The Prevalence of Asthma and Respiratory Symptoms among Cross-Country Skiers in Early Adolescence

Abstract

Objective. To determine the prevalence of asthma and respiratory symptoms among Swedish cross-country skiers in early adolescence in comparison to a population-based reference group of similar ages. Methods. A postal questionnaire on asthma, asthma medication, allergy, respiratory symptoms, and physical activity was distributed to Swedish competitive cross-country skiers aged 12–15 years (n = 331) and a population-based reference group (n = 1000). The level of asthma control was measured by the Asthma Control Test. Results. The response rate was 27% (n = 87) among skiers and 29% (n = 292) in the reference group. The prevalence of self-reported asthma (physician-diagnosed asthma and use of asthma medication in the last 12 months) and the prevalence of reported wheezing during the last 12 months were 23% and 25%, respectively, among skiers, which were significantly higher than the values reported in the reference group (12% and 14%). Skiers exercised more hours/week than the reference group. Among adolescents with self-reported asthma, neither the usage of asthma medications nor the level of asthma control according to the Asthma Control Test differed between skiers and the reference group. Conclusions. Adolescent competitive cross-country skiers have an increased prevalence of respiratory symptoms and asthma compared to nonskiers.

Are Respiratory Responses to Cold Air Exercise Different in Females Compared to Males? Implications for Exercise in Cold Air Environments

“…This, potentially, would have increased the prevalence of respiratory symptoms, because cold dry air and mountainous environments have recently been cited as the most potent for the development of symptoms following exercise in athletes [53]. Relative to young athletic individuals in Sweden [23], our results show higher prevalence, but compared to athletes in Quebec, Canada, we observed the same prevalence of symptoms after exercise [50]. We also found the same pattern of respiratory symptoms as other research following a cold air race [18,51] or intense exercise [13], where cough was the most prevalent symptom compared to other symptoms (wheeze, chest tightness/trouble breathing and excessive mucus).…”

“…Some limited descriptive studies have shown that adult female athletes have significantly greater self-reported respiratory symptoms in a variety of HV sports compared to male athletes [21,22]; however, sex-based respiratory symptom differences have not been researched extensively. Recent evidence also indicates that prepubescent, male Nordic athletes (less than 13 years of age) have a greater self-reported wheeze than females, but this finding was related to greater training hours in males compared to females [23]. A recent field-based study did find a more severe EIB response in females than males at −15 • C [15]; however, the majority of known sex-based differences in respiratory function are based on warm weather or normal laboratory conditions [24,25].…”

Higher prevalence but later age at onset of asthma in cross‐country skiers compared with general population

“…The usual age at onset of asthma in cross-country skiers is reported in early adolescence between 10 and 20 years of age, while the typical age at onset of asthma in the non-skier population of the same age is in early childhood. [3][4][5] However, it is not known whether asthma onset in early childhood prevents competitive cross-country skiing in the first place and what the relation is between age at onset of asthma and age at starting skiing career.…”

“…Asthma control in skiers has been recently studied in two Swedish studies. 5,6 The first study included elite crosscountry skiers and orienteers and found that 82% of the athletes had well-controlled asthma, 6 but the results were not divided based on the sport. Among adolescent crosscountry skiers aged 12-15 years (n = 20), the median Asthma Control Test (ACT) score was 21, suggesting wellcontrolled asthma.…”

Differences in nitric oxide airway diffusion after maximum oxygen uptake test in asthmatic and nonasthmatic elite junior cross-country skiers

“…In a Swedish study among skiers that used a postal questionnaire, 29% in the age group 15–19 years self-reported physician-diagnosed asthma [ 2 ]. In another Swedish postal questionnaire study among adolescent skiers that also included control subjects, the prevalence of physician-diagnosed asthma was 23% among skiers and 12% in the control group [ 3 ]. Beta 2 -agonists and inhaled corticosteroids (ICS), which are asthma medications, are often used among skiers for the treatment of respiratory symptoms.…”