Asthma and the elite athlete: summary of the International Olympic Committee's consensus conference, Lausanne, Switzerland, January 22-24, 2008.
Respiratory symptoms cannot be relied on to make a diagnosis of asthma and/or airways hyperresponsiveness (AHR) in elite athletes. For this reason, the diagnosis should be confirmed with bronchial provocation tests. Asthma management in elite athletes should follow established treatment guidelines (eg, Global Initiative for Asthma) and should include education, an individually tailored treatment plan, minimization of aggravating environmental factors, and appropriate drug therapy that must meet the requirements of the World Anti-Doping Agency. Asthma control can usually be achieved with inhaled corticosteroids and inhaled beta(2)-agonists to minimize exercise-induced bronchoconstriction and to treat intermittent symptoms. The rapid development of tachyphylaxis to beta(2)-agonists after regular daily use poses a dilemma for athletes. Long-term intense endurance training, particularly in unfavorable environmental conditions, appears to be associated with an increased risk of developing asthma and AHR in elite athletes. Globally, the prevalence of asthma, exercise-induced bronchoconstriction, and AHR in Olympic athletes reflects the known prevalence of asthma symptoms in each country. The policy of requiring Olympic athletes to demonstrate the presence of asthma, exercise-induced bronchoconstriction, or AHR to be approved to inhale beta(2)-agonists will continue.
Fitch
Kenneth D
KD
School of Sports Science, Exercise and Health, Faculty of Life Sciences, University of Western Australia, Crawley, Australia. kfitch@cyllene.uwa.edu.au
Sue-Chu
Malcolm
M
Anderson
Sandra D
SD
Boulet
Louis-Philippe
LP
Hancox
Robert J
RJ
McKenzie
Donald C
DC
Backer
Vibeke
V
Rundell
Kenneth W
KW
Alonso
Juan M
JM
Kippelen
Pascale
P
Cummiskey
Joseph M
JM
Garnier
Alain
A
Ljungqvist
Arne
A
D000318:Adrenergic beta-Agonists / Q000009:adverse effects* / Q000627:therapeutic use*; D001250:Asthma, Exercise-Induced / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D001985:Bronchial Provocation Tests; D016084:Bronchoconstriction / Q000502:physiology; D006801:Humans; D013177:Sports
D000318:Adrenergic beta-Agonists