All participants reported at least one illness symptom in the previous month. Low energy availability was a leading variable associated with illness in Olympic-class athletes. The estimates duration of symptoms ranged from 2 to 7 days. Factor analyses show the interdependence of various health domains and support multidisciplinary care.

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BackgroundIllnesses affect the ability of an athlete to perform. Few studies investigate risk factors in athletes across disciplines.ObjectiveTo investigate risk factors for illness in athletes preparing for the Olympic Games.DesignCross-sectional.SettingAustralian athletes eligible for selection for the Olympic Games.Participants317 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 FactorsPhase 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 MeasurementsA 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.ResultsFemale 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).ConclusionsThe 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.