title: Prevalence of allergy and upper respiratory tract symptoms in runners of the London marathon.
abstract: BACKGROUND
  The prevalence of self-reported upper respiratory tract (URT) symptoms in athletes has been traditionally associated with opportunistic infection during the temporal suppression of immune function after prolonged exercise. There is little evidence for this, and a competing noninfectious hypothesis has been proposed, whereby the exercise-induced immune system modulations favor the development of atopy and allergic disease, which manifests as URT symptoms. The aim of this study was to examine the association between allergy and URT symptoms in runners after an endurance running event.
  
  
  METHODS
  Two hundred eight runners from the 2010 London Marathon completed the validated Allergy Questionnaire for Athletes (AQUA) and had serum analyzed for total and specific immunoglobulin E response to common inhalant allergens. Participants who completed the marathon and nonrunning controls who lived in the same household were asked to complete a diary on URT symptoms.
  
  
  RESULTS
  Forty percent of runners had allergy as defined by both a positive AQUA and elevated specific immunoglobulin E. Forty-seven percent of runners experienced URT symptoms after the marathon. A positive AQUA was a significant predictor of postmarathon URT symptoms in runners. Only 19% of nonrunning controls reported symptoms.
  
  
  CONCLUSIONS
  The prevalence of allergy in recreational marathon runners was similar to that in elite athletes and higher than that in the general population. There was a strong association between a positive AQUA and URT symptoms. The low proportion of households in which both runners and nonrunners were symptomatic suggests that the nature of symptoms may be allergic or inflammatory based rather than infectious. Allergy is a treatable condition, and its potential effect on performance and health may be avoided by accurate clinical diagnosis and management. Both athletes' and coaches' awareness of the potential implications of poorly managed allergy needs to be raised.
authors.affiliation: School of Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom. paula.ansley@unn.ac.uk
authors.forename: Paula
authors.initials: P
authors.lastname: Robson-Ansley
authors.forename: Glyn
authors.initials: G
authors.lastname: Howatson
authors.forename: Jamie
authors.initials: J
authors.lastname: Tallent
authors.forename: Kelly
authors.initials: K
authors.lastname: Mitcheson
authors.forename: Ian
authors.initials: I
authors.lastname: Walshe
authors.forename: Chris
authors.initials: C
authors.lastname: Toms
authors.forename: George
authors.initials: G
authors.lastname: DU Toit
authors.forename: Matt
authors.initials: M
authors.lastname: Smith
authors.forename: Les
authors.initials: L
authors.lastname: Ansley
mesh_terms: D000328:Adult; D001250:Asthma, Exercise-Induced / Q000453:epidemiology / Q000276:immunology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood; D016013:Likelihood Functions; D008131:London / Q000453:epidemiology; D008297:Male; D010807:Physical Endurance; D011237:Predictive Value of Tests; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000276:immunology; D012420:Running; D012680:Sensitivity and Specificity; D012882:Skin Tests; D011795:Surveys and Questionnaires
chemical_list: D007073:Immunoglobulin E