Allergenic Pollen in Europe and in the Mediterranean Area

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Allergy and the role of environment in sportsmen

Luís Delgado, MD PhD

Allergy, Asthma & Sports Unit, Immunoallergology, S.João Hospital, Porto, Portugal

During training, athletes are repeatedly exposed to allergens, cold air and pollutants, which can have a significant effect on those with allergic diseases or asthma. Several recent studies have shown a high prevalence of asthma and exercise-induced bronchoconstriction in elite athletes. The prevalence rate is particularly high in endurance athletes, winter sport athletes, swimmers and athletes with concomitant risk factors, such as atopy. Further, the prevalence of asthma in athletes is increasing (9.7% in 1976 to 16.7% in 1996, in US Olympic athletes). The prevalence of allergic rhinitis is also high in athletes (25–56% in Olympic athletes), and a significant proportion of athletes with rhinitis may have sub-clinical bronchial obstruction. Severe allergic symptoms may also be induced by heavy exercise following allergen exposure, e.g. exercise-induced food-dependent anaphylaxis.

In spite of the increased prevalence, allergic diseases and asthma are under-diagnosed and under-treated in athletes. This may be due to atypical or unusual symptoms, reluctance to take medication and/or poor knowledge of doping regulations. The best criteria for diagnosing exercise-induced bronchoconstriction in athletes and the implications of treatment on exercise performance are still under discussion. However, if appropriately detected and managed, allergic disorders and asthma should not constitute a limiting factor in exercise performance in athletes.

In addition, as athletes are often role models for young people, they may influence other patients with allergic diseases or asthma to lead as normal a life as possible.

Capão-Filipe M, Moreira A, Delgado L, Rodrigues J, Vaz M. Exercise-induced bronchoconstriction and respiratory symptoms in elite athletes. Allergy 2003; 58: 1196.

Carlsen K-H. Asthma and allergy in sportsmen. ACI International 2001; 13: 140-6.

Delgado L, Capão-Filipe M, Moreira A. Rhinitis and its impact in sports. ACI International 2004 (in press).

Gioulekas D, Damialis A, Papakosta D, Syrigou A, Mpaka G, Saxoni F, Patakas D. 15-Year aeroallergen records. Their usefulness in Athens Olympics, 2004. Allergy 2003; 58:933–938.

Katelaris CH, Carrozzi FM, Burke TV. Allergic rhinoconjunctivitis in elite athletes. Optimal management for quality of life and performance. Sports Med 2003;33(6):401-6.

Pedersen BK, Hoffman-Goetz L. Exercise and the immune system: regulation, integration, and adaptation. Physiol Rev 2000; 80: 1055-81.

Storms WW. Review of exercise-induced asthma. Med Sci Sports Exerc 2003; 1464-70.

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