Screening Elite Winter Athletes for Exercise Induced Asthma: a Comparison of Three Challenge Methods

Overview

Journal Br J Sports Med

Publisher BMJ Publishing Group

Specialty Orthopedics

Date 2006 Jan 25

PMID 16432008

Citations 16

Authors

J W Dickinson

G P Whyte

A K McConnell

M G Harries

Affiliations

Soon will be listed here.

Abstract

Background: The reported prevalence of exercise induced asthma (EIA) in elite winter athletes ranges from 9% to 50%. Many elite winter athletes do not report symptoms of EIA. At present there is no gold standard test for EIA.

Objective: To establish the efficacy of screening for EIA and examine the role of the eucapnic voluntary hyperventilation (EVH) challenge and laboratory based and sport specific exercise challenges in the evaluation of elite winter athletes.

Methods: 14 athletes (mean (SD) age 22.6 (5.7) years, height 177.2 (7.0) cm, body mass 68.9 (16.9) kg) from the Great Britain short-track speed skating (n = 10) and biathlon teams (n = 4) were studied. Each athlete completed a laboratory based and sport specific exercise challenge as well as an EVH challenge, in randomised order.

Results: All 14 athletes completed each challenge. Two had a previous history of asthma. Ten (including the two with a previous history) had a positive test to at least one of the challenges. Ten athletes had a positive response to EVH; of these, only three also had a positive response to the sport specific challenge. No athletes had a positive response to the laboratory based challenge.

Conclusions: Elite athletes should be screened for EIA. EVH is a more sensitive challenge in asymptomatic athletes than sport specific and laboratory based challenges. If sporting governing bodies were to implement screening programmes to test athletes for EIA, EVH is the challenge of choice.

Citing Articles

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Exercise-Induced Bronchospasm in Elite Athletes.

Pigakis K, Stavrou V, Pantazopoulos I, Daniil Z, Kontopodi A, Gourgoulianis K Cureus. 2022; 14(1):e20898.

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A Meta-analysis of Diagnostic Test Agreement Between Eucapnic Voluntary Hyperventilation and Cardiopulmonary Exercise Tests for Exercise-Induced Bronchoconstriction.

Iftikhar I, Greer M, Jaiteh A Lung. 2019; 197(4):483-492.

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Anti-doping Policy, Therapeutic Use Exemption and Medication Use in Athletes with Asthma: A Narrative Review and Critical Appraisal of Current Regulations.

Allen H, Backhouse S, Hull J, Price O Sports Med. 2019; 49(5):659-668.

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References

Rundell K, Wilber R, Szmedra L, Jenkinson D, Mayers L, Im J . Exercise-induced asthma screening of elite athletes: field versus laboratory exercise challenge. Med Sci Sports Exerc. 2000; 32(2):309-16. DOI: 10.1097/00005768-200002000-00010. View

Dickinson J, Whyte G, McConnell A, Harries M . Impact of changes in the IOC-MC asthma criteria: a British perspective. Thorax. 2005; 60(8):629-32. PMC: 1747493. DOI: 10.1136/thx.2004.037499. View

Anderson S, Daviskas E . The mechanism of exercise-induced asthma is . J Allergy Clin Immunol. 2000; 106(3):453-9. DOI: 10.1067/mai.2000.109822. View

Rundell K, Im J, Mayers L, Wilber R, Szmedra L, Schmitz H . Self-reported symptoms and exercise-induced asthma in the elite athlete. Med Sci Sports Exerc. 2001; 33(2):208-13. DOI: 10.1097/00005768-200102000-00006. View

Anderson S, Argyros G, Magnussen H, Holzer K . Provocation by eucapnic voluntary hyperpnoea to identify exercise induced bronchoconstriction. Br J Sports Med. 2001; 35(5):344-7. PMC: 1724385. DOI: 10.1136/bjsm.35.5.344. View

Holzer K, Anderson S, Douglass J . Exercise in elite summer athletes: Challenges for diagnosis. J Allergy Clin Immunol. 2002; 110(3):374-80. DOI: 10.1067/mai.2002.127784. View

Bokulic R . Screening for exercise-induced asthma. J Pediatr. 2002; 141(3):306-8. DOI: 10.1067/mpd.2002.127273. View

Anderson S, Fitch K, Perry C, Sue-Chu M, Crapo R, McKenzie D . Responses to bronchial challenge submitted for approval to use inhaled beta2-agonists before an event at the 2002 Winter Olympics. J Allergy Clin Immunol. 2003; 111(1):45-50. DOI: 10.1067/mai.2003.1. View

Joos G, OConnor B, Anderson S, Chung F, Cockcroft D, Dahlen B . Indirect airway challenges. Eur Respir J. 2003; 21(6):1050-68. DOI: 10.1183/09031936.03.00008403. View

10.

Rundell K, Anderson S, Spiering B, Judelson D . Field exercise vs laboratory eucapnic voluntary hyperventilation to identify airway hyperresponsiveness in elite cold weather athletes. Chest. 2004; 125(3):909-15. DOI: 10.1378/chest.125.3.909. View

11.

Holzer K, Brukner P . Screening of athletes for exercise-induced bronchoconstriction. Clin J Sport Med. 2004; 14(3):134-8. DOI: 10.1097/00042752-200405000-00005. View

12.

Anderson S . Is there a unifying hypothesis for exercise-induced asthma?. J Allergy Clin Immunol. 1984; 73(5 Pt 2):660-5. DOI: 10.1016/0091-6749(84)90301-4. View

13.

Hahn A, Anderson S, Morton A, Black J, Fitch K . A reinterpretation of the effect of temperature and water content of the inspired air in exercise-induced asthma. Am Rev Respir Dis. 1984; 130(4):575-9. DOI: 10.1164/arrd.1984.130.4.575. View

14.

McFadden Jr E, Lenner K, Strohl K . Postexertional airway rewarming and thermally induced asthma. New insights into pathophysiology and possible pathogenesis. J Clin Invest. 1986; 78(1):18-25. PMC: 329525. DOI: 10.1172/JCI112549. View

15.

Rupp N, Guill M, Brudno D . Unrecognized exercise-induced bronchospasm in adolescent athletes. Am J Dis Child. 1992; 146(8):941-4. DOI: 10.1001/archpedi.1992.02160200063028. View

16.

Rupp N, Brudno D, Guill M . The value of screening for risk of exercise-induced asthma in high school athletes. Ann Allergy. 1993; 70(4):339-42. View

17.

Helenius I, Tikkanen H, Haahtela T . Exercise-induced bronchospasm at low temperature in elite runners. Thorax. 1996; 51(6):628-9. PMC: 1090496. DOI: 10.1136/thx.51.6.628. View

18.

Helenius I, Tikkanen H, Haahtela T . Occurrence of exercise induced bronchospasm in elite runners: dependence on atopy and exposure to cold air and pollen. Br J Sports Med. 1998; 32(2):125-9. PMC: 1756081. DOI: 10.1136/bjsm.32.2.125. View

19.

Kukafka D, Lang D, Porter S, Rogers J, Ciccolella D, Polansky M . Exercise-induced bronchospasm in high school athletes via a free running test: incidence and epidemiology. Chest. 1999; 114(6):1613-22. DOI: 10.1378/chest.114.6.1613. View

20.

Mannix E, MANFREDI F, Farber M . A comparison of two challenge tests for identifying exercise-induced bronchospasm in figure skaters. Chest. 1999; 115(3):649-53. DOI: 10.1378/chest.115.3.649. View