New research hints that a large number of Olympic athletes may be using inhaled steroids for exercise-induced Asthma when they don’t have the condition, while others may unknowingly have exercise-induced Asthma and aren’t being treated.
The findings stem in large part from changes in Asthma criteria instituted by the International Olympic Committee’s Medical Commission (IOC-MC) in 2001.
Prior to 2001, Olympic athletes who using inhaled steroids for asthma need only get the team doctor to sign a form stating that the athlete had asthma and needed the medication.
Since 2001, the IOC-MC has required that Olympic athletes using inhaled steroids for exercise-induced asthma provide clinical evidence for their asthmatic condition in the form of a physiological test performed by a doctor.
“A doctor’s signature was not good enough after 2001,” said John Dickinson, a research physiologist at the English Institute of Sport, Bisham Abbey High Performance Centre in the UK, even though inhaled short acting beta-agonists have no performance enhancing effects.
To gauge the impact of the IOC rule change, Dickinson and others compared the prevalence of exercise-induced Asthma within the Great Britain Olympic teams of 2000 and 2004. They report their results in the medical journal Thorax.
The researchers discovered that the prevalence of asthma within the Great Britain Olympic team remained unchanged between 2000 and 2004. According to Dickinson, “we demonstrated that one in five elite athletes suffer from exercise-induced asthma.”
At the same time, however, the 2001 IOC-MC requirement that asthmatic athletes submit physiologic evidence of their disease has highlighted that 13 of 62 athletes on the 2004 team, or 21 percent, with a previous diagnosis of asthma had negative bronchodilator test results, indicating that they may no longer have asthma.
In contrast, seven other athletes on the team who had no previous history of asthma tested positive for exercise-induced asthma.
“As a result, we have recommended to all elite athletes and teams that it is best to screen athletes for exercise-induced asthma rather than rely on athletes reporting symptoms to their doctor,” Dickinson told.
This is because it is sometimes difficult to recognize the symptoms of exercise-induced Asthma especially when an athlete only has a mild case, he explained.
“A large number of athletes have exercise-induced Asthma,” according to Dickinson. “This does not mean that they can’t compete at the highest level as many of our asthmatic elite athletes won medals at the Olympic Games.”
The key is to ensure athletes are correctly diagnosed, “so they can receive the correct treatment that will enable them to compete to their maximum potential,” he added.
It’s quite possible that other national Olympic teams are fielding athletes with undiagnosed Asthma as well as athletes using inhaled steroids who don’t need them, Dickinson said.
“Our report is the first to describe the prevalence of asthma in Olympic teams since the rule change so it is difficult to compare our prevalence rate to other countries at the moment.”
SOURCE: Thorax, August 2005.
Revision date: June 14, 2011
Last revised: by Jorge P. Ribeiro, MD