| | Asthma and the elite athlete: Summary of the International Olympic Committee's Consensus Conference, Lausanne, Switzerland, January 22-24, 2008Received 7 March 2008; received in revised form 3 July 2008; accepted 3 July 2008. Respiratory symptoms cannot be relied on to make a diagnosis of asthma and/or airways hyperresponsiveness (AHR) in elite athletes. For this reason, the diagnosis should be confirmed with bronchial provocation tests. Asthma management in elite athletes should follow established treatment guidelines (eg, Global Initiative for Asthma) and should include education, an individually tailored treatment plan, minimization of aggravating environmental factors, and appropriate drug therapy that must meet the requirements of the World Anti-Doping Agency. Asthma control can usually be achieved with inhaled corticosteroids and inhaled β2-agonists to minimize exercise-induced bronchoconstriction and to treat intermittent symptoms. The rapid development of tachyphylaxis to β2-agonists after regular daily use poses a dilemma for athletes. Long-term intense endurance training, particularly in unfavorable environmental conditions, appears to be associated with an increased risk of developing asthma and AHR in elite athletes. Globally, the prevalence of asthma, exercise-induced bronchoconstriction, and AHR in Olympic athletes reflects the known prevalence of asthma symptoms in each country. The policy of requiring Olympic athletes to demonstrate the presence of asthma, exercise-induced bronchoconstriction, or AHR to be approved to inhale β2-agonists will continue. Abbreviations used: AHR, Airway hyperresponsiveness, ASM, Airway smooth muscle, ATUE, Abbreviated Therapeutic Use Exemption, BPT, Bronchial provocation test, EIB, Exercise-induced bronchoconstriction, EVH, Eucapnic voluntary hyperpnea, IAAF, International Association of Athletics Federations, ICS, Inhaled corticosteroid, IOC, International Olympic Committee, ISAAC, International Study on Asthma and Allergies in Childhood, PM, Particulate matter, WADA, World Anti-Doping Agency a School of Sports Science, Exercise and Health, Faculty of Life Sciences, University of Western Australia, Crawley, Australia b Department of Lung Medicine, St Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway c Department of Circulation and Imaging, Norwegian University of Science and Technology, Trondheim, Norway d Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, Australia e Institut de Cardiologie et de Pneumologie de l'Université Laval, Hôpital Laval, Laval, Québec, Canada f Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand g Department of Respiratory Medicine, Waikato Hospital, Hamilton, New Zealand h Division of Sports Medicine and the School of Human Kinetics, University of British Columbia, Vancouver, British Columbia, Canada i Department of Respiratory Medicine L, Bispebjerg University Hospital, Copenhagen, Denmark j Human Physiology Laboratory, Marywood University, Scranton, Pa k Medical Department, Royal Spanish Athletics Federation, Madrid, Spain l Medical and Anti-Doping Commission, International Association of Athletics Federations, Monaco m School of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom n Respiratory Medicine, Blackrock Clinic, Dublin, Ireland o World Anti-Doping Agency, Lausanne, Switzerland p Medical Commission, International Olympic Committee, Lausanne, Switzerland  Reprint requests: Kenneth D. Fitch, MBBS, MD, School of Sports Science, Exercise and Health, Faculty of Life Sciences, University of Western Australia, M408 Crawley, Western Australia.
Consensus Conference supported by the International Olympic Committee. Disclosure of potential conflict of interest: K. D. Fitch is a member of the International Olympic Committee (IOC) Medical Commission and chair of the IOC Independent Asthma Panel. M. Sue-Chu is on the Advisory Board of Novartis and GlaxoSmithKline, has delivered lectures funded by AstraZeneca, has participated in a clinical trial funded by Novartis, and is a member of the IOC Independent Asthma Panel. S. D. Anderson invented the mannitol test for Pharmaxis Ltd and is a member of the IOC Independent Asthma Panel. L.-P. Boulet has received sponsorship or funding from AstraZeneca, GlaxoSmithKline, Merck Frosst, Schering-Plough, Novartis, Alexion, AsthmaTx, Boehringer-Ingelheim, Ception, Genentech, IVAX, MedImmune, Topigen, and Wyeth. D. C. McKenzie has received research funding from the World Anti-Doping Agency and is a member of the IOC Independent Asthma Panel. V. Backer has received research funding from Pharmaxis Ltd and the Danish Lung Association and is a member of the Advisory Board of MSD, Novartis, ALK-Abelló, AstraZeneca, and GlaxoSmithKline. K. W. Rundell has delivered lectures sponsored by Merck and has received research funding from the World Anti-Doping Agency, Pharmaxis, SkyPharma, and Forest Research. P. Kippelen has received research funding from the British Olympic Association and is a member of the IOC Independent Asthma Panel. The rest of the authors have declared that they have no conflict of interest. PII: S0091-6749(08)01305-5 doi:10.1016/j.jaci.2008.07.003 © 2008 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. | |
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