Public Release:  Asthma, outdoor air quality and the Olympic Games

Canadian Medical Association Journal

As we come close to the Beijing Olympic Games, a review article, http://www.cmaj.ca/cgi/rapidpdf/cmaj.080982 , in CMAJ (Canadian Medical Association Journal) reminds us that the heat and humidity in the Beijing region will present a formidable challenge to all athletes. Moreover, poor quality of air can also affect all athletes, especially those with asthma.

"With exposure to an environment that has poor quality, air pollutants may trigger symptoms of asthma in a dose-dependent manner," say Donald McKenzie and Louis-Philippe Boulet. "With the high minute ventilation [amount of air breathed in one minute] seen during exercise, the effects of exposure to these pollutants are more noticeable in athletes than in non-athletes and likely more evident in people with asthma than in those without asthma."

Physical activity and regular exercise can improve the control of asthma and is recommended to patients. However, there is mounting evidence that frequent, intense exercise by highly trained athletes could itself contribute to the development of asthma. Long-term endurance training may influence the structure and function of airways in the lungs and make them hyperresponsive, contributing to the development of asthma.

McKenzie and Boulet say that athletes with asthma need an individualized management plan that needs to comply with the anti-doping regulations of the International Olympic Committee and the World Anti-Doping Agency. For example, athletes who wish to use an inhaled medication, such as one of the permissible beta-2 agonists, need to document the need for this medication by appropriate lung function testing and submit an application to the International Olympic Committee's Medical Commission.

China has implemented strategies in the Beijing region to improve air quality during the Olympic Games. "However, a significant percentage of the pollution (about 35%) at the Olympic Stadium can be attributed to sources outside Beijing. Controlling only local sources of pollution may not be sufficient to achieve the air quality goal set for the Beijing games," say McKenzie and Boulet.

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