Airway responsiveness and inflammation in adolescent elite swimmers

Swimming pool, respiratory health, and childhood asthma: Should we change our beliefs?

“…In their study, the swimmers most exposed to chloramines revealed significantly more upper and lower respiratory symptoms. The authors also found a link between the occurrence of irritative symptoms and chloramine concentrations (particularly in the ambient air), with a significant increase in respiratory complaints when air levels were 0.37 mg/m 36 conducted a study to compare respiratory health, allergic status, and pulmonary epithelium integrity in school-age children who took part in infant swimming programs and those who did not. They reported a significant decrease in serum CC16 and an even more significant decrease in the CC16/SP-D ratio (an integrated index of Clara cell damage and permeability changes) in the children of infant swimming group.…”

“…34 In fact, both in training and in competitions, their ventilation increases considerably (up to 200 L/min in adults), leading to aspiration of water droplets and inhalation of large amounts of air floating just above the water surface and therefore rich in chlorine by-products, which may be responsible for lung damage and respiratory symptoms. 35 Noteworthy, a recent study demonstrates that adolescent elite swimmers at the beginning of their careers do not show major differences from adolescents not involved in competitive swimming in terms of prevalence of respiratory symptoms, airway responsiveness, or airway inflammation 36 , suggesting that elite swimmers do not have particularly susceptible airways when they take up competitive swimming. The follow-up of this group of young athletes might be important to prove that the development of respiratory symptoms, airway inflammation, and airway hyperresponsiveness is related to prolonged exposure to chlorine by-products during their swimming careers.…”

Exercise-Induced Bronchospasm in Soccer Athletes Living in a Tropical Humid Region

“…The prevalence of respiratory symptom among elite athletes is high [22] and exercises of long duration with high loads, requiring high ventilation levels, are those that most often cause EIB [23][24][25]. It is believed that the mechanism responsible for EIB is airway periciliary fluid dehydration due to hyperventilation that leads to mediators release by airway epithelial and mast cells [26].…”

“…Some sports organizations have established EIB screening programs for all of their internationally competitive athletes but this is far from being a consensus [35]. On the other hand, it is clear that individuals with exercise associated respiratory complaints and/or a clinical diagnosis of asthma that are engaged in competitive sportive activities should be evaluated for EIB [3,8,9,12,15,20,24,35].…”

Is there a need to improve asthma diagnosis in young athletes?

“…As such, serial measurements of forced expiratory volume in 1 s (FEV 1 ) -an index of airway caliber -are recommended for objective assessment of EIB [6]. The use of respiratory symptoms alone is strongly discouraged for diagnostic purpose, in that symptoms are neither sufficient, nor essential to confirm the presence of asthma/EIB in young athletes [3,[7][8][9]. Further, resting spirometry measurements are poor predictors of variable airflow obstruction in athletes [10].…”