Why do so many Olympic athletes have “asthma”?

As the Olympic Games are set to open in Vancouver, an interesting topic is making a comeback: the significant proportion of high-ranking cold-weather sports athletes who suffer from exercise-induced bronchoconstriction (EIB).

The condition, which was previously called exercise-induced asthma or exertional asthma, has been diagnosed in nearly half of all elite cross-country skiers and almost as many speed skaters and hockey players. It is much more common among athletes who practice winter sports. Even among recreational athletes, EIB tends to occur most commonly in those who train hard in the winter.

EIB is a reversible obstructive airway disease. The condition typically develops five minutes after the individual stops exercising, particularly if the effort was intense. Approximately 90 percent of asthmatics also suffer from EIB, but it is possible to have EIB without suffering from another type of asthma.

The main causes of symptoms are the cold and the dryness of the air in winter. The airways are believed to have difficulty warming up and humidifying the large quantity of air inhaled by athletes during intense exercise. This is why bronchial tube tissue dries up like a sponge that has been squeezed of all moisture, which is thought to trigger a local inflammatory response that tightens the airways and causes symptoms.

Researchers believe that a disproportionate number of elite winter sports athletes suffer from EIB because they “injure” their airways by breathing so intensely. An athlete can actually breathe in up to 200 litres of air per minute, compared to five or six litres per minute at rest. The resulting inflammation can become chronic over time, and each subsequent workout triggers an EIB episode more rapidly.

How can we prevent and treat EIB? Medication must be taken to reduce the inflammation and dilate the airways. Warming up for five to fifteen minutes at a lower intensity before a workout is also recommended, as this can often prevent bronchospasms. Lastly, winter sports enthusiasts could help their airways by breathing through the nose rather than the mouth, and by wearing a scarf in front of the nose and mouth, as these measures could help warm up and humidify the air further.

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