title: Respiratory health of elite athletes - preventing airway injury: a critical review.
abstract: Elite athletes, particularly those engaged in endurance sports and those exposed chronically to airborne pollutants/irritants or allergens, are at increased risk for upper and lower airway dysfunction. Airway epithelial injury may be caused by dehydration and physical stress applied to the airways during severe exercise hyperpnoea and/or by inhalation of noxious agents. This is thought to initiate an inflammatory cascade/repair process that, ultimately, could lead to airway hyperresponsiveness (AHR) and asthma in susceptible athletes. The authors review the evidence relating to prevention or reduction of the risk of AHR/asthma development. Appropriate measures should be implemented when athletes exercise strenuously in an attempt to attenuate the dehydration stress and reduce the exposure to noxious airborne agents. Environmental interventions are the most important. Non-pharmacological strategies can assist, but currently, pharmacological measures have not been demonstrated to be effective. Whether early prevention of airway injury in elite athletes can prevent or reduce progression to AHR/asthma remains to be established.
authors.affiliation: Brunel University, Centre for Sports Medicine & Human Performance, Uxbridge UB8 3PH, UK. pascale.kippelen@brunel.ac.uk
authors.forename: Pascale
authors.initials: P
authors.lastname: Kippelen
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Fitch
authors.forename: Sandra Doreen
authors.initials: SD
authors.lastname: Anderson
authors.forename: Valerie
authors.initials: V
authors.lastname: Bougault
authors.forename: Louis-Philippe
authors.initials: LP
authors.lastname: Boulet
authors.forename: Kenneth William
authors.initials: KW
authors.lastname: Rundell
authors.forename: Malcolm
authors.initials: M
authors.lastname: Sue-Chu
authors.forename: Donald C
authors.initials: DC
authors.lastname: McKenzie
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D001250:Asthma, Exercise-Induced / Q000503:physiopathology / Q000517:prevention & control; D016535:Bronchial Hyperreactivity / Q000517:prevention & control; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002713:Chlorine / Q000009:adverse effects; D003080:Cold Temperature / Q000009:adverse effects; D003371:Cough / Q000517:prevention & control; D004781:Environmental Exposure / Q000009:adverse effects; D005081:Exercise Therapy / Q000379:methods; D006801:Humans; D007818:Laryngeal Diseases / Q000517:prevention & control; D011654:Pulmonary Edema / Q000517:prevention & control; D012140:Respiratory Tract Diseases / Q000517:prevention & control*; D012141:Respiratory Tract Infections / Q000517:prevention & control; D012220:Rhinitis / Q000517:prevention & control; D013177:Sports
chemical_list: D000393:Air Pollutants; D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D000975:Antioxidants; D001993:Bronchodilator Agents; D002713:Chlorine