title: Asthma medication is increasingly prescribed for finnish olympic athletes--for a reason?
abstract: BACKGROUND
  Use of asthma medication is common among athletes. In 2009, the World Anti-Doping Committee (WADA) and the International Olympic Committee removed the need to document asthma by lung function tests before the use of inhaled β2-agonists.
  
  
  METHODS
  We assessed the changes in asthma medication use in Finnish Olympic athletes 8 years apart in 2002 (N = 446) and 2009 (N = 372). The athletes filled out a questionnaire on asthma symptoms, diagnosis, and medication.
  
  
  RESULTS
  The use of asthma medication increased from 9.4% in 2002 to 12.6% in 2009 (adjusted odds ratio (OR) = 1.71, 95% confidence interval (CI) 1.08-2.69). Fixed combinations of inhaled long-acting β2-agonists (LABAs) and inhaled corticosteroids (ICSs) were used three times more in 2009 vs. 2002 (OR = 3.38, 95% CI 1.26-9.12). At the same time, no significant changes were observed in the occurrences of physician-diagnosed asthma (13.9% vs. 15.9%) or wheezing (10.3% vs. 10.2%). In 2002, all athletes on asthma medication also had a physician-diagnosed disease, but in 2009, 11.8% of the athletes on medication were lacking it.
  
  
  CONCLUSIONS
  Especially, the use of combination therapy of LABAs and ICSs is increasing among Finnish Olympic athletes. This trend is worrying as it is not based on increasing occurrence of symptoms, asthma diagnoses, or objective lung function measurements. More data, also from other countries, are needed to change recommendations or WADA rules.
authors.affiliation: Paavo Nurmi Centre Sports & Exercise Medical Unit, Department of Physiology, University of Turku, Turku, Finland. annheik@utu.fi
authors.forename: Anni
authors.initials: A
authors.lastname: Aavikko
authors.forename: Ilkka
authors.initials: I
authors.lastname: Helenius
authors.forename: Antti
authors.initials: A
authors.lastname: Alaranta
authors.forename: Tommi
authors.initials: T
authors.lastname: Vasankari
authors.forename: Tari
authors.initials: T
authors.lastname: Haahtela
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology*; D056352:Athletes; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D015995:Prevalence; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D018927:Anti-Asthmatic Agents