Br J Sports Med 46:413-416 doi:10.1136/bjsports-2011-090814
  • Reviews

An overview of asthma and airway hyper-responsiveness in Olympic athletes

  1. Kenneth D Fitch
  1. Correspondence to Kenneth D Fitch, School of Sports Science, Exercise and Health (M408), Faculty of Life Science, University of Western Australia, Crawley 6009, Western Australia, Australia; ken.fitch{at}
  1. Contributors This paper is solely my work but I acknowledge that the information was collected at successive Olympic Games and reviewed by the named members of the IOC's Independent Expert Asthma Panel.

  • Received 6 December 2011
  • Accepted 11 December 2011
  • Published Online First 8 January 2012


Data from the past five Olympic Games obtained from athletes seeking to inhale β2 adrenoceptor agonists (IBA) have identified those athletes with documented asthma and airway hyper-responsiveness (AHR). With a prevalence of about 8%, asthma/AHR is the commonest chronic medical condition experienced by Olympic athletes. In Summer and Winter athletes, there is a marked preponderance of asthma/AHR in endurance-trained athletes. The relatively late onset of asthma/AHR in many older athletes is suggestive that years of endurance training may be a contributory cause. Inspiring polluted or cold air is considered a significant aetiological factor in some but not all sports. During the last five Olympic Games, there has been improved management of athletes with asthma/AHR with a much higher proportion of athletes combining inhaled corticosteroids (ICS) with IBA and few using long-acting IBA as monotherapy. Athletes with asthma/AHR have consistently outperformed their peers, which research suggests is not due to their treatment enhancing sports performance. Research is necessary to determine how many athletes will continue to experience asthma/AHR in the years after they cease intensive endurance training.


  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed

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