Self‐reported obstructive airway symptoms are common in young cross‐country skiers

Larsson, Lars; Hemminqsson, P.; Boëthius, Göran

doi:10.1111/j.1600-0838.1994.tb00414.x

Cited by 38 publications

(27 citation statements)

References 12 publications

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“…Our results contrast with other studies reporting a high prevalence of asthma among athletes in the United Kingdom, United States and Scandinavian countries (Dickinson et al, 2005;Larsson et al, 1993;Larsson et al, 1994;Leuppi et al, 1998;Weiler et al, 1998). The different results are probably due to the fact that these studies were conducted on elite athletes, such as those taking part in the Olympic Games (Dickinson et al, 2005;Maiolo et al, 2004;Weiler et al, 1998;Weiler & Ryan, 2000).…”

Section: Discussioncontrasting

confidence: 85%

“…In apparent contrast with our findings, studies published in the last few years have demonstrated a high prevalence of self-reported asthma in elite athletes exercising in a cold environment (Larsson et al, 1993;Larsson et al, 1994;Leuppi et al, 1998). We hypothesise that strenuous training with inhalation of a high volume of air in competitive athletes may increase the asthma risk, differently from lower intensity exercise in amateurs.…”

Section: Discussioncontrasting

confidence: 85%

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Self‐reported asthma and respiratory symptoms among Italian amateur athletes

Tardivo

Zerman

et al. 2011

European Journal of Sport Science

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The prevalence and the factors influencing respiratory symptoms and asthma in recreational athletes are still poorly defined. The aim of the study is to estimate the prevalence of self-reported asthma and respiratory symptoms in a sample of Italian amateur athletes compared with the general population. We also intend to estimate the association between asthma, the type of exercise and the environment where it was practised. The study population included athletes (A) practising sports in the city of Bozen (northern Italy) (n 0 1022). A random sample from the general population (GP) (n 0 2166) was used as the control group. All participants filled in a questionnaire including items regarding asthma, respiratory symptoms and type of sporting activities. Associations between exposure variables and outcomes, adjusted for potential confounding factors, were estimated using logistic regression. Our findings revealed that the prevalence of asthma (''Have you ever had asthma?'') was lower among A (4.0%) than in the GP (11.0%, P B 0.001). Similar figures were recorded for current asthma (asthma in the past plus an asthma attack or wheezing in the last 12 months and/or current use of medication for asthma) (A 3.0%, GP 4.8%, P 0 0.044) and for respiratory symptoms (A 3.9%, GP 18.9%, P B 0.001). Comparisons within the sample of athletes, taking indoor sports as a reference category, revealed that performing outdoor sports in spring and summer was associated with a higher risk of asthma, the same however was not true for outdoor sports performed in winter (adjusted OR 0 2.8, 95% CI 0 1.1Á7.5). Where OR 0 Odds Ratio and CI 0 Confidence Interval. The risk of developing symptoms after exercise was higher for outdoor sports practised in the mild or cold seasons (adjusted OR 0 4.6, 95% CI 0 1.0Á21.3 and adjusted OR 0 11.9, 95% CI 0 2.5Á56.1, respectively). Training for more than five hours a week was associated with a lower prevalence of asthma than training for less (adjusted OR 0 0.45, 95% CI 0 0.2Á0.9). Finally, no relationship emerged between type of exercise, asthma and respiratory symptoms. The results of this study indicate that asthma is less common in amateur athletes than in the general population and that the risk of asthma and respiratory symptoms is associated more with outdoor than with indoor sports, but not with any particular type of exercise.

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Section: Discussioncontrasting

confidence: 85%

Section: Discussioncontrasting

confidence: 85%

Self‐reported asthma and respiratory symptoms among Italian amateur athletes

Tardivo

Zerman

et al. 2011

European Journal of Sport Science

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“…39 Finally, a possibly related phenomenon is the induction of an asthmalike syndrome in high-performance skiers, which has been confirmed by various groups in Scandinavia and has been associated with airways inflammation and the duration of exposure to subfreezing, windy conditions. [40][41][42] It would be interesting to know whether the individuals who developed this syndrome had a history of nasal sensitivity to CDA. In dogs, repetitive exposure of peripheral airways to CDA generates eosinophil, mast cell, and neutrophil influx and leads to thickening of the lamina propria, but it is not known whether these changes are associated with the magnitude of epithelial shedding induced by CDA.…”

Section: Discussionmentioning

confidence: 98%

Epithelial shedding is associated with nasal reactions to cold, dry air

Cruz

Naclerio

Proud

et al. 2006

Journal of Allergy and Clinical Immunology

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“…Cross-sectional studies subsequent to this observation6–8 reported a higher prevalence of cough, wheeze, breathlessness and chest tightness on exercise in cross-country skiers than in non-athletic controls (figure 1). Importantly, the onset of symptoms is primarily in late adolescence and early adulthood8 and the prevalence of respiratory symptoms is higher in the adult than in the adolescent skier,6 7 In one study by Larsson, et al 6 50% of adult skiers had respiratory symptoms and airway hyper-responsiveness to methacholine and/or physician-diagnosed asthma. As airway hyper-responsiveness is also present in the winter and summer months, they suggested that strenuous training at low temperatures with the repeated inhalation of large amounts of cold air may be pathogenic factors for the development of asthma in athletes.…”

Section: Long-term Effectsmentioning

confidence: 90%

Winter sports athletes: long-term effects of cold air exposure

Sue‐Chu

2012

Br J Sports Med

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Athletes such as skaters and skiers inhale large volumes of cold air during exercise and shift from nasal to mouth breathing. Endurance athletes, like cross-country skiers, perform at 80% or more of their maximal oxygen consumption and have minute ventilations in excess of 100 l/min. Cold air is always dry, and endurance exercise results in loss of water and heat from the lower respiratory tract. In addition, athletes can be exposed to indoor and outdoor pollutants during the competitive season and during all-year training. Hyperpnoea with cold dry air represents a significant environmental stress to the airways. Winter athletes have a high prevalence of respiratory symptoms and airway hyper-responsiveness to methacholine and hyperpnoea. The acute effects of exercise in cold air are neutrophil influx as demonstrated in lavage fluid and airway epithelial damage as demonstrated by bronchoscopy. Upregulation of pro-inflammatory cytokines has been observed in horses. Chronic endurance training damages the epithelium of the small airways in mice. Airway inflammation has been observed on bronchoscopy of cross-country skiers and in dogs after a 1100-mile endurance race in Alaska. Neutrophilic and lymphocytic inflammation with remodelling is present in bronchial biopsies from skiers. Repeated peripheral airway hyperpnoea with dry air causes inflammation and remodelling in dogs. As it is currently unknown if these airway changes are reversible upon cessation of exposure, preventive measures to diminish exposure of the lower airways to cold air should be instituted by all winter sports athletes.

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Self‐reported obstructive airway symptoms are common in young cross‐country skiers

Cited by 38 publications

References 12 publications

Self‐reported asthma and respiratory symptoms among Italian amateur athletes

Self‐reported asthma and respiratory symptoms among Italian amateur athletes

Epithelial shedding is associated with nasal reactions to cold, dry air

Winter sports athletes: long-term effects of cold air exposure

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