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. © 2008 American Academy of Allergy, Asthma & Immunology.
Fitch, K. D., Sue-Chu, M., Anderson, S. D., Boulet, L. P., Hancox, R. J., McKenzie, D. C., … Ljungqvist, A. (2008). Asthma and the elite athlete: Summary of the International Olympic Committee’s Consensus Conference, Lausanne, Switzerland, January 22-24, 2008. Journal of Allergy and Clinical Immunology, 122(2). https://doi.org/10.1016/j.jaci.2008.07.003