TY - JOUR T1 - The benefits of a systematic assessment of respiratory health in illness susceptible athletes JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.03722-2020 SP - 2003722 AU - James H. Hull AU - Anna R. Jackson AU - Craig Ranson AU - Freddie Brown AU - Moses Wootten AU - Mike Loosemore Y1 - 2020/01/01 UR - http://erj.ersjournals.com/content/early/2020/11/26/13993003.03722-2020.abstract N2 - 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.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: JH has no conflict of interest to declareConflict of interest: AJ has no conflict of interest to declareConflict of interest: CR has no conflict of interest to declareConflict of interest: FB has no conflict of interest to declareConflict of interest: Dr. Loosemore has nothing to disclose.Conflict of interest: MW has no conflict of interest to declare ER -