Translation of exhaled breath volatile analyses to sport and exercise applications

Exhaled breath gases are becomingly increasingly investigated for use as non-invasive measurements for clinical diagnosis, prognosis and therapeutic monitoring. Exhaled volatile organic compounds (VOCs) in the breath, which make up the exhaled volatilome, offer a rich sample medium that provides both information to external exposures as well as endogenous metabolism. For these reasons, exhaled breath analyses can be extended further beyond disease-based investigations, and used for wider biomarker measurement purposes. The use of a rapid, non-invasive (and potentially non-physically demanding) test in an exercise and/or sporting situation may provide additional information for translation to performance sport, recreational exercise/fitness and clinical exercise health. This review intends to provide an overview into the initial exploration of exhaled VOC measurements in sport and exercise science, and understand current limitations in knowledge and instrumentation that have restricted these methodologies in becoming common practice. Exhaled VOCs have been applied to sport/exercise investigations with a current emphasis on measurement of chemical exposure during and/or following exercise. This includes the measurement of disinfection by-products from chlorine-disinfected swimming pools, as well as exposure to petrochemicals from combustion engines (e.g. vehicle fumes). However, exhaled VOC measurements have been less employed in the context of performance sport. For example, the application of exhaled VOCs to map biochemical/physiological processes of intense exercise is currently under explored and warrants further study. Nevertheless, there is promise for exhaled VOC testing in the development of rapid/on-line anti-doping screens, with initial steps taken in this field.