title: Respiratory symptoms, bronchial responsiveness, and cellular characteristics of induced sputum in elite swimmers.
abstract: To investigate respiratory symptoms, increased bronchial responsiveness, and signs of airway inflammation in elite swimmers, we examined 29 swimmers from the Finnish national team and 19 healthy control subjects (nonasthmatic, symptom-free). They answered a questionnaire and were interviewed for respiratory symptoms. Lung volumes were measured and bronchial responsiveness assessed by a histamine challenge test. Induced sputum samples were also collected. Fourteen (48%) of the swimmers and three (16%) of the control subjects showed increased bronchial responsiveness (P<0.05). The sputum cell differential counts of eosinophils (mean 2.7% vs 0.2%) and neutrophils (54.7% vs 29.9%) from swimmers were significantly higher than those from controls (P<0.01). Eosinophilia (sputum differential eosinophil count of >4%) was observed in six (21%) of the swimmers and in none of the controls (P<0.05). Symptomatic swimmers had significantly more sputum eosinophils than did the symptom-free. The concentrations of sputum eosinophil peroxidase (EPO) and human neutrophil lipocalin (HNL) were significantly higher in swimmers than control subjects (P<0.001 and P=0.05). We conclude that elite swimmers had significantly more often increased bronchial responsiveness than control subjects. Sputum from swimmers contained a higher percentage of eosinophils and neutrophils, and higher concentrations of EPO and HNL than sputum from controls. Long-term and repeated exposure to chlorine compounds in swimming pools during training and competition may contribute to the increased occurrence of bronchial hyperresponsiveness and airway inflammation in swimmers.
authors.affiliation: Department of Allergology, Helsinki University Central Hospital, Finland.
authors.forename: I J
authors.initials: IJ
authors.lastname: Helenius
authors.forename: P
authors.initials: P
authors.lastname: Rytilä
authors.forename: T
authors.initials: T
authors.lastname: Metso
authors.forename: T
authors.initials: T
authors.lastname: Haahtela
authors.forename: P
authors.initials: P
authors.lastname: Venge
authors.forename: H O
authors.initials: HO
authors.lastname: Tikkanen
mesh_terms: D000293:Adolescent; D000328:Adult; D016535:Bronchial Hyperreactivity / Q000209:etiology*; D001991:Bronchitis / Q000209:etiology*; D004804:Eosinophils; D005260:Female; D006801:Humans; D008297:Male; D009504:Neutrophils; D013183:Sputum / Q000166:cytology*; D013550:Swimming