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Objectives: To explore the relationship between potential psychological risk factors and injury risk in circus artists.

Design: Historical cohort study.

Setting Cirque du Soleil training programme.

Participants: Forty-seven circus artists training to become Cirque du Soleil artists.

Assessment of risk factors: Artists completed the validated REST-Q questionnaire (19 domains) during their first 2 weeks of training.

Main outcome: Injury risk ratio.

Results: Of the five a priori exposures of interest, injury, emotional exhaustion, self-efficacy and fatigue were associated with an increase in injury risk (risk ratios between 1.8 and 2.8), but Conflicts/Pressure was not (risk ratio=0.8). Of the several specific psychological aspects that are considered risk factors for injury, low self-efficacy had the strongest relationship.

Conclusions: Most of the strong psychological risk factors for injuries previously identified in athletes also appear to be risk factors in circus artists