Asthma is presently the most common chronic condition found among elite athletes participating in the Olympic Games. It is of particular interest that asthmatic Olympic athletes have won significantly more medals than non-asthmatic competitors in every Olympic Games since the year 2000. It has been speculated that the harder an athlete trains, the better the performance, simultaneously increasing asthma risk.
There has been an increase in asthma prevalence among elite athletes that has occurred in recent decades. Asthma is presently the most common chronic condition found among elite athletes participating in the Olympic Games.
Increased prevalence of asthma is now reported in athletes who participate in a number of summer and winter endurance sports: speed skaters, figure skaters, ice hockey players, biathalon athletes, cyclists, swimmers, triathalon athletes, rowers and long distance runners. Sports that require short bursts of activity such as volleyball, gymnastics, baseball, golf and some track and field events are less likely to trigger asthma. Swimming is a good exercise option for asthma because its a warm, moist environment that won’t dry airways. Although the chlorine could be problematic.
In particular, asthma in endurance athletes is believed to be related to daily training sessions and frequent competitions with heavily increased ventilation. This has been shown to cause respiratory epithelial damage and airway drying. Daily training can cause respiratory water loss and mucosal dehydration. This leads to respiratory inflammation, exercise-induced bronchoconstriction in athletes. Environmental elements also contribute to increased inflammation, including cold air exposure during winter sports, chlorine exposure during swimming in indoor pools and exposure to ultrafine particles in indoor ice rinks.
The World Anti-doping Agency presently allows free use of all inhaled corticosteroids and limited use of B2-agonists (athletes are drug tested to see if they are over a maximum allowed amount.) Even subjects who do not have asthma seem to benefit from using albuterol during competition.
Increased asthma among Olympic athletes seem be due to a multitude of factors including, daily training and frequent competitions of high intensity and during with increased ventilation, which leads to epithelial damage and bronchial hyper-responsiveness and inflammation that leads to asthma symptoms.
Because asthma is the most common chronic disease in Olympic athletes, it is important that the present available treatment according to international guidelines enables those with asthma to compete on an equal level and with equal success as other healthy athletes.
Former Olympians with asthma, are Justine Henin who captured the gold in Athens in 2004, US swimmer Tom Dolan who won gold in Atlanta in 1996 and in 2016 US swimmer Kelsi Worrell who competed in Rio.