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Impact of changes in the International Olympic Committee Medical

Impact of changes in the International Olympic Committee Medical. Prevalence of astma in Olympic atletes - between 9% and 55% High in winter sport athletes and swimmers IOCMC criteria for diagnosis of asthma: positive bronchodilator response to inhaled B-2 agonists

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Impact of changes in the International Olympic Committee Medical

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  1. Impact of changes in the International Olympic Committee Medical • Prevalence of astma in Olympic atletes - between 9% and 55% • High in winter sport athletes and swimmers • IOCMC criteria for diagnosis of asthma: • positive bronchodilator response to inhaled B-2 agonists • fall of FEV 1 more than 1O% after exercise or eucapnic voluntary hyperpnea Commission (IOCMC) Criteria for Astma

  2. False negative results • Cough equivalent of asthma without airway obstruction (underlying upper or lower airway inflammation, increased respiratory heat exchange) • Intense hyperventilation-increased stimulation of sensory nerve endings (cold air,enviromental pollutants, chlorine in swimmers) • Variability over time - intercurrent allergen exposure-timing of the test crucial

  3. False positive results • Asymptomatic airway hyperresponsiveness(Rundel,2001- 26% positive results,only 39% of them symptoms of asthma) • Overuse of bronchodilators in Olympic athletes • Progressive increase of B-2 agonists use since 1980 • Alaranta,2004- Finnish olympic athletes-7,4 % using B-2 agonists,nonasthmatics-3,0 % • Shaaban,2007-protective effect of physical activity against bronchial hyperreactivity • Bonsignore,2008-casual relationship between endurance exercise and low BHR-probably mediated by ventilation at increased lung volumes • increased number of neutrophils in induced sputum in runners(no activation observed) • marathon runners- response to methacholine inhalation blunted shortly after the race

  4. Conclusion Objective measurement of variable airflow obstruction in athletes (bronchodilatation tests) needed to prevent non-indicated use of asthma drugs Exploration of relationships between high level exercise and asthma and various consequences of intensive training in athletes (noninvasive measures of airway inflammation) Reconsider beneficial effects of regular exercise as a strategy to preserve respiratory health

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