Baseline lung function is related to symptoms and precludes EIB in some rink athletes, suggesting that EIB and its development is a heterogeneous and may involve fibrotic as well as inflammatory processes. Small airway dysfunction in ice arena athletes is likely related to internal combustion pollutants emitted from ice resurfacing machines.

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Background: Exercise induced bronchoconstriction (EIB) is common in elite athletes. Eucapnic voluntary hyperventilation (EVH) is a laboratory test recommended for the identification of EIB in athletes, secondary to a field exercise challenge. Montelukast attenuates EIB, but its protective effect against airway narrowing from EVH has not been investigated. Objective: To examine the effectiveness of montelukast after exercise and after EVH. Methods: A randomised, placebo controlled, double blind, crossover study was performed with 11 physically active EIB positive subjects (eight men, three women; mean (SD) age 22.8 (6.8) years). Six hours before each of the following challenges 10 mg montelukast or placebo was ingested: (a) a six minute, cold air (23˚C) maximal effort work accumulation cycle ergometer exercise; (b) EVH, breathing 5% CO 2 compressed air at 85% maximal voluntary ventilation for six minutes. Spirometry was performed before and 5, 10, and 15 minutes after the challenge. At least 48 hours was observed between challenges. Results: No differences in forced expiratory volume in one second (FEV 1 ) were found after the two challenges. Exercise and EVH resulted in falls in FEV 1 of 22.4 (18.0) and 25.6 (16.8) respectively. Falls in FEV 1 after montelukast were less than after placebo (10.6 (10.6) and 14.3 (11.3) after exercise and EVH respectively; p,0.05). Montelukast provided protection against bronchoconstriction (59% and 53%; p,0.05) for eight exercising subjects and 10 EVH subjects; no protection was afforded for three exercising and one EVH challenged subject. Conclusions: Both exercise and EVH were potent stimuli of airway narrowing. A single dose of montelukast provided reasonable protection in attenuating bronchoconstriction from either exercise or EVH. The similar protection by montelukast suggests that EVH is a suitable laboratory surrogate for EIB evaluation.

Similar postchallenge percent falls in FEV1 for room- and cold-temperature EVH and exercise suggest that dryness is essential to test conditions, as cold temperature did not have an additive effect to the EIB response.

Airway responses were compared following 6-minute eucapnic voluntary hyperventilation and 6-minute exercise challenges by examining resting and post-challenge impulse oscillometry and spirometry variables. Twenty-two physically active individuals with probable exercise-induced bronchoconstriction took part in this study. Impulse oscillometry and spirometry were performed at baseline and for 20 minutes post-challenge at 5-minute intervals. High correlation was found between the two measures of change in airway function for both methods of challenge. Impulse oscillometry detected a difference in degree of response to the challenges, whereas spirometry indicated no difference, suggesting that impulse oscillometry is a more sensitive measure of change in airway function.