Allergy and asthma in elite summer sport athletes

Exercise may increase ventilation up to 200 L/min for short periods of time in speed and power athletes, and for longer periods in endurance athletes, such as long-distance runners and swimmers. Therefore highly trained athle tes are repeatedly and strongly exposed to cold air during winter training and to many pollen allergens in spring and summer. Competitive swimmers inh ale and microaspirate large amounts of air that floats above the water surf ace, which means exposure to chlorine derivatives from swimming pool disinf ectants. In the summer Olympic Games, 4% to 15% of the athletes showed evid ence of asthma or used anti-asthmatic medication. Asthma is most commonly f ound in endurance events, such as cycling, swimming, or long-distance runni ng. The risk of asthma is especially increased among competitive swimmers, of which 36% to 79% show bronchial hyperresponsiveness to methacholine or h istamine. The risk of asthma is closely associated with atopy and its sever ity among athletes. A few studies have investigated occurrence of exercise- induced bronchospasm among highly trained athletes, The occurrences of exer cise-induced bronchospasm vary from 3% to 35% and depend on testing environ ment, type of exercise used, and athlete population tested. Mild eosinophil ic airway inflammation has been shown to affect elite swimmers and cross-co untry skiers. This eosinophilic inflammation correlates with clinical param eters (ie, exercise-induced bronchial symptoms and bronchial hyperresponsiv eness). Athletes commonly use antiasthmatic medication to treat their exerc ise-induced bronchial symptoms. However, controlled studies on their long-t erm effects on bronchial hyperresponsiveness and airway inflammation in the athletes are lacking. Follow-up studies on asthma in athletes are also lac king. What will happen to bronchial hyperresponsiveness and airway inflamma tion after discontinuation of competitional career is unclear. In the futur e, follow-up studies on bronchial responsiveness and airway inflammation, a s well as controlled studies on both short- and long-term effects of antias thmatic drugs in the athletes are needed.