The benefits of a systematic assessment of respiratory health in illness susceptible athletes

Abstract

Respiratory tract illness is a leading cause of training and in-competition time-loss in elite athletes. Asthma is known to be prevalent in athletes but the co-existence of other respiratory problems, in those deemed to be susceptible to respiratory tract illness, is unknown. The aim of this study was to apply a comprehensive prospective approach to identify respiratory problems and explore relationships in athletes with heightened respiratory illness susceptibility.

UK World Class Performance Programme athletes prospectively completed a systematic review of respiratory health with validated questionnaires and respiratory-focussed investigations, including studies of nasal flow, exhaled nitric oxide, spirometry, bronchoprovocation testing and allergy testing.

Systematic respiratory health assessment was completed by 122 athletes (55 females, age 24±4 year). At least one respiratory health issue, requiring intervention, was identified in 97 (80%) athletes and ≥2 abnormalities were found in 73 (60%). Sinonasal problems were the most commonly identified problem (49%) and 22% of athletes had a positive indirect bronchoprovocation test. Analysis revealed two respiratory health clusters; i) asthma, sinus problems and allergy and ii) laryngeal and breathing pattern dysfunction. Respiratory illness susceptible athletes had 3.6±2.5 episodes in the year prior to assessment and were more likely (as odds ratio [95% confidence intervals] to have allergy (2.6 [1.0–6.5]), sinonasal problems (2.6 [1.1–6.0]), and symptoms of laryngeal (5.4 [1.8–16.8] and breathing pattern dysfunction (3.9 [1.1–14.0] than non-susceptible athletes (all p<0.05).

A systematic approach to respiratory assessment identifies a high prevalence and co-existence of multiple respiratory problems in illness-susceptible athletes.