Prevalence and characteristics of asthma in the aquatic disciplines - 25/03/15

Doi : 10.1016/j.jaci.2015.01.041

Margo Mountjoy, MD, CCFP, FCFP, FACSM, Dip Sport Med ^a,^b,^c,^⁎ , Ken Fitch, MBBS, MD, FACRM, FACSP, FACSM ^d, Louis-Philippe Boulet, MD, FCCP, FRCPC ^e, Valerie Bougault, PhD ^f, Willem van Mechelen, MD, PhD, FACSM, FECSS ^g, Evert Verhagen, PhD, FECSS ^g,^h
^a Department of Family Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
^b International Olympic Committee (IOC), Lausanne, Switzerland
^c Fédération Internationale de Natation (FINA), Lausanne, Switzerland
^d School of Sports Science, Exercise and Health, Faculty of Life Sciences, University of Western Australia, Crawley, Australia
^e Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
^f Faculty of Sport Sciences, University of Lille, Lille, France
^g Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
^h Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, SMB Campus, Ballarat, Australia

^∗Corresponding author: Margo Mountjoy, MD, CCFP, FCFP, FACSM, Dip Sport Med, FINA c/o Michael G. DeGroote School of Medicine, McMaster University Waterloo Regional Campus, 10-B Victoria St South, Kitchener, Ontario N2G 1C5, Canada.

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Abstract

Background

Despite the health benefits of swimming as a form of exercise, evidence exists that both the swimming pool environment and endurance exercise are etiologic factors in the development of asthma. The prevalence of asthma in swimmers is high compared with that in participants in other Olympic sport disciplines. There are no publications comparing the prevalence of asthma in the 5 aquatic disciplines.

Objective

The purpose of this study is to examine and compare the prevalence of asthma in the aquatic disciplines and in contrast with other Olympic sports.

Methods

Therapeutic Use Exemptions containing objective evidence of athlete asthma/airway hyperresponsiveness (AHR) were collected for all aquatic athletes participating in swimming, diving, synchronized swimming, water polo, and open water swimming for major events during the time period from 2004-2009. The prevalence of asthma/AHR in the aquatic disciplines was analyzed for statistical significance (with 95% CIs) and also compared with that in other Olympic sports.

Results

Swimming had the highest prevalence of asthma/AHR in comparison with the other aquatic disciplines. The endurance aquatic disciplines have a higher prevalence of asthma/AHR than the aquatic nonendurance disciplines. Asthma/AHR is more common in Oceania, Europe, and North America than in Asia, Africa, and South America. In comparison with other Olympic sports, swimming, synchronized swimming, and open water swimming were among the top 5 sports for asthma/AHR prevalence.

Conclusion

Asthma/AHR in the endurance aquatic disciplines is common at the elite level and has a varied geographic distribution. Findings from this study demonstrate the need for development of aquatic discipline–specific prevention, screening, and treatment regimens.

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Key words : Asthma, exercise-induced bronchoconstriction, airway hyperresponsiveness, swimming, diving, synchronized swimming, water polo, Olympic Games, endurance training

Abbreviations used : AHR, BPT, FINA, IBA, IOC, TUE, WADA

Plan

Methods

Determination of the study period

Definition of asthma

Acquisition and processing of nominator and denominator data

Analyses

Results

Discussion

Disclosure of potential conflict of interest: M. Mountjoy is employed by the McMaster Medical School and the University of Guelph, has received payment for delivering lectures from Serie Cientifica Latinoamerican, and has received compensation for travel and other meeting-related expenses from the International Olympic Committee, FINA, and the World Anti-Doping Agency. K. Fitch has received payment for the development of educational presentations from the Australasian College of Sports Physicians. L.-P. Boulet has received compensation for board membership from GlaxoSmithKline, Novartis, AstraZeneca, Merck, and Schering; has received or has grants pending from AstraZeneca, GlaxoSmithKline, Merck, Schering, AllerGen, Altair, Amgen, Asmacure, Boehringer Ingelheim, Genentech, Novartis, Ono Pharma, Pharmaxis, and Wyeth; has received payment for delivering lectures from AstraZeneca, GlaxoSmithKline, Merck, and Novartis; has received payment for the development of educational presentations from AstraZeneca, GlaxoSmithKline, Merck, Boehringer Ingelheim, Novartis; and has received payment as a governmental advisor for INNESS, the Quebec National Health Institute, and as a member of the Quebec Workmen Compensation Board Respiratory Committee. The rest of the authors declare that they have no relevant conflicts of interest.