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International Olympic Committee (IOC) consensus statement on acute respiratory illness in athletes part 2: non-infective acute respiratory illness
  1. Martin Schwellnus1,2,
  2. Paolo Emilio Adami3,
  3. Valerie Bougault4,
  4. Richard Budgett5,
  5. Hege Havstad Clemm6,7,
  6. Wayne Derman8,9,
  7. Uğur Erdener5,
  8. Ken Fitch10,
  9. James H Hull11,12,
  10. Cameron McIntosh13,
  11. Tim Meyer14,
  12. Lars Pedersen15,
  13. David B Pyne16,
  14. Tonje Reier-Nilsen17,18,
  15. Wolfgang Schobersberger19,
  16. Yorck Olaf Schumacher20,
  17. Nicola Sewry1,2,
  18. Torbjørn Soligard5,21,
  19. Maarit Valtonen22,
  20. Nick Webborn23,
  21. Lars Engebretsen5,18
  1. 1Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
  2. 2SEMLI, IOC Research Centre, Pretoria, Gauteng, South Africa
  3. 3Health & Science Department, World Athletics, Monaco, Monaco Principality
  4. 4Laboratoire Motricité Humaine Expertise Sport Santé, Université Côte d’Azur, Nice, Provence-Alpes-Côte d'Azu, France
  5. 5Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
  6. 6Department of Pediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
  7. 7Department of Clinical Science, University of Bergen, Bergen, Norway
  8. 8Institute of Sport and Exercise Medicine (ISEM), Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
  9. 9ISEM, IOC Research Center, South Africa, Stellenbosch, South Africa
  10. 10School of Human Science; Sports, Exercise and Health, The University of Western Australia, Perth, Western Australia, Australia
  11. 11Department of Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
  12. 12Institute of Sport, Exercise and Health (ISEH), University College London (UCL), London, UK
  13. 13Dr CND McIntosh INC, Edge Day Hospital, Port Elizabeth, South Africa
  14. 14Institute of Sports and Preventive Medicine, Saarland University, Saarbrucken, Germany
  15. 15Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark
  16. 16Research Institute for Sport and Exercise, University of Canberra, Canberra, Australian Capital Territory, Australia
  17. 17Oslo Sports Trauma Research Centre, The Norwegian Olympic Sports Centre, Oslo, Norway
  18. 18Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
  19. 19Insitute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), Kliniken Innsbruck and Private University UMIT Tirol, Hall, Austria
  20. 20Orthopedic and Sports Medicine Hospital, Aspetar, Doha, Qatar
  21. 21Sport Injury Prevention Research Centre, Faculty of Kinesiology, Calgary, Alberta, Canada
  22. 22KIHU, Research Institute for Olympic Sports, Jyväskylä, Finland
  23. 23Centre for Sport and Exercise Science and Medicine, University of Brighton, Brighton, UK
  1. Correspondence to Professor Martin Schwellnus, Sport, Exercise Medicine and Lifestyle Institute, University of Pretoria, Faculty of Health Sciences, Pretoria, South Africa; mschwell{at}


Acute respiratory illness (ARill) is common and threatens the health of athletes. ARill in athletes forms a significant component of the work of Sport and Exercise Medicine (SEM) clinicians. The aim of this consensus is to provide the SEM clinician with an overview and practical clinical approach to non-infective ARill in athletes. The International Olympic Committee (IOC) Medical and Scientific Committee appointed an international consensus group to review ARill in athletes. Key areas of ARill in athletes were originally identified and six subgroups of the IOC Consensus group established to review the following aspects: (1) epidemiology/risk factors for ARill, (2) infective ARill, (3) non-infective ARill, (4) acute asthma/exercise-induced bronchoconstriction and related conditions, (5) effects of ARill on exercise/sports performance, medical complications/return-to-sport (RTS) and (6) acute nasal/laryngeal obstruction presenting as ARill. Following several reviews conducted by subgroups, the sections of the consensus documents were allocated to ‘core’ members for drafting and internal review. An advanced draft of the consensus document was discussed during a meeting of the main consensus core group, and final edits were completed prior to submission of the manuscript. This document (part 2) of this consensus focuses on respiratory conditions causing non-infective ARill in athletes. These include non-inflammatory obstructive nasal, laryngeal, tracheal or bronchial conditions or non-infective inflammatory conditions of the respiratory epithelium that affect the upper and/or lower airways, frequently as a continuum. The following aspects of more common as well as lesser-known non-infective ARill in athletes are reviewed: epidemiology, risk factors, pathology/pathophysiology, clinical presentation and diagnosis, management, prevention, medical considerations and risks of illness during exercise, effects of illness on exercise/sports performance and RTS guidelines.

  • respiratory system
  • consensus

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  • Contributors All authors confirmed the final version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

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