When the world’s top athletes convene next month for the Beijing 2008 Olympic Games, some will face a challenge that tests more than their athletic abilities. Heavy pollution in the Chinese capital could pose problems for competitors, especially those with asthma, according to the American Academy of Allergy, Asthma & Immunology (AAAAI).
The ozone, sulfur dioxide, nitric oxide and other pollutants in Beijing’s hazy air are asthmagenic – meaning exposure can inflame the airways of sensitive people and even cause an asthma attack. Similar problem were witnessed in past Olympic host cities of Atlanta, Athens and Seoul, but Beijing’s place among the world’s worst in air quality has experts concerned.
“Not only will athletes have irritated eyes, but a good portion may have decreased potential to be competitive,” said Timothy Craig, DO, FAAAAI, and chair of the AAAAI Sports Medicine Committee. “Exercise can enhance the adverse effects air pollutants have on health. Rigorous exercise combined with pollutants can sometimes stimulate an asthma attack.”
Research points to EIA origins
New research to be presented next month in the Journal of Allergy and Clinical Immunology (JACI), the official scientific journal of the AAAAI, investigates the origins of exercise-induced asthma.
Sandra D. Anderson, PhD, DSc, and colleagues report that exercise-induced asthma results from injuries to the airway caused by breathing poorly conditioned air – particularly cold, dry air – over long periods of time. The researchers concluded that cold-weather athletes and swimmers, who train in irritant environments, may be at risk of airway injury leading to increased airway sensitivity.
In a European study of adolescent elite swimmers, Lars Pedersen, MD, and colleagues found that young competition swimmers had the same healthy airways as their non-swimming peers after two years in the sport. However, previous studies have shown a higher prevalence of respiratory symptoms among adult endurance athletes, suggesting that these sensitivities develop over time and repeated exposure to the pool environment.
EIA common among athletes
Exercise-induced asthma (EIA) affects an estimated 20 percent of top athletes and an estimated 1 in 6 of all Olympic athletes, according to the AAAAI. EIA frequently affects individuals who do not suffer from chronic asthma.
Typically, athletes with EIA experience difficulty breathing 5-10 minutes after exercise. Other symptoms include:
- Chest tightness
- Chest pain
- Prolonged or unexpected shortness of breath
Prescription asthma medications, including controller and rescue medication, can be used to control and treat EIA. Due to anti-doping regulations, which restrict the use of many asthma medications at the Olympic Games, athletes must obtain official approval for many medications.
Tactics that can help mitigate EIA include warming up before exercise and keeping hydrated.
Spectators should also prepare
In addition to athletes, high pollution levels threaten to take a toll on spectators with a history of allergies or asthma.
“Spectators may develop the same symptoms as the athletes and need to be prepared to treat their asthma and other allergic diseases if they develop or worsen,” Craig said. “Remember to take your asthma medication as prescribed and carry albuterol and hydrating eye drops at all times to treat symptoms. Think ‘avoidance’ and be willing to stay indoors on a very poor air quality day so the rest of your trip is completed in health.”
The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has more than 6,500 members in the United States, Canada and 60 other countries.