Prevalence and characteristics of asthma in the aquatic disciplines

Margo Mountjoy; Ken Fitch; Louis-Philippe Boulet; Valerie Bougault; Willem van Mechelen; Evert Verhagen

doi:10.1016/j.jaci.2015.01.041

Prevalence and characteristics of asthma in the aquatic disciplines

J Allergy Clin Immunol. 2015 Sep;136(3):588-94. doi: 10.1016/j.jaci.2015.01.041. Epub 2015 Mar 24.

Authors

Margo Mountjoy¹, Ken Fitch², Louis-Philippe Boulet³, Valerie Bougault⁴, Willem van Mechelen⁵, Evert Verhagen⁶

Affiliations

¹ Department of Family Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada; International Olympic Committee (IOC), Lausanne, Switzerland; Fédération Internationale de Natation (FINA), Lausanne, Switzerland. Electronic address: mmsportdoc@mcmaster.ca.
² School of Sports Science, Exercise and Health, Faculty of Life Sciences, University of Western Australia, Crawley, Australia.
³ Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.
⁴ Faculty of Sport Sciences, University of Lille, Lille, France.
⁵ Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
⁶ Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, SMB Campus, Ballarat, Australia.

PMID: 25819982
DOI: 10.1016/j.jaci.2015.01.041

Abstract

Background: Despite the health benefits of swimming as a form of exercise, evidence exists that both the swimming pool environment and endurance exercise are etiologic factors in the development of asthma. The prevalence of asthma in swimmers is high compared with that in participants in other Olympic sport disciplines. There are no publications comparing the prevalence of asthma in the 5 aquatic disciplines.

Objective: The purpose of this study is to examine and compare the prevalence of asthma in the aquatic disciplines and in contrast with other Olympic sports.

Methods: Therapeutic Use Exemptions containing objective evidence of athlete asthma/airway hyperresponsiveness (AHR) were collected for all aquatic athletes participating in swimming, diving, synchronized swimming, water polo, and open water swimming for major events during the time period from 2004-2009. The prevalence of asthma/AHR in the aquatic disciplines was analyzed for statistical significance (with 95% CIs) and also compared with that in other Olympic sports.

Results: Swimming had the highest prevalence of asthma/AHR in comparison with the other aquatic disciplines. The endurance aquatic disciplines have a higher prevalence of asthma/AHR than the aquatic nonendurance disciplines. Asthma/AHR is more common in Oceania, Europe, and North America than in Asia, Africa, and South America. In comparison with other Olympic sports, swimming, synchronized swimming, and open water swimming were among the top 5 sports for asthma/AHR prevalence.

Conclusion: Asthma/AHR in the endurance aquatic disciplines is common at the elite level and has a varied geographic distribution. Findings from this study demonstrate the need for development of aquatic discipline-specific prevention, screening, and treatment regimens.

Keywords: Asthma; Olympic Games; airway hyperresponsiveness; diving; endurance training; exercise-induced bronchoconstriction; swimming; synchronized swimming; water polo.

MeSH terms

Asia / epidemiology
Asthma / diagnosis
Asthma / epidemiology*
Athletes*
Bronchial Hyperreactivity / diagnosis
Bronchial Hyperreactivity / epidemiology*
Bronchial Provocation Tests
Europe / epidemiology
Female
Humans
Male
North America / epidemiology
Occupational Diseases / diagnosis
Occupational Diseases / epidemiology*
Physical Endurance
Prevalence
Swimming Pools
Swimming*