SCREENING ADOLESCENT ATHLETES FOR EXERCISE-INDUCED ASTHMA

Objective: To pilot test an exercise-induced asthma (EIA) screening pr ogram using a submaximal step-test and pulmonary function test (PFT) t o identify athletes with EIA and to determine if a physical examinatio n or self-reported history could be used to predict the existence of E IA. Design: Screening and diagnostic testing using a convenience sampl e. Setting: Birmingham, Alabama, during athletic preparticipation exam ination (PPE). Subjects: Fifty-two African-American, male football pla yers aged 14-18 years being evaluated for participation in scholastic athletics. No athlete refused participation. Four were excluded becaus e of need for further evaluation unrelated to any pulmonary condition. Intervention: Each athlete completed a medical history, allergy histo ry, physical examination, preexercise pulmonary function test (PFT), s ubmaximal step-test, and a series of postexercise PFTs. Main Outcome M easures: Major outcome measurements were changes in forced expiration volume in 1s (FEV1) or peak expiratory flow rate (PEFR) after completi ng an exercise challenge. Results: Seventeen of 48 athletes had a grea ter than or equal to 15% decrease in PEFR after exercise. Nine of 48 a thletes had a greater than or equal to 15% decrease in FEV1 after exer cise. The only self-reported item that differentiated subjects with no rmal and abnormal PFTs was a personal history of asthma (p < 0.05). Co nclusion: Many athletes can be identified as having abnormal PFTs by u se of a submaximal step-test as an exercise challenge. Self-reporting questionnaires and PPEs do not appear to be sensitive enough to identi fy athletes with this condition. If validated by future studies, this protocol could be used for the diagnosis of EIA.