The asthmatic athlete, inhaled beta agonists, and performance.
BACKGROUND
The large increase in the number of athletes who apply to use inhaled beta agonists (IBAs) at the Olympic Games is a concern to the medical community. This review will examine the use of IBAs in the asthmatic athlete, the variability that exists between countries and sport, and outline a plan to justify the use of these medications.


METHODS
Much of this article is a result of an International Olympic Committee (IOC) Medical Commission-sponsored meeting that took place in May 2001. Records of the use of IBAs at previous Olympics were reviewed. MEDLINE Searches (PubMed interface) were performed using key words to locate published work relating to asthma, elite athletes, performance, treatment, and ergogenic aids.


RESULTS
Since 1984 there have been significant increases in the use of IBAs at the Olympic Games as well as marked geographical differences in the percentage of athletes requesting the use of IBAs. There are large differences in the incidence of IBA use between sports with a trend towards increased use in endurance sports. There are no ergogenic effects of any IOC-approved IBA given in a therapeutic dose.


CONCLUSIONS
In many cases, the prescription of IBAs to this population has been made on empirical grounds. Beginning with the 2002 Winter Games, athletes will be required to submit to the IOC Medical Commission clinical and laboratory evidence that justifies the use of this medication. The eucapnic voluntary hyperpnea test will be used to assess individuals who have not satisfied an independent medical panel of the need to use an IBA.
McKenzie
Donald C
DC
Division of Sports Medicine, The University of British Columbia, Vancouver, British Columbia, Canada. kari@interchange.ubc.ca
Stewart
Ian B
IB
Fitch
Kenneth D
KD
D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D001249:Asthma / Q000150:complications / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D004300:Doping in Sports; D015444:Exercise / Q000502:physiology; D006291:Health Policy; D006801:Humans; D007391:International Cooperation; D010807:Physical Endurance; D013177:Sports; D013647:Task Performance and Analysis
D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents