Airway dysfunction in elite athletes - an occupational lung disease?

Abstract

Airway dysfunction is prevalent in elite endurance athletes and when left untreated may impact upon both health and performance. There is now concern that the intensity of hyperpnoea necessitated by exercise at an elite level may be detrimental for an athlete's respiratory health. This article addresses the evidence of causality in this context with the aim of specifically addressing whether airway dysfunction in elite athletes should be classified as an occupational lung disease. The approach used highlights a number of concerns and facilitates recommendations to ensure airway health is maintained and optimized in this population. We conclude that elite athletes should receive the same considerations for their airway health as others with potential and relevant occupational exposures.

Exercise-induced bronchoconstriction in athletes – A qualitative assessment of symptom perception

“…The most common cause for abnormal or excessive exertional respiratory symptoms in young athletic individuals is exercise-induced bronchoconstriction (EIB); a condition characterised by transient airway narrowing that occurs in association with physical activity (3). The diagnosis of EIB in athletes, is often suspected by clinicians following an assessment of symptoms alone; with treatment frequently commenced without objective confirmation (4).…”

Diagnosing Exercise-Induced Bronchoconstriction With Eucapnic Voluntary Hyperpnea: Is One Test Enough?

“…It is prevalent in both elite and recreational athletes (1) and may impact upon both their respiratory health and athletic performance (2)(3)(4). It is now well established that the diagnosis of EIB in athletes should not be based on clinical assessment alone (5-7) since a poor correlation exists between exercise-related symptoms and objective evidence of airway narrowing (8).…”

The Impact of Exercise-Induced Bronchoconstriction on Athletic Performance: A Systematic Review

“…Others have suggested that airway dysfunction develops in elite athletes throughout the course of their careers by virtue of greater training volume in conjunction with chronic exposure to noxious environmental conditions [4] (i.e. those with EIB may have trained harder and longer to gain a competitive advantage).…”

“…More specifically, up to half of certain cohorts of elite athletes such as swimmers and cross country skiers, appear to develop a post exercise transient narrowing of the airways [4]. This phenomenon, termed exerciseinduced bronchoconstriction (EIB), can occur either in the presence or absence of other characteristic features of asthma [5].…”