Bronchoconstriction: Airway problems in ski-mountaineers

Bronchoconstriction: Airway problems in ski-mountaineers...

The first-ever study of airway constriction in ski-mountaineers has found that about half of them develop exercise-induced bronchoconstriction (EIB). More worryingly, nearly three quarters of them are unaware that they have a problem.

These are the key conclusions of a French study set up to research the prevalence of EIB in this population of athletes, following reports of a high prevalence of EIB in cross-country skiers and ice skaters who also exercise in cold dry air, which has been shown in animals to induce small airways inflammation, obstruction and hyper-reactivity.

The study included 31 highly trained ski-mountaineers working at national or international level. Lung function measurements were obtained the day before and within 30 minutes of finishing the ‘Trace Catalane’ race, held on January 2002 in Les Angles, France, 90% of it performed at an altitude above 2,100m and taking a mean time of 159 minutes to complete.

The day before the race, all subjects filled in a questionnaire enquiring, among other things, into their respiratory history, diagnosis of asthma/EIB, use of asthma/EIB medication, known allergy and presence or absence of four common symptoms of asthma – cough, wheeze, chest tightness and breathlessness – during training and/or competition.

After post-race testing, athletes were classified as either EIB positive or normal according to the degree of fall they exhibited in forced expiratory volume (FEV), the key measure of lung function.

The main findings were as follows:

  • Six of the 31 athletes had been previously diagnosed with asthma and/or EIB, and at the time of the study three of these were taking the appropriate medication;
  • Sixteen of the athletes were classified as normal after testing – including two of the six previously diagnosed with asthma/EIB (one of whom was on medication);
  • Of the 15 athletes who tested positive for asthma/EIB, only four had a previous diagnosis – ie 11 (73%) were unaware they had a problem, even though all but one of them reported at least one symptom of asthma.

‘This study showed,’ the researchers point out, ‘that in ski- mountaineering racers regularly exposed to frigid conditions postexercise airway narrowing is very common… More importantly, we showed that 73% of these athletes were undiagnosed for the problem despite a high proportion of self-reported symptoms.’

They recommend the establishment of systematic screening for all athletes considered at risk for EIB and an investigation into the consequences of developing EIB for athletes like ski-mountaineers who are obliged to exercise continuously at altitude.

Int J Sports Med 2005; 26:233-237

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