Article Text

Download PDFPDF
Sports in extreme conditions: The impact of exercise in cold temperatures on asthma and bronchial hyper-responsiveness in athletes
  1. Kai-Håkon Carlsen1,2
  1. 1Faculty of Medicine, University of Oslo, Institute of Clinical Medicine, Oslo, Norway
  2. 2Norwegian School of Sport Sciences, Oslo, Norway
  3. 3Department of Paediatrics, Rikshospitalet, Oslo University Hospital, Oslo, Norway
  1. Correspondence to Professor Kai-Håkon Carlsen, Department of Paediatrics, Rikshospitalet, Oslo University Hospital, PO Box 4950 Nydalen, Oslo 0424, Norway; k.h.carlsen{at}


Exercise-induced asthma (EIA) and bronchial hyper-responsiveness (BHR) are frequently reported among elite athletes of outdoor endurance winter sports, particularly in cross-country and biathlon skiers. The pathogenesis of EIA is related to water loss and heat-loss through the increased respiration during exercise, leading to mediator release, airways inflammation and increased parasympathetic nervous activity in the airways, causing bronchial constriction and BHR. In the competing elite athlete this is presently considered to be due to the frequently repeated increased ventilation during training and competitions in combination with the repeated environmental exposure to cold air in outdoor winter sports. It is important that athletes at risk of asthma and BHR are monitored through regular medical control with assessment of lung function and BHR, and when BHR or asthma is diagnosed, optimal controlling treatment through anti-inflammatory treatment by inhaled steroids should be started and relieving treatment (inhaled ipratropium bromide and inhaled β2-agonists) should be used to relieve bronchial constriction if present.

  • Athletics
  • Respiratory
  • Elite performance
  • Endurance
  • Exercise

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.