Every breath you take every move you make. Studies on Asthma and Sports in Adolescent Athletes

Abstract: Asthma and allergies are common diseases in adolescents and have increased during the last few decades. All elite level sports activities result in increased risk of asthma and rhinitis regardless of sport practised. Physical activity is at the same time regarded as a health-promoting factor and is recommended both for the prevention and treatment of diseases. The aim of this study was to explore the prevalence of asthma and allergy among aspiring elite athletes, swimmers and tennis players, and to compare them with a reference group. A second aim was to characterize the asthmatic presentation in both sports trying to identify factors that can help us to diagnos better. We also aimed to explore gender-related differences and factors related to life quality and physical activity in the different Groups. Methods: All groups answered a questionnaire to explore the frequency of respiratory symptom, health behaviour and life quality. To assess allergic sensitization, and airway hyper-reactivity skin-prick test, fractionated exhaled nitric oxide, mannitol provocation and exercise challenge tests were used. Clara Cell protein (CC16), 11β-prostaglandin (11-βPGF2α) and leukotriene E4 (LTE4) were measured in urine as biomarkers reflecting inflammatory reactions in the airways. Results: Respiratory symptoms and asthma were more common among the athletes and most common among the swimmers. The frequency of positive mannitol provocation test was higher among the swimmers than the tennis players while the number of positive exercise tests did not differ between the groups. There was an elevation of Clara Cell protein 16 in both groups after exercise challenge test, significantly higher among the tennis players, not seen after the mannitol provocation. Females had a higher frequency of respiratory symptoms and positive provocation tests, despite the same frequency of doctor-diagnosed asthma and asthma treatment. Physical activity led to a healthier life style and indicated better life quality most prominently among females. Conclusion: We found a high prevalence of asthma among elite swimmers and tennis players. The swimmers had a higher frequency of respiratory symptoms, current asthma and a higher rate of positive mannitol provocation tests. This may indicate an unfavorable exercise environment where trichloramine might play a role. The discrepancy between respiratory symptoms and airway hyper-reactivity on one hand and doctor-diagnosed asthma on the other could be in line with a tendency of not being sufficiently aware of the asthma diagnosis in females. Physical activity, even among athletes, seems to be a health-promoting factor.