Feature London 2012 Olympics

What can we learn from asthma in elite athletes?

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e2556 (Published 24 April 2012) Cite this as: BMJ 2012;344:e2556

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  1. Sophie Arie, freelance journalist, London
  1. [email protected]

As Olympic competitors are told they no longer need authorisation for using the most common inhalers, Sophie Arie looks at why asthma seems so common in elite athletes and the lessons that could be of huge benefit to the general public

As Olympic athletes prepare for the London 2012 games, there is one thing that many are relieved they won’t have to worry about in future. As of this year, those with asthma no longer have to seek authorisation to use the most common inhalers.

Asthma in elite athletes has gradually risen at almost every Olympic Games since the 1970s. At the Atlanta Games in 1996 some 20% of the US team declared problems with asthma.1 and almost 21% of Team GB had asthma in 2004 tests,2 compared with 8% of the British population.3

Why more asthma in athletes?

Little was understood about why athletes would have more problems with asthma than the ordinary population, and suspicions grew that some athletes might be declaring themselves asthmatic out of a belief that inhaled β2 agonists, the bronchodilator drugs used to prevent and relieve symptoms, could enhance their performance.

In 2001, the International Olympic Committee Medical Commission introduced clinical tests before authorising each athlete to use inhaled β2 agonists. The International Olympic Committee said its concern was for the health of the athletes, and although testing did not bring the numbers down substantially it did expose the need for much closer attention to the problem—some had been misdiagnosed and others had asthma without realising it.

Asthma remains the most common health problem among elite athletes. So why do so many athletes have it? And do the drugs they use to control it affect their performance?

Certain facts are known: asthma symptoms are most often provoked by intense exertion over long periods and …

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