Respiratory health of elite athletes – preventing airway injury: a critical review

Elite athletes, particularly those engaged in endurance sports and those exposed chronically to airborne pollutants/irritants or allergens, are at increased risk for upper and lower airway dysfunction. Airway epithelial injury may be caused by dehydration and physical stress applied to the airways d...

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Bibliographic Details
Published in:British journal of sports medicine 2012-06, Vol.46 (7), p.471-476
Main Authors: Kippelen, Pascale, Fitch, Kenneth D, Anderson, Sandra Doreen, Bougault, Valerie, Boulet, Louis-Philippe, Rundell, Kenneth William, Sue-Chu, Malcolm, McKenzie, Donald C
Format: Article
Language:English
Subjects:
Air Pollutants - adverse effects
Airway management
Allergies
Anti-Asthmatic Agents - therapeutic use
Anti-Inflammatory Agents - therapeutic use
Antioxidants
Antioxidants - therapeutic use
Asthma
Asthma, Exercise-Induced - physiopathology
Asthma, Exercise-Induced - prevention & control
Athletes
Bronchial Hyperreactivity - prevention & control
Bronchodilator Agents - therapeutic use
Chlorine - adverse effects
Cold Temperature - adverse effects
Cough - prevention & control
Cross country skiing
Ecology, environment
Environmental Exposure - adverse effects
Exercise
Exercise Therapy - methods
Health
Highlight Papers
Human health and pathology
Humans
Ice
Laryngeal Diseases - prevention & control
Life Sciences
Nitric oxide
Oxidative stress
Pharmacology
Pollutants
Pulmonary Edema - prevention & control
Respiratory Tract Diseases - prevention & control
Respiratory Tract Infections - prevention & control
Rhinitis - prevention & control
Skating
Sports
Swimming
Tissues and Organs
Ventilation
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Summary:Elite athletes, particularly those engaged in endurance sports and those exposed chronically to airborne pollutants/irritants or allergens, are at increased risk for upper and lower airway dysfunction. Airway epithelial injury may be caused by dehydration and physical stress applied to the airways during severe exercise hyperpnoea and/or by inhalation of noxious agents. This is thought to initiate an inflammatory cascade/repair process that, ultimately, could lead to airway hyperresponsiveness (AHR) and asthma in susceptible athletes. The authors review the evidence relating to prevention or reduction of the risk of AHR/asthma development. Appropriate measures should be implemented when athletes exercise strenuously in an attempt to attenuate the dehydration stress and reduce the exposure to noxious airborne agents. Environmental interventions are the most important. Non-pharmacological strategies can assist, but currently, pharmacological measures have not been demonstrated to be effective. Whether early prevention of airway injury in elite athletes can prevent or reduce progression to AHR/asthma remains to be established.
ISSN:0306-3674
1473-0480
DOI:10.1136/bjsports-2012-091056