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Expanding the screening toolbox to promote athlete health: how the US Olympic & Paralympic Committee screened for health problems in 940 elite athletes
  1. Dustin Nabhan1,2,
  2. Melie Lewis1,2,
  3. David Taylor1,2,
  4. Roald Bahr3
  1. 1 Sports Medicine, United States Olymic & Paralympic Committee, Colorado Springs, Colorado, USA
  2. 2 US Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
  3. 3 Oslo Sports Trauma Research Center, Oslo, Norway
  1. Correspondence to Dr Dustin Nabhan, Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, CO 80909, USA; Dustin.Nabhan{at}


Aim To assess the value of including validated screening tools for allergies, anxiety, depression, sleep apnoea and sleep quality into an electronic patient health history questionnaire.

Methods In this descriptive study, we reviewed electronic medical records of Olympic and Paralympic athletes who completed health screenings, which included validated screens for allergies (Allergy Questionnaire for Athletes), anxiety (General Anxiety Disorder-2), depression (Patient Health Questionaire-2), sleep apnoea (Berlin Questionnaire) and sleep quality (Pittsburgh Sleep Quality Index), using established criteria for a positive screen. We report the prevalence of positive tests and the associations between positive screening tools.

Results A total of 683 Olympic and 257 Paralympic athletes (462 male, 478 female) completed the health history between May and September of 2019. At least one positive screen was reported by 37% of athletes training for the Olympics and 48% of athletes training for the Paralympics. More than 20% of all athletes screened positive for allergies and poor sleep quality. Athletes training for the Paralympics had a significantly higher percentage of positive screens for anxiety, depression, poor sleep quality and sleep apnoea risk. Females had significantly more positive screens for allergy and poor sleep quality.

Conclusions The addition of standardised screening tools to an electronic health history resulted in the identification of potential mental health, sleep and allergy problems in both Olympic and Paralympic athletes. Strong associations between mental health and sleep disorders suggest these problems should be considered together in health screening programmes.

  • epidemiology
  • health promotion
  • olympics
  • injury prevention

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  • Contributors DN, DT and RB conceived and planned the project. DN and ML collected data for the project and completed data analysis. All authors participated in writing the manuscript. DN and RB directed the project.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval Ethics approval for the use of this data set for the purpose of this project was provided by Southern California University of Health Sciences.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as online supplemental information. All publicly available data are included in the publication.