Loughborough University
Svendsen et al 2016 BJSM ACCEPTED MANUSCRIPT.pdf (237.72 kB)

Training-related and competition-related risk factors for respiratory tract and gastrointestinal infections in elite cross-country skiers

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posted on 2020-11-27, 13:50 authored by Ida Svendsen, Ian TaylorIan Taylor, Espen Tonnessen, Roald Bahr, Michael Gleeson
Aim To examine symptoms indicative of respiratory tract and gastrointestinal infections and determine risk factors for such symptoms in elite cross-country skiers. Methods Self-reported training and symptom data for 37 elite cross-country skiers from 2007 to 2015 were analysed using multilevel logistic regression equations with symptom incidence and duration as outcome variables, and sex, performance level, season, competition, air travel, altitude exposure and training characteristics as independent variables. Results Data for 7016 person-weeks were analysed, including 464 self-reported infection events and 110 959 h of training. Athletes reported median (range) 3 (1–7) respiratory tract and/or gastrointestinal events per year, with symptoms lasting 5 (1–24) days. During the winter, symptoms occurred more frequently (OR 2.09, p<0.001) and lasted longer (b=0.043, p<0.001) compared with summer. Competition and air travel increased the risk of symptoms, with ORs of 2.93 (95% CI 2.24 to 3.83) and 4.94 (95% CI 3.74 to 6.53), respectively (p<0.001). Athletes with higher training monotony had lower risk of symptoms (OR 0.87 (95% CI 0.73 to 0.99), p<0.05). Other training variables were not associated with symptoms. Athletes who had won an Olympic/World Championship medal reported shorter symptom duration compared with less successful athletes (b=−0.019, p<0.05) resulting in significantly fewer symptomatic days/year (14 (6–29) vs 22 (8–43) days/year). Conclusions Air travel and competition are major risk factors for acute respiratory tract and gastrointestinal symptoms in this population. Athletes who have large fluctuations in training load experience such symptoms more frequently. Shorter duration of symptoms appears to be associated with success in cross-country skiing.



  • Sport, Exercise and Health Sciences

Published in

British Journal of Sports Medicine






809 - 815


SVENDSEN, I.S. ... et al, 2016. Training-related and competition-related risk factors for respiratory tract and gastrointestinal infections in elite cross-country skiers. British Journal of Sports Medicine, 50 (13), pp. 809-815.


BMJ Publishing Group / © The Authors


  • AM (Accepted Manuscript)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

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Publication date



This article has been accepted for publication in British Journal of Sports Medicine, 2016 following peer review, and the Version of Record can be accessed online at https://doi.org/10.1136/bjsports-2015-095398.




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