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  1. Michael Drew1,2,
  2. Vlahovich Nicole1,4,
  3. Hughes David1,
  4. Appaneal Renee1,
  5. Peterson Kirsten1,
  6. Burke Louise1,5,
  7. Lundy Bronwen1,5,
  8. Toomey Mary6,7,
  9. Watts David6,
  10. Lovell Greg1,
  11. Praet Stephan1,
  12. Halson Shona1,
  13. Colbey Candice8,
  14. Manzanero Silvia1,4,
  15. Welvaert Marijke1,3,
  16. West Nic8,
  17. Pyne David1,3,
  18. Waddington Gordon1,3
  1. 1Australian Institute of Sport, Canberra, Australia
  2. 2Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Australia
  3. 3University of Canberra Research Institute for Sport and Exercise (UCRISE), Canberra, Australia
  4. 4Bond University, Gold Coast, Australia
  5. 5Mary MacKillop Institute for Health Research, Australian Catholic University, Canberra, Australia
  6. 6Queensland Academy of Sport, Brisbane, Australia
  7. 7Department of Physiotherapy, Brisbane, Australia
  8. 8Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia


    Background Illnesses affect the ability of an athlete to perform. Few studies investigate risk factors in athletes across disciplines.

    Objective To investigate risk factors for illness in athletes preparing for the Olympic Games.

    Design Cross-sectional.

    Setting Australian athletes eligible for selection for the Olympic Games.

    Participants 317 athletes from 15 sports completed at least one component of the study (59% of athletes). To be eligible, athlete had to be available for selection for the Olympics.

    Assessment of Risk Factors Phase 1 (P1) was in the summer period of December 2015-January 2016 and Phase 2 (P2) involved the period in the autumn (late April-June 2016). Questionnaires were administered in an electronic system. Depression, Anxiety and Stress Questionnaire (DASS-21), Perceived Stress Scale (PSS), Dispositional Resilience Scale (DRS), Recovery-Stress Questionnaire (REST-Q-52 item), Low Energy in Females Questionnaire (LEAF-Q), a modified Personal and Household Hygiene questionnaire, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and custom-made questionnaires on probiotic usage and travel were administered.

    Main Outcome Measurements A monthly sports incapacity defintion was used in P1. A symptom checklist, including sports incapacity, was utilized in P2 investigating Upper Respiratory Tract Symptoms (URTS), bodily aches, gastrointestinal, head, eye, fatigue or chest symptoms.

    Results Female athletes were at higher odds of respiratory illness (OR=2.8, 95% CI 1.3 to 6.0). The prevalence of a high LEAF-Q score (≥8) was 49 and 53% and was associated with illness (P1: Any illness OR 7.4, 95% CI 0.8–352; P2: URTS OR 3.8, 95% CI 1.3–11.6). High DASS-21 scores were associated with increased reports of illness in P1 (Depression, OR=8.4 95% CI 1.1–59). High PSQI scores increased the reports of illness (P2: URTS: PSQI≥5, OR=2.8 95% CI 1.2–6.9).

    Conclusions The results highlight that female athletes, particularly when exhibiting low energy availability, are at higher risk. Poor mental health and sleep quality were associated with illness.

    • Injury

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