Exercise-induced respiratory symptoms and allergy in elite athletes: Allergy and Asthma in Polish Olympic Athletes (A2POLO) project within GA2LEN initiative

Introduction Exercise-induced respiratory symptoms are often reported by professional athletes, but asthma and allergy are underdiagnosed. Few studies used standardized questionnaires combined with clinical assessment to investigate asthma and allergy among athletes. Objectives Assessment of the prevalence of allergy and asthma symptoms among Polish professional athletes and confronting it with clinical data. Methods Two hundred twenty-two Olympic athletes participated in the project being part of the Global Allergy and Asthma European Network (GA2LEN) Olympic study. Allergy and asthma status was determined using Allergy Questionnaire for Athletes (AQUA), spirometry, reversibility test, methacholine challenge and skin prick testing. Final diagnosis was established by an allergist. Results At least one exercise-induced asthma (EIA) symptom was reported by 28.4% athletes, and finally asthma diagnosis was established in 11.3% while only 5.9% of athletes had history of asthma. Reversibility test was positive in 36% of athletes finally diagnosed with asthma. Allergic rhinitis (AR) symptoms were reported by 27%, and the diagnosis was confirmed in 21% of athletes while only 9% had previously diagnosed AR. No significant differences in frequency of asthma and AR were observed between endurance and non-endurance athletes. Conclusions High prevalence of exercise-induced respiratory symptoms among top athletes is not reflected by asthma diagnosis. As it was expected, our data confirm that – in diagnosis of EIA – lung function testing alone is not useful, whereas reversibility tests are of limited value.