Abstract
Increased frequency of asthma has been reported among swimmers, but many tests have a low sensitivity to detect asthma among elite athletes. The
Aim was to investigate the prevalence of asthma among elite swimmers, to compare sport specific exercise test with Mannitol and explore the tests ability to detect asthma.
Methods: 101 elite swimmers (14-24 years) performed both Mannitol provocation and a sport specific exercise test. Mannitol positivity was defined as either direct FEV1 PD15 or as β2- reversibility ≥ 15% after challenge (=extended criteria). A direct positive exercise test was defined as a drop in FEV1 of 10% compared to baseline or a difference in FEV of >15% either spontaneous, variability or with β2-agonist, reversibility (=extended criteria).
Results: We found a high prevalence of Mannitol and/or Exercise positivity. For Mannitol, 26 were positive by ordinary criteria and 43 with extended criteria. The corresponding numbers for exercise test were 14 and 24. When including reversibility and variability to define a positive test the sensitivity to detect current asthma with or without exercise induced symptoms increased while the specificity remained unchanged. Direct positivity for Mannitol or Exercise poorly overlapped using ordinary criteria. The conformity was better using the extended criteria.
Conclusion: We found a high prevalence of EIA among elite swimmers. The use of variability and reversibility as additional criteria to define a positive test increased the ability to detect asthma with or without exercise induced symptoms, without lowering the specificity, and should therefore be considered in the interpretation of the tests.
- © 2011 ERS