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.