16 person aged 16 years and older mean value in relation to the population aged 16 years and older independently of sport the respondents also reported an average of 13 days of absence or illness 17 The share of sport in all days of absence is thus approx 21 3 4 16 4 Employers medical costs associated with absenteeism due to illness or injury continued pay ment of wages in the event of illness are estimated by the umbrella organization of company health insurance funds at a total of approx 53 billion Institut der deutschen Wirtschaft 2019 Of this amount about 44 3 billion is accounted for by gross wages and 8 8 billion by em ployers social security contributions In relation to the 21 of sick days caused by sports inju ries there are pro rata sport related indirect costs of approximately 11 billion due to occupa tional absences 9 1 billion for gross remuneration and 1 8 billion for social security contributions The health costs caused by sport thus amount to about 17 5 billion the 11 billion indirect costs and the 6 5 billion direct costs together Non monetary costs are those due to disability or death caused by sport As mentioned above these are conceptual estimates which need to be further verified by stud ies18 Current studies on sports injuries differentiated according to sport are also scarce According to Henke et al 2000 football ranks first in the injury table in both organized i e club related and non organized sport measured by the absolute number of sports injuries In organized sport handball and volleyball follow in 2nd and 3rd place in non organized sport alpine skiing and in line skating If the absolute number of sports injuries is compared to the number of sportsmen and women a different ranking of sports according to the relative risk of injury is obtained For example the ball sports football volleyball and handball have a similarly high relative risk of in jury Henke et al 2000 To date negative psychological side effects of playing sports have been largely unilluminated or quantified E g Niedermeier et al 2019 point out that excessive sports practice in particular can increase the risk of mental disorders such as eating disorders substance abuse or sports addic tion Economic effects of this are either impossible or extremely difficult to assess Cycling fitness and jogging contribute the most to physical ac tivity Activity and duration Different sports contribute to different degrees to the fulfilment of WHO recommendations Table 2 shows the most frequently practiced sports and the amount of weekly training in the last four weeks The sports are sorted according to the proportion of the population over 16 years of age who exercise the sport at least once a year cf Repenning et al 2019 According to this criterion cycling and swimming are the most popular sports in the adult population Other sports such as many team sports are practiced much less frequently by the 17 For comparison According to the umbrella organization of company health insurance funds German employees were on sick leave for an average of 15 4 days in 2015 Institut der deutschen Wirtschaft 2019 18 For comparison For Austria Alt et al 2015 have calculated total costs resulting from movement injuries in the amount of approximately 0 4 billion on the basis of different calculation logics Henke et al 2000 put the economic costs due to sports injuries for Germany at about DM 8 billion in 2000

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