Skip to main content
Log in

Exercise-induced asthma in the competitive cold weather athlete

  • Published:
Current Sports Medicine Reports

Abstract

Exercise-induced asthma (EIA) is a very common condition that affects winter sport athletes at rates as high as 50%. It has become clear that the main etiologic factors in EIA are the extremely low humidity and high respiratory rates in these athletes, which lead to extreme airway drying. New developments in objective testing for this condition have been recently described and are reviewed here. EIA is easily treated with oral and inhaled medications. These medications are closely regulated by the antidoping agencies; therefore, care must be taken by the treating physician to ensure compliance with the latest restrictions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Buchan W: Domestic Medicine, a Treatise on the Prevention and Cure of Diseases, edn 16 London: The Booksellers; 1799.

    Google Scholar 

  2. Rice SG, Bierman CW, Shapiro GG, et al.: Identification of exercise-induced asthma among intercollegiate athletes. Ann Allergy 1985, 55:790–793.

    CAS  PubMed  Google Scholar 

  3. Pierson WE, Voy RO: Exercise-induced bronchospasm in the XXIII summer Olympic games. N Engl Reg Allergy Proc 1988, 9:209–213.

    Article  CAS  PubMed  Google Scholar 

  4. Sue-Chu M, Larsson L, Bjermer L: Prevalence of asthma in young cross-country skiers in central Scandinavia: differences between Norway and Sweden. Respir Med 1996, 90:99–105.

    Article  CAS  PubMed  Google Scholar 

  5. Larsson K, Ohlsen P, Larsson L, et al.: High prevalence of asthma in cross country skiers. BMJ 1993, 307:1326–1329.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Rundell KW, Wilber RL, Szmedra L, et al.: Exercise induced asthma screening of elite athletes: field versus laboratory exercise challenge. Med Sci Sports Exerc 2000, 32:309–316.

    Article  CAS  PubMed  Google Scholar 

  7. Pohjantahti H, Laitinen J, Parkkari J: Exercise-induced bronchospasm among healthy elite cross country skiers and non-athletic students. Scand J Med Sci Sports 2005, 15:324–328.

    Article  CAS  PubMed  Google Scholar 

  8. Durand F, Kippelen P, Ceugniet F, et al.: Undiagnosed exercise-induced bronchoconstriction in ski-mountaineers. Int J Sports Med 2005, 26:233–237.

    Article  CAS  PubMed  Google Scholar 

  9. Evans TM, Rundell KW, Beck KC, et al.: Cold air inhalation does not affect the severity of EIB after exercise or eucapnic voluntary hyperventilation. Med Sci Sports Exerc 2005, 37:544–549. This study compared subjects with EIA using dry bottled air at room temperature and at cold temperature. They showed no change in FEV1 decrement between the challenges.

    Article  PubMed  Google Scholar 

  10. Finnerty JP, Holgate ST: Evidence for the roles of histamine and prostaglandins as mediators in exercise-induced asthma: the inhibitory effect of terfenadine and flurbiprofen alone and in combination. Eur Respir J 1990, 3:540–547.

    CAS  PubMed  Google Scholar 

  11. Hallstrand TS, Moody MW, Aitken ML, et al.: Airway immunopathology of asthma with exercise-induced bronchoconstriction. J Allergy Clin Immunol 2005, 116:586–593.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Csoma Z, Huszar E, Vizi E, et al.: Adenosine level in exhaled breath increases during exercise-induced bronchoconstriction. Eur Respir J 2005, 25:873–878.

    Article  CAS  PubMed  Google Scholar 

  13. Rundell KW, Im J, Mayers LB, et al.: Self-reported symptoms and exercise-induced asthma in the elite athlete. Med Sci Sports Exerc 2001, 33:208–213.

    Article  CAS  PubMed  Google Scholar 

  14. Holzer K, Anderson SD, Douglass J: Exercise in elite summer athletes: Challenges for diagnosis. J Allergy Clin Immunol 2002, 110:374–380.

    Article  PubMed  Google Scholar 

  15. Ogston J, Butcher J: A sports specififc protocol for the diagnosis of exercise induced asthma. Clin J Sports Med 2002, 12:291–295.

    Article  Google Scholar 

  16. Garcia de la Rubia S, Pajaron-Fernandez MJ, Sanchez- Solis M, et al.: Exercise-induced asthma in children: a comparative study of free and treadmill running. Ann Allergy Asthma Immunol 1998, 80:232–236.

    Article  CAS  PubMed  Google Scholar 

  17. Randolph S, Fraser B, Matasavage C: The free running athletic screening test as a screening test for exercise induced astham in high school. Allergy Asthma Proc 1997, 18:311–312.

    Article  Google Scholar 

  18. Carlsen KH, Engh G, Mork M: Exercise-induced bronchoconstriction depends on exercise load. Respir Med 2000, 94:750–755.

    Article  CAS  PubMed  Google Scholar 

  19. Anderson SD, Daviskas E: The mechanism of exerciseinduced asthma is .... J Allergy Clin Immunol 2000, 106:453–459.

    Article  CAS  PubMed  Google Scholar 

  20. Rundell KW, Anderson SD, Spiering BA, Judelson DA: Field exercise vs laboratory eucapnic voluntary hyperventilation to identify airway hyperresponsiveness in elite cold weather athletes. Chest 2004, 125:909–915.

    Article  PubMed  Google Scholar 

  21. Dickinson JW, Whyte GP, McConnell AK, Harries MG: Screening elite winter athletes for exercise induced asthma: a comparison of three challenge methods. Br J Sports Med 2006, 40:179–182. This group studied 14 winter sport athletes using three methods: sport-specific exercise challenge, laboratory exercise challenge, and EVHC. This well-designed comparison clearly demonstrated EVHC to be the most sensitive test for EIA in athletes.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Kemp JP, Dockhorn RJ, Shapiro GG, et al.: Montelukast once daily inhibits exercise-induced bronchoconstriction in 6- to 14-year-old children with asthma. J Pediatr 1998, 133:424–428.

    Article  CAS  PubMed  Google Scholar 

  23. Edelman JM, Turpin JA, Bronsky EA, et al.: Oral montelukast compared with inhaled salmeterol to prevent exercise-induced bronchoconstriction. A randomized, double-blind trial. Exercise Study Group. Ann Intern Med 2000, 132:97–104.

    Article  CAS  PubMed  Google Scholar 

  24. Rundell KW, Spiering BA, Baumann JM, Evans TM: Effects of montelukast on airway narrowing from eucapnic voluntary hyperventilation and cold air exercise. Br J Sports Med 2005, 39:232–236. This study utilized a single dose of montelukast, 10 mg, in a randomized double crossover design. They found protection against EIA as measured by multiple testing protocols.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  25. Weiler JM, Nathan RA, Rupp NT, et al.: Effect of fluticasone/ salmeterol administered via a single device on exercise-induced bronchospasm in patients with persistent asthma. Ann Allergy Asthma Immunol 2005, 94:65–72.

    Article  CAS  PubMed  Google Scholar 

  26. Christie P. Roflumilast: a selective phosphodiesterase 4 inhibitor. Drugs Today (Barc) 2005, 41:667–675.

    Article  CAS  Google Scholar 

  27. Mickleborough TD, Lindley MR, Ray S: Dietary salt, airway inflammation, and diffusion capacity in exerciseinduced asthma. Med Sci Sports Exerc 2005, 37:904–914.

    CAS  PubMed  Google Scholar 

  28. Baumann JM, Rundell KW, Evans TM, Levine AM: Effects of cysteine donor supplementation on exerciseinduced bronchoconstriction. Med Sci Sports Exerc 2005, 37:1468–1473.

    Article  CAS  PubMed  Google Scholar 

  29. Goubault C, Perault MC, Leleu E, et al.: Effects of inhaled salbutamol in exercising non-asthmatic athletes. Thorax 2001, 56:675–679.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  30. van Baak MA, Mayer LH, Kempinski RE, Hartgens F: Effect of salbutamol on muscle strength and endurance performance in nonasthmatic men. Med Sci Sports Exerc 2000, 32:1300–1306.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Janus D. Butcher MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Butcher, J.D. Exercise-induced asthma in the competitive cold weather athlete. Curr Sports Med Rep 5, 284–288 (2006). https://doi.org/10.1007/s11932-006-0054-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11932-006-0054-8

Keywords

Navigation