%0 Journal Article %A Imran Satia %A Eldar Priel %A Baraa K. Al-Khazraji %A Graham Jones %A Andy Freitag %A Paul M. O'Byrne %A Kieran J. Killian %T Exercise Induced Bronchoconstriction and Bronchodilation; investigating the effects of age, sex, airflow limitation and the FEV1 %D 2021 %R 10.1183/13993003.04026-2020 %J European Respiratory Journal %P 2004026 %X Exercise induced bronchoconstriction (EIBc) is a recognised response to exercise in asthmatics and athletes but is less well understood in an unselected broad population. Exercise induced bronchodilation (EIBd) has received even less attention. The objective of this study was to Investigate the effects of age, sex, forced expiratory volume in 1 s (FEV1), airflow limitation (FEV1/FVC<0.7) on the prevalence of EIBc and EIBd. Incremental CPET on cycle ergometry to symptom limitation was performed between 1988–2012 at McMaster University. The FEV1 was performed before and 10 mins after exercise. EIBc was defined as a % fall in FEV1 post exercise below the 5th percentile, whilst EIBd as % increase in FEV1 above the 95% percentile. 35 258 subjects between age 6–95 were included in the study (mean age 53, 60% male, 10.3% had airflow limitation (AL, FEV1/FVC<0.7). The lowest 5% of subjects demonstrated a >7.6% fall in FEV1 post exercise (EIBc), whilst the top 5% a >11% increase (EIBd). The probability of both EIBc and EIBd increased with age and was highest in females across all ages (OR 1.76(1.60–1.94) p<0.0001). The probability of EIBc increased as the FEV1%predicted declined (<40% OR 4.38(3.04–6.31),p<0.0001), a >2× increased likelihood in females (OR 2.31(1.71–3.113)p<0.0001), with a trend with AL(p=0.06). The probability of EIBd increased as the FEV1%predicted declined, in the presence of AL (OR 1.55 (1.24–0.95) p=0.0001), but sex had no effect. EIBc and EIBd can be demonstrated at the population level and is influenced by age, sex, FEV1%predicted and airflow limitation.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: Dr. Satia reports personal fees from Educational Talks for GPs from GSK, Astrazeneca, grants and personal fees from Merck Canada, grants from ERS Respire 3 Marie Curie Fellowship, outside the submitted work; Dr. Satia reports personal fees from Educational Talks for GPs; GSK, Astrazeneca, grants and personal fees from Merck Canada, grants from ERS Respire 3 Marie Curie Fellowship, outside the submitted work.Conflict of interest: Dr. Priel has nothing to disclose.Conflict of interest: Dr. Al-Khazraji has nothing to disclose.Conflict of interest: Dr. Jones has nothing to disclose.Conflict of interest: Dr. Freitag has nothing to disclose.Conflict of interest: Dr. Killian has nothing to disclose.Conflict of interest: Dr. O'Byrne reports grants and personal fees from AstraZeneca, personal fees from GSK, grants from Novartis, grants and personal fees from Medimmune, personal fees from Chiesi, outside the submitted work. %U https://erj.ersjournals.com/content/erj/early/2021/01/08/13993003.04026-2020.full.pdf