Self-reported symptoms and exercise-induced asthma in the elite athlete.
OBJECTIVE
The purpose of this study was to compare self-reported symptoms for exercise-induced asthma (EIA) to postexercise challenge pulmonary function test results in elite athletes.


METHODS
Elite athletes (N = 158; 83 men and 75 women; age: 22 +/- 4.4 yr) performed pre- and post-exercise spirometry and were grouped according to postexercise pulmonary function decrements (PFT-positive, PFT-borderline, and PFT-normal for EIA). Before the sport/environment specific exercise challenge, subjects completed an EIA symptoms-specific questionnaire.


RESULTS
Resting FEV1 values were above predicted values (114--121%) and not different between groups. Twenty-six percent of the study population demonstrated >10% postexercise drop in FEV1 and 29% reported two or more symptoms. However, the proportion of PFT-positive and PFT-normal athletes reporting two or more symptoms was not different (39% vs. 41%). Postrace cough was the most reported symptom, reported significantly more frequently for PFT-positive athletes (P < 0.05). Sensitivity/specificity analysis demonstrated a lack of effectiveness of self-reported symptoms to identify PFT-positive or exclude PFT-normal athletes. Postexercise lower limit reference ranges (MN-2SDs) were determined from normal athletes for FEV1, FEF25--75% and PEF to be -7%, -12.5%, and -18%, respectively.


CONCLUSIONS
Although questionnaires provide reasonable estimates of EIA prevalence among elite cold-weather athletes, the use of self-reported symptoms for EIA diagnosis in this population will likely yield high frequencies of both false positive and false negative results. Diagnosis should include spirometry using an exercise/environment specific challenge in combination with the athlete's history of asthma symptoms.
Sports Science and Technology Division, United States Olympic Committee, Lake Placid, NY 12946, USA. krundell@usoc.org
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Mayers
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Wilber
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D000293:Adolescent; D000328:Adult; D001250:Asthma, Exercise-Induced / Q000473:pathology*; D001986:Bronchial Spasm; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D010807:Physical Endurance; D012720:Severity of Illness Index; D013177:Sports; D013696:Temperature