European Respiratory Society Monograph, Vol. 33. 2005
Asthma and allergy represent increasing problems for the actively competing athlete. The prevalence of exercise-induced asthma (EIA) has increased over the last two decades, especially amongst elite endurance athletes; it has been reported that high-level endurance training in particular may increase bronchial hyperresponsiveness (BHR) and cause inflammation in the airways. Intensive endurance training and competition, together with environmental influences, are thought to be causative factors. For winter sports, inhaled cold air represents such an environmental factor; moreover, exposure of competing swimmers to organic chlorine products released from indoor swimming pools is another example of a harsh environment. Furthermore, the increased amount of training and increased level of physical fitness and maximum oxygen uptake reached by present-day elite athletes may, in some cases, make it difficult to discriminate between limitations to maximum exercise set by normal airways and EIA. This underlines the need for developing good diagnostic criteria for EIA and BHR in relation to sports.