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Strategies to reduce illness risk in athletes: Part 1

In the previous blog "How common are illnesses amongst athletes?" we saw that a large number of athletes are affected by illness. The prevention of illness is a key component in athlete health management.

Prevention of illness in athletes

Illness prevention

Illness prevention strategies are not only important to optimise uninterrupted training, but also to reduce the risk of illness that can prevent participation in important competitions. Furthermore, illness prevention can also reduce the risk of medical complications during exercise. Illness prevention programs in Olympic teams have been shown to increase the sporting success of the athlete and the team. Although there is no single method that completely eliminates the risk of illness in athletes, there are several effective behavioural, nutritional and training strategies that can lower exposure to pathogens and limit the extent of exercise-induced immune system depression, thereby reducing the risk of illness. Some of the more important behavioural, lifestyle and medical strategies are described in this blog. A separate blog Strategies to reduce illness risk in athletes Part 2 focusses on the training, psychological stress management and nutritional strategies to limit infection risk.

A variety of behavioural, lifestyle and medical intervention strategies have been advocated (1, 2) to reduce the risk of illness in the athlete. These include advice to athletes, measures taken by medical staff, and the athlete support team.

Athletes are advised to:

  • Minimise contact with infected people, young children, animals and contagious objects

  • Avoid crowded areas and shaking hands and minimise contact with people outside the team and support staff

  • Keep at distance to people who are coughing, sneezing or have a ‘runny nose’, and when appropriate wear (or ask them to wear) a disposable mask

  • Cough or sneeze on to the elbow and not on the hands – always clean the hands and nose after sneezing or coughing

  • Wash hands regularly and effectively with soap and water, especially before meals, and after direct contact with potentially contagious people, animals, blood, secretions, public places and bathrooms

  • Use disposable paper towels and limit hand to mouth/nose contact when suffering from upper respiratory symptoms or gastrointestinal illness (putting hands to eyes and nose is a major route of viral self-inoculation)

  • Carry insect repellent, anti-microbial foam/cream or alcohol-based handwashing gel with them

  • Not to share drinking bottles, cups, cutlery, towels etc. with other people

  • Choose beverages from sealed bottles, avoid raw vegetables and undercooked meat, wash and peel fruit before eating, while competing or training abroad

  • Wear enough covered clothing (covering the arms and legs) during training sessions when travelling in tropical areas, particularly at dusk and dawn

  • Wear open footwear when using public showers, swimming pools and locker rooms in order to avoid dermatological diseases

  • Adopt strategies that facilitate good quality sleep such as strategic napping during the day and correct sleep hygiene practices at night

  • Avoid excessive drinking and binge drinking of alcohol as this impairs immune function for several hours, particularly after strenuous training or competition

  • Practice the principles of safe sex and use condoms

Medical staff taking care of athletes are advised to consider the following:

  • Develop, implement, and monitor illness prevention guidelines for athletes and medical and administrative support staff

  • Screening for airway inflammation disturbances (asthma, allergy and other inflammatory airway conditions)

  • Identify the high risk athletes and take full preventative precautions during high risk training or competition periods

  • Arrange for single room accommodation during tournaments for athletes with heavy competition load or known susceptibility to respiratory-tract infections, or high performance priority athletes

  • Consider protecting the airways of athletes from being directly exposed to very cold (below 0°C) and dry air during strenuous exercise by using a facial mask

  • Adopt measures to reduce the risk of illness associated with international travel

  • Update athletes vaccines needed at home and for foreign travel and take into consideration that influenza vaccines take 5-7 weeks to take effect, intramuscular vaccines may have a few small side effects, vaccinations are performed preferably out of season, and avoid vaccinating just before competitions or if symptoms of illness are present

  • Update administrative and support staff vaccines needed at home and for foreign travel

  • Consider zinc lozenges (>75 mg zinc/day; high ionic zinc content) at the onset of upper respiratory symptoms, as there is some evidence that the number of days with illness symptoms can be reduced

Continue to read about strategies to reduce illness risk in athletes in Part 2: Nutritional, training, psychological and monitoring strategies



  1. Gleeson M and Walsh N (2012) The BASES Expert Statement on Exercise, Immunity and Infection. Journal of Sports Sciences 30(3):321-324.

  2. Schwellnus M, Soligard T, Alonso JM, Bahr R, Clarsen B, Dijkstra P, Gabbett TJ, Gleeson M, Hägglund M, Hutchinson MR, Van Rensburg CJ, Khan K, Meeusen R, Orchard JW, Pluim BM, Raftery M, Erdener U, Budgett R and Engebretsen L (2016) How much is too much? (Part 2) International Olympic Committee consensus statement on load in sport and risk of illness. British Journal of Sports Medicine 50(17):1043-1052.

A pdf of a vertical version of the infographic can be purchased from the online store for £5. This can be printed in any desired size without losing resolution. To be used to remind athletes of these 16 important principles in lorckerrooms, dining areas or other facilities.


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