the Sudden Cardiovascular Death in Sport Consensus.

  1. Cardiac auscultation:
  • Rate /rhythm
  • Murmur: systolic/diastolic
  • Systolic click
      • Blood Pressure
      • Radial and Femoral Pulses
      • Marfan stigmata
  1. A 12 lead rest electrocardiogram (ECG): Doctor to look for anomalies in rhythm, conduction or repolarisation.

More than 90% of sudden death in competitive athletes are related to pre-existing cardiovascular problems (SCD). The SCD of an athlete on the field remains the most devastating medical event in sports. The purpose of this screening is to identify, as accurately as possible, athletes at risk in order to advise them accordingly.

Once you have completed your PPE, you will need to submit the PPE certification to Indian Triathlon Federation. The certificate should be sent to

Note: It is important that you to complete the PPE test as soon as possible if you intend to race in immediate upcoming events.