Endurance athletes develop occupational asthma

The review uses the Bradford Hill criteria to show that vigorous exercise, particularly in cold air athletes and swimmers, causes asthma. For professional athletes this is occupational asthma. The review convincingly shows that hyperventilation is more important than the environment, with cross-country skiers developing asthma more frequently than ski jumpers, and endurance swimmers more comonly than divers. Intrigingly synchronised swimmers are at intermediate risk, perhaps because of the long breath-hold time after inhaling chloramines. This is a good and comprehensive review, but shies away from the obvious occupation consequence of removing the athlete from further exposure. One rule for the industrial worker, another for the athlete. At least for swimmers there are alternatives to chlorine for water sterilisation which could reduce chloramine exposures.

References

	Price OJ, Ansley L, Menzies-Gow A, Cullinan P, Hull JH, Airway dysfunction in elite athletes – an occupational lung disease? , Allergy, 2013;68:1343-1352,

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