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Misdiagnosis of exercise‐induced bronchoconstriction in professional soccer players
Author(s) -
Ansley L.,
Kippelen P.,
Dickinson J.,
Hull J. H. K.
Publication year - 2012
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/j.1398-9995.2011.02762.x
Subject(s) - medicine , bronchoconstriction , asthma , provocation test , bronchodilator , spirometry , pulmonary function testing , bronchial hyperresponsiveness , athletes , physical therapy , exercise induced asthma , bronchodilator agents , respiratory disease , lung , alternative medicine , pathology
Background: Physicians typically rely heavily on self‐reported symptoms to make a diagnosis of exercise‐induced bronchoconstriction ( EIB ). However, in elite sport, respiratory symptoms have poor diagnostic value. In 2009, following a change in international sports regulations, all elite athletes suspected of asthma and/or EIB were required to undergo pulmonary function testing (PFT) to permit the use of inhaled β 2 ‐agonists. The aim of this study was to examine the diagnostic accuracy of physician diagnosis of asthma/ EIB in English professional soccer players. Methods: Sixty‐five players with a physician diagnosis of asthma/ EIB were referred for pulmonary function assessment. Medication usage and respiratory symptoms were recorded by questionnaire. A bronchial provocation test with dry air was conducted in 42 players and a mannitol challenge in 18 players. Five players with abnormal resting spirometry performed a bronchodilator test. Results: Of the 65 players assessed, 57 (88%) indicated regular use of asthma medication. Respiratory symptoms during exercise were reported by 57 (88%) players. Only 33 (51%) of the players tested had a positive bronchodilator or bronchial provocation test. Neither symptoms nor the use of inhaled corticosteroids were predictive of pulmonary function tests’ outcome. Conclusion: A high proportion of E nglish professional soccer players medicated for asthma/ EIB (a third with reliever therapy only) do not present reversible airway obstruction or airway hyperresponsiveness to indirect stimuli. This underlines the importance of objective PFT to support a symptoms‐based diagnosis of asthma/ EIB in athletes.