Allergic rhinitis in endurance athletes

Allergic rhinitis in endurance athletes

Endurance athletes are significantly more likely to suffer from allergic rhinitis (AR) – inflammation of the nasal mucous membranes – than other athletes or non-athlete controls, according to a large-scale study from Finland.

However, only half of the athletes reporting allergic rhinitis had used antiallergic medication during the previous year, despite the fact that untreated AR has the potential to severely weaken athletes’ maximal exercise performance.

The aim of the study was to assess the frequency of allergic rhinitis and the use of antiallergic medication within subgroups of elite athletes as compared with a representative sample of young adults of the same age. A structured questionnaire on asthma and allergies was completed by 446 athletes financially supported by the National Olympic Committee and 1,504 Finnish young adults, a representative sample serving as controls.

The main findings were as follows:

  • Endurance athletes reported physician-diagnosed allergic rhinitis more often than other athletes or control subjects – with prevalence rates of 36.1%, 23.4% and 20.2% respectively;
  • A total of 55.1% of athletes and 53.5% of controls with diagnosed rhinitis reported using antiallergic medication;
  • Female athletes with diagnosed AR used antiallergic medication more often than their male athletes (65.3% compared with 47.8%).

Allergic rhinitis is particularly likely to occur in conditions when ventilation increases to the level when combined mouth and nasal breathing is necessary, resulting in a greater deposition of airborne allergens and other inhaled particles into the lower airways.

Chronic AR is associated with many complications, observe the researchers, including snoring, sleep disturbance, headaches and fatigue, all of which are likely to impair quality of life.

‘When AR affects elite athletes, however, these quality-of-life issues make it particularly troublesome, and it may cause significant impairment in their athletic performance.’

For this reason, the apparent undertreatment of symptoms shown by the study is a matter for concern. Available treatments for AR include intranasal corticosteroids, short-term decongestants, oral or topical antihistamines. Previous research suggests that intranasal corticosteroids are significantly more effective at relieving symptoms and maintaining quality of life and performance than other medications. So it was of particular concern to the researchers that only 6% of the athletes in their study and 3.6% of controls reported that they had used these drugs of choice.

‘More attention thus needs to be paid,’ they conclude, ‘to the optimal management of AR in highly trained athletes.’

Med Sci Sports Exerc 2005; 37, 5:707-711

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