AIRWAY INFLAMMATION, BRONCHIAL HYPERRESPONSIVENESS, AND ASTHMA IN ELITE ICE HOCKEY PLAYERS

Abstract

PURPOSE Investigate the occurrence and characteristics of airway inflammation, bronchial hyperresponsiveness, and asthma in elite ice hockey players. METHODS We examined 88 players and 47 control subjects (mean ages 18 and 27 years). Athletes were from three junior, national league ice hockey teams in Helsinki (participation rate 86%). Mean duration of active sports career was 11 years and mean training time 580h/year. Patients were clinically examined, skin prick tested, filled in a respiratory symptom questionnaire, performed spirometry and histamine challenge test, gave induced sputum samples. The study was approved by local ethics committee, and all patients gave their written informed consent. RESULTS Bronchial hyperresponsiveness in a histamine challenge test was found in 21 (24%) of the athletes and in 5 (11%) of the control subjects (NS). Current asthma (asthmatic symptoms and bronchial hyperresponsiveness) was observed in 13 (15%) of the athletes and in 1 (2%) of the control subjects (p = 0.033). Total asthma (current or previously physician diagnosed asthma) occurred in 22% (19/88) of the athletes and in 4% (2/47) of the controls (p = 0.011). Atopy according to skin prick tests was observed in 51 (58%) of the athletes and in 17 (36%) of the control subjects (p = 0.025). The differential cell counts of eosinophils (2.6% vs 0.2%) and neutrophils (80.9% vs 29.9%) in the sputum samples of the athletes were significantly higher than in those of the control subjects (p = 0.039 and p <0.001, respectively). CONCLUSION Asthma is more common in elite ice hockey players than in control subjects. Ice hockey players showed signs of a mixed type of neutrophilic and eosinophilic airway inflammation. Inhalation of cold air associated with carbon and nitrogen oxides exposure during intensive training may enhance airway inflammation and symptoms. Supported by MSD, Väinö and Laina Kivi Foundation, Ida Montin Foundation, Allergy Research Foundation