Breathless in Beijing: Olympics 2008

The 2008 Summer Olympics in Beijing began on Friday. I love the Olympics, always have, and you can bet I'll be watching and cheering on our American team. But, as a respiratory therapist, I'll be watching and listening especially to see how the athletes with asthma do with the unique challenges presented at this Olympics.

Athletes with asthma (I prefer to not use the term "asthmatic" athletes - just don't like the label) competing this month in Beijing face not only the challenge of competing against the best in the world, but the threat of significant air pollution, as well as making sure that their asthma medications are approved in light of anti-doping regulations.

There's a lot to consider here so I thought I'd break this article into four aspects of asthma and the Beijing Games.

• What is EIB? Exercise Induced Bronchospasm (EIB) otherwise known as Exercise Induced Asthma
• The prevalence of asthma in elite athletes, and what sports are more likely to be affected by asthma
• Can they take their meds? Doping regulations and asthma medications
• Is it really as bad as they say? Air quality in Beijing for the 2008 Olympics

Exercise Induced Asthma / or Exercise Induced Bronchospasm

Exercise induced bronchospasm (EIB) affects as many as one in every six Olympic athletes, according to the American Academy of Allergy, Asthma & Immunology (AAAAI).

EIB is caused by airways that are overly sensitive to sudden changes in temperature, cold, humidity, allergens and irritants. During strenuous activity, people tend to breathe a larger volume of air and take it in through their mouths, allowing more air to reach the lungs without passing through the filtering, humidifying, and warming effects of the nose.

People with EIB experience difficulty breathing within 5-20 minutes after exercising.

Symptoms include:

• Wheezing
• Chest tightness
• Coughing
• Chest pain
• Prolonged or unexpected shortness of breath

Sports that require short bursts of energy, such as baseball, football, wrestling, golfing, gymnastics, and short-term track and field events are less likely to trigger EIB, as opposed to endurance sports such as distance running, cycling, and basketball.

Swimming has many benefits for those with EIB. The warm, humid atmosphere, toning of upper body muscles, and horizontal body position can help mobilize mucus. However, chemicals used in and around pools can be an irritant for the athlete with asthma.

Why are there so many elite athletes with asthma?

The prevalence of asthma in elite athletes is well documented, but perhaps not as remarkable as in that of a study done with the 1998 United States Winter Olympic team. In this study, researchers tested every athlete in seven sports - biathlon, cross-country skiing, figure skating, ice hockey, Nordic combined, long-track speed skating and short-track speed skating. It was found that nearly a quarter of the athletes (25 per cent), including half of the cross-country skiers (50 per cent), had asthma. In comparison, about 5 percent of the general population has asthma.