This section attempts to explain the increased occurrence of asthma and bronchial hyperresponsiveness among elite athletes, and give information about recommended treatment and testing regulations.

Exercise-induced asthma and bronchial hyperresponsiveness (BHR) have become increasingly common in top athletes, particularly those who compete in endurance sports. BHR is a measure of how easily the airways constrict or become narrow in response to different stimuli such as: physical exercise; viral infections; smells and cold or dry air.

The widespread use of asthma drugs, particularly inhaled β2-agonists, among top athletes has led the International Olympic Committee Medical Commission (IOC-MC) and the World Anti-Doping Association (WADA) to restrict their use to athletes who have been diagnosed with asthma and show evidence of BHR.

Elite athletes may have had asthma since childhood or they may have developed asthma and BHR since becoming active in sports. Asthma and BHR occur most often in endurance sports such as cross-country skiing, biathlon and swimming, particularly in older athletes.

Endurance sports require a high level of fitness and stamina to enable the body to keep exercising for a long time. As you exercise, your breathing will get faster to ensure the body has enough oxygen to keep going. Athletes may inhale potentially harmful substances in the air, depending on the environment, which may cause asthma symptoms or damage the lungs directly.

Treatment and approval of medication

If you are an elite athlete competing at an Olympic or professional level, you must ensure that your current treatment is permitted by authorities. If you experience asthma symptoms and suspect that you need treatment, visit your doctor and ensure you are treated within the current guidelines.