Respiratory health of elite athletes – preventing airway injury: a critical review
Identifieur interne : 000F05 ( Istex/Corpus ); précédent : 000F04; suivant : 000F06Respiratory health of elite athletes – preventing airway injury: a critical review
Auteurs : Pascale Kippelen ; Kenneth D. Fitch ; Sandra Doreen Anderson ; Valerie Bougault ; Louis-Philippe Boulet ; Kenneth William Rundell ; Malcolm Sue-Chu ; Donald C. MckenzieSource :
- British Journal of Sports Medicine [ 0306-3674 ] ; 2012-06.
English descriptors
- KwdEn :
- Acute effects, Airborne pollutants, Airway, Airway cooling, Airway dysfunction, Airway epithelial cells, Airway epithelial injury, Airway epithelium, Airway hyperresponsiveness, Airway injury, Airway surface, Allergy, Allergy clin immunol, Animal studies, Antioxidant, Antioxidant supplementation, Antioxidant supplements, Appl physiol, Arterial hypoxemia, Asthma, Athlete, Bronchial hyperresponsiveness, Bronchial responsiveness, Bronchoconstriction, Brunel university, Chlorinated, Clin, Cold environment, Competition rules, Critical review, Dehydration, Dehydration stress, Dysfunction, Elite athletes, Elite endurance athletes, Elite swimmers, Environmental factors, Epithelial, Epithelial cells, Epithelium, Exerc, Experimental data, February, Federation internationale, Functional changes, Gure skaters, High levels, High prevalence, High ventilation, Hockey players, Hyperresponsiveness, Immune system, Immunol, Indoor chlorinated, Inhal toxicol, Inhalation, Inhaled, Inhaled corticosteroids, Inspiratory stridor, Intense training, Intermittent exercises, January, Lung function, Murine model, Nasal breathing, Nitrogen trichloride, Noxious agents, Olympic athletes, Online, Oxidative stress, Particulate matter, Pharmacological agents, Physical forces, Physiol, Pollutant, Pool water, Prevention strategies, Protective effect, Pulmonary function, Respir, Respir crit care, Respiratory symptoms, Respiratory tract infection, Rhinitis, Rundell, Serum pneumoproteins, Skier, Sports exerc, Sports medicine, Supplementation, Susceptible athletes, Swimmer, Synchronised swimmers, Toxicol, Training schedules, Uorine particles, Vocal cord dysfunction, Water content, Water loss, Western australia, Wind chill factor, Young athletes.
- Teeft :
- Acute effects, Airborne pollutants, Airway, Airway cooling, Airway dysfunction, Airway epithelial cells, Airway epithelial injury, Airway epithelium, Airway hyperresponsiveness, Airway injury, Airway surface, Allergy, Allergy clin immunol, Animal studies, Antioxidant, Antioxidant supplementation, Antioxidant supplements, Appl physiol, Arterial hypoxemia, Asthma, Athlete, Bronchial hyperresponsiveness, Bronchial responsiveness, Bronchoconstriction, Brunel university, Chlorinated, Clin, Cold environment, Competition rules, Critical review, Dehydration, Dehydration stress, Dysfunction, Elite athletes, Elite endurance athletes, Elite swimmers, Environmental factors, Epithelial, Epithelial cells, Epithelium, Exerc, Experimental data, February, Federation internationale, Functional changes, Gure skaters, High levels, High prevalence, High ventilation, Hockey players, Hyperresponsiveness, Immune system, Immunol, Indoor chlorinated, Inhal toxicol, Inhalation, Inhaled, Inhaled corticosteroids, Inspiratory stridor, Intense training, Intermittent exercises, January, Lung function, Murine model, Nasal breathing, Nitrogen trichloride, Noxious agents, Olympic athletes, Online, Oxidative stress, Particulate matter, Pharmacological agents, Physical forces, Physiol, Pollutant, Pool water, Prevention strategies, Protective effect, Pulmonary function, Respir, Respir crit care, Respiratory symptoms, Respiratory tract infection, Rhinitis, Rundell, Serum pneumoproteins, Skier, Sports exerc, Sports medicine, Supplementation, Susceptible athletes, Swimmer, Synchronised swimmers, Toxicol, Training schedules, Uorine particles, Vocal cord dysfunction, Water content, Water loss, Western australia, Wind chill factor, Young athletes.
Abstract
Elite athletes, particularly those engaged in endurance sports and those exposed chronically to airborne pollutants/irritants or allergens, are at increased risk for upper and lower airway dysfunction. Airway epithelial injury may be caused by dehydration and physical stress applied to the airways during severe exercise hyperpnoea and/or by inhalation of noxious agents. This is thought to initiate an inflammatory cascade/repair process that, ultimately, could lead to airway hyperresponsiveness (AHR) and asthma in susceptible athletes. The authors review the evidence relating to prevention or reduction of the risk of AHR/asthma development. Appropriate measures should be implemented when athletes exercise strenuously in an attempt to attenuate the dehydration stress and reduce the exposure to noxious airborne agents. Environmental interventions are the most important. Non-pharmacological strategies can assist, but currently, pharmacological measures have not been demonstrated to be effective. Whether early prevention of airway injury in elite athletes can prevent or reduce progression to AHR/asthma remains to be established.
Url:
DOI: 10.1136/bjsports-2012-091056
Links to Exploration step
ISTEX:4F7EC469790D0AA3F9C581D2FF08D4A800C795E2Le document en format XML
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Mckenzie</name><affiliation><mods:affiliation>Division of Sports Medicine, School of Human Kinetics, University of British Columbia, Vancouver, Canada</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">British Journal of Sports Medicine</title><title level="j" type="abbrev">Br J Sports Med</title><idno type="ISSN">0306-3674</idno><idno type="eISSN">1473-0480</idno><imprint><publisher>BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine</publisher><date type="published" when="2012-06">2012-06</date><biblScope unit="volume">46</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="471">471</biblScope></imprint><idno type="ISSN">0306-3674</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0306-3674</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acute effects</term><term>Airborne pollutants</term><term>Airway</term><term>Airway 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factors</term><term>Epithelial</term><term>Epithelial cells</term><term>Epithelium</term><term>Exerc</term><term>Experimental data</term><term>February</term><term>Federation internationale</term><term>Functional changes</term><term>Gure skaters</term><term>High levels</term><term>High prevalence</term><term>High ventilation</term><term>Hockey players</term><term>Hyperresponsiveness</term><term>Immune system</term><term>Immunol</term><term>Indoor chlorinated</term><term>Inhal toxicol</term><term>Inhalation</term><term>Inhaled</term><term>Inhaled corticosteroids</term><term>Inspiratory stridor</term><term>Intense training</term><term>Intermittent exercises</term><term>January</term><term>Lung function</term><term>Murine model</term><term>Nasal breathing</term><term>Nitrogen trichloride</term><term>Noxious agents</term><term>Olympic athletes</term><term>Online</term><term>Oxidative stress</term><term>Particulate matter</term><term>Pharmacological agents</term><term>Physical forces</term><term>Physiol</term><term>Pollutant</term><term>Pool water</term><term>Prevention strategies</term><term>Protective effect</term><term>Pulmonary function</term><term>Respir</term><term>Respir crit care</term><term>Respiratory symptoms</term><term>Respiratory tract infection</term><term>Rhinitis</term><term>Rundell</term><term>Serum pneumoproteins</term><term>Skier</term><term>Sports exerc</term><term>Sports medicine</term><term>Supplementation</term><term>Susceptible athletes</term><term>Swimmer</term><term>Synchronised swimmers</term><term>Toxicol</term><term>Training schedules</term><term>Uorine particles</term><term>Vocal cord dysfunction</term><term>Water content</term><term>Water loss</term><term>Western australia</term><term>Wind chill factor</term><term>Young athletes</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Acute effects</term><term>Airborne pollutants</term><term>Airway</term><term>Airway cooling</term><term>Airway dysfunction</term><term>Airway epithelial cells</term><term>Airway epithelial injury</term><term>Airway epithelium</term><term>Airway hyperresponsiveness</term><term>Airway injury</term><term>Airway surface</term><term>Allergy</term><term>Allergy clin immunol</term><term>Animal studies</term><term>Antioxidant</term><term>Antioxidant supplementation</term><term>Antioxidant supplements</term><term>Appl physiol</term><term>Arterial hypoxemia</term><term>Asthma</term><term>Athlete</term><term>Bronchial hyperresponsiveness</term><term>Bronchial responsiveness</term><term>Bronchoconstriction</term><term>Brunel university</term><term>Chlorinated</term><term>Clin</term><term>Cold environment</term><term>Competition rules</term><term>Critical review</term><term>Dehydration</term><term>Dehydration stress</term><term>Dysfunction</term><term>Elite athletes</term><term>Elite endurance athletes</term><term>Elite swimmers</term><term>Environmental factors</term><term>Epithelial</term><term>Epithelial cells</term><term>Epithelium</term><term>Exerc</term><term>Experimental data</term><term>February</term><term>Federation internationale</term><term>Functional changes</term><term>Gure skaters</term><term>High levels</term><term>High prevalence</term><term>High ventilation</term><term>Hockey players</term><term>Hyperresponsiveness</term><term>Immune system</term><term>Immunol</term><term>Indoor chlorinated</term><term>Inhal toxicol</term><term>Inhalation</term><term>Inhaled</term><term>Inhaled corticosteroids</term><term>Inspiratory stridor</term><term>Intense training</term><term>Intermittent exercises</term><term>January</term><term>Lung function</term><term>Murine model</term><term>Nasal breathing</term><term>Nitrogen trichloride</term><term>Noxious agents</term><term>Olympic athletes</term><term>Online</term><term>Oxidative stress</term><term>Particulate matter</term><term>Pharmacological agents</term><term>Physical forces</term><term>Physiol</term><term>Pollutant</term><term>Pool water</term><term>Prevention strategies</term><term>Protective effect</term><term>Pulmonary function</term><term>Respir</term><term>Respir crit care</term><term>Respiratory symptoms</term><term>Respiratory tract infection</term><term>Rhinitis</term><term>Rundell</term><term>Serum pneumoproteins</term><term>Skier</term><term>Sports exerc</term><term>Sports medicine</term><term>Supplementation</term><term>Susceptible athletes</term><term>Swimmer</term><term>Synchronised swimmers</term><term>Toxicol</term><term>Training schedules</term><term>Uorine particles</term><term>Vocal cord dysfunction</term><term>Water content</term><term>Water loss</term><term>Western australia</term><term>Wind chill factor</term><term>Young athletes</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Elite athletes, particularly those engaged in endurance sports and those exposed chronically to airborne pollutants/irritants or allergens, are at increased risk for upper and lower airway dysfunction. Airway epithelial injury may be caused by dehydration and physical stress applied to the airways during severe exercise hyperpnoea and/or by inhalation of noxious agents. This is thought to initiate an inflammatory cascade/repair process that, ultimately, could lead to airway hyperresponsiveness (AHR) and asthma in susceptible athletes. The authors review the evidence relating to prevention or reduction of the risk of AHR/asthma development. Appropriate measures should be implemented when athletes exercise strenuously in an attempt to attenuate the dehydration stress and reduce the exposure to noxious airborne agents. Environmental interventions are the most important. Non-pharmacological strategies can assist, but currently, pharmacological measures have not been demonstrated to be effective. Whether early prevention of airway injury in elite athletes can prevent or reduce progression to AHR/asthma remains to be established.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>airway</json:string><json:string>airway injury</json:string><json:string>asthma</json:string><json:string>allergy</json:string><json:string>elite athletes</json:string><json:string>swimmer</json:string><json:string>epithelial</json:string><json:string>dysfunction</json:string><json:string>clin</json:string><json:string>immunol</json:string><json:string>epithelium</json:string><json:string>hyperresponsiveness</json:string><json:string>airway epithelium</json:string><json:string>bronchoconstriction</json:string><json:string>respir</json:string><json:string>inhaled</json:string><json:string>pollutant</json:string><json:string>online</json:string><json:string>allergy clin 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pollutants</json:string><json:string>lung function</json:string><json:string>nitrogen trichloride</json:string><json:string>nasal breathing</json:string><json:string>bronchial hyperresponsiveness</json:string><json:string>water content</json:string><json:string>prevention strategies</json:string><json:string>antioxidant supplementation</json:string><json:string>respir crit care</json:string><json:string>high prevalence</json:string><json:string>murine model</json:string><json:string>airway epithelial injury</json:string><json:string>sports medicine</json:string><json:string>bronchial responsiveness</json:string><json:string>vocal cord dysfunction</json:string><json:string>water loss</json:string><json:string>federation internationale</json:string><json:string>wind chill factor</json:string><json:string>pool water</json:string><json:string>high ventilation</json:string><json:string>experimental data</json:string><json:string>particulate matter</json:string><json:string>elite swimmers</json:string><json:string>uorine particles</json:string><json:string>animal studies</json:string><json:string>respiratory tract infection</json:string><json:string>intermittent exercises</json:string><json:string>inhaled corticosteroids</json:string><json:string>oxidative stress</json:string><json:string>brunel university</json:string><json:string>gure skaters</json:string><json:string>training schedules</json:string><json:string>protective effect</json:string><json:string>young athletes</json:string><json:string>physical forces</json:string><json:string>critical review</json:string><json:string>airway epithelial cells</json:string><json:string>western australia</json:string><json:string>airway cooling</json:string><json:string>epithelial cells</json:string><json:string>olympic athletes</json:string><json:string>inspiratory stridor</json:string><json:string>respiratory symptoms</json:string><json:string>antioxidant supplements</json:string><json:string>intense training</json:string><json:string>immune system</json:string><json:string>indoor chlorinated</json:string><json:string>high levels</json:string><json:string>environmental factors</json:string><json:string>arterial hypoxemia</json:string><json:string>functional changes</json:string><json:string>cold environment</json:string><json:string>airway surface</json:string><json:string>pharmacological agents</json:string><json:string>competition rules</json:string><json:string>serum pneumoproteins</json:string><json:string>synchronised swimmers</json:string><json:string>acute effects</json:string><json:string>elite endurance athletes</json:string></teeft></keywords><author><json:item><name>Pascale Kippelen</name><affiliations><json:string>Centre for Sports Medicine & Human Performance, Brunel University, Uxbridge, UK</json:string></affiliations></json:item><json:item><name>Kenneth D Fitch</name><affiliations><json:string>School of Sports Science, Exercise and Health, Faculty of Life Sciences, University of Western Australia, Crawley, Western Australia, Australia</json:string></affiliations></json:item><json:item><name>Sandra Doreen Anderson</name><affiliations><json:string>Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia</json:string></affiliations></json:item><json:item><name>Valerie Bougault</name><affiliations><json:string>Faculté des Sciences du Sport, Université Droit et Santé de Lille 2, Lille, France</json:string></affiliations></json:item><json:item><name>Louis-Philippe Boulet</name><affiliations><json:string>Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada</json:string></affiliations></json:item><json:item><name>Kenneth William Rundell</name><affiliations><json:string>Medical Affairs, Pharmaxis, Exton, Pennsylvania, USA</json:string></affiliations></json:item><json:item><name>Malcolm Sue-Chu</name><affiliations><json:string>Department of Thoracic Medicine, St Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway</json:string><json:string>Department of Circulation and Imaging, Norwegian University of Science and Technology, Trondheim, Norway</json:string></affiliations></json:item><json:item><name>Donald C McKenzie</name><affiliations><json:string>Division of Sports Medicine, School of Human Kinetics, University of British Columbia, Vancouver, Canada</json:string></affiliations></json:item></author><articleId><json:string>bjsports-2012-091056</json:string></articleId><arkIstex>ark:/67375/NVC-469DQX9K-6</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Elite athletes, particularly those engaged in endurance sports and those exposed chronically to airborne pollutants/irritants or allergens, are at increased risk for upper and lower airway dysfunction. Airway epithelial injury may be caused by dehydration and physical stress applied to the airways during severe exercise hyperpnoea and/or by inhalation of noxious agents. This is thought to initiate an inflammatory cascade/repair process that, ultimately, could lead to airway hyperresponsiveness (AHR) and asthma in susceptible athletes. The authors review the evidence relating to prevention or reduction of the risk of AHR/asthma development. Appropriate measures should be implemented when athletes exercise strenuously in an attempt to attenuate the dehydration stress and reduce the exposure to noxious airborne agents. Environmental interventions are the most important. Non-pharmacological strategies can assist, but currently, pharmacological measures have not been demonstrated to be effective. Whether early prevention of airway injury in elite athletes can prevent or reduce progression to AHR/asthma remains to be established.</abstract><qualityIndicators><score>8.872</score><pdfWordCount>5981</pdfWordCount><pdfCharCount>39496</pdfCharCount><pdfVersion>1.6</pdfVersion><pdfPageCount>6</pdfPageCount><pdfPageSize>595.277 x 793.702 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>156</abstractWordCount><abstractCharCount>1141</abstractCharCount><keywordCount>0</keywordCount></qualityIndicators><title>Respiratory health of elite athletes – preventing airway injury: a critical review</title><pmid><json:string>22522585</json:string></pmid><genre><json:string>research-article</json:string></genre><host><title>British Journal of Sports 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scheme="https://publisher-list.data.istex.fr">BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine</publisher><availability status="free"><p>Open Access</p></availability><date>2012-04-20</date></publicationStmt><notesStmt><note type="research-article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Respiratory health of elite athletes – preventing airway injury: a critical review</title><author xml:id="author-0000"><persName><forename type="first">Pascale</forename><surname>Kippelen</surname></persName><affiliation>Centre for Sports Medicine & Human Performance, Brunel University, Uxbridge, UK</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Kenneth D</forename><surname>Fitch</surname></persName><affiliation>School of Sports Science, Exercise and Health, Faculty of Life Sciences, University of Western Australia, Crawley, Western Australia, Australia</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Sandra Doreen</forename><surname>Anderson</surname></persName><affiliation>Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Valerie</forename><surname>Bougault</surname></persName><affiliation>Faculté des Sciences du Sport, Université Droit et Santé de Lille 2, Lille, France</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Louis-Philippe</forename><surname>Boulet</surname></persName><affiliation>Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada</affiliation></author><author xml:id="author-0005"><persName><forename type="first">Kenneth William</forename><surname>Rundell</surname></persName><affiliation>Medical Affairs, Pharmaxis, Exton, Pennsylvania, USA</affiliation></author><author xml:id="author-0006"><persName><forename type="first">Malcolm</forename><surname>Sue-Chu</surname></persName><affiliation>Department of Thoracic Medicine, St Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway</affiliation><affiliation>Department of Circulation and Imaging, Norwegian University of Science and Technology, Trondheim, Norway</affiliation></author><author xml:id="author-0007"><persName><forename type="first">Donald C</forename><surname>McKenzie</surname></persName><affiliation>Division of Sports Medicine, School of Human Kinetics, University of British Columbia, Vancouver, Canada</affiliation></author><idno type="istex">4F7EC469790D0AA3F9C581D2FF08D4A800C795E2</idno><idno type="ark">ark:/67375/NVC-469DQX9K-6</idno><idno type="DOI">10.1136/bjsports-2012-091056</idno><idno type="href">bjsports-46-471.pdf</idno><idno type="article-id">bjsports-2012-091056</idno><idno type="PMID">22522585</idno><idno type="local">bjsports;46/7/471</idno></analytic><monogr><title level="j">British Journal of Sports Medicine</title><title level="j" type="abbrev">Br J Sports Med</title><idno type="pISSN">0306-3674</idno><idno type="eISSN">1473-0480</idno><idno type="publisher-id">bjsm</idno><idno type="PublisherID-hwp">bjsports</idno><idno type="PublisherID-nlm-ta">Br J Sports Med</idno><imprint><publisher>BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine</publisher><date type="published" when="2012-06"></date><biblScope unit="volume">46</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="471">471</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2012-04-20</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Elite athletes, particularly those engaged in endurance sports and those exposed chronically to airborne pollutants/irritants or allergens, are at increased risk for upper and lower airway dysfunction. Airway epithelial injury may be caused by dehydration and physical stress applied to the airways during severe exercise hyperpnoea and/or by inhalation of noxious agents. This is thought to initiate an inflammatory cascade/repair process that, ultimately, could lead to airway hyperresponsiveness (AHR) and asthma in susceptible athletes. The authors review the evidence relating to prevention or reduction of the risk of AHR/asthma development. Appropriate measures should be implemented when athletes exercise strenuously in an attempt to attenuate the dehydration stress and reduce the exposure to noxious airborne agents. Environmental interventions are the most important. Non-pharmacological strategies can assist, but currently, pharmacological measures have not been demonstrated to be effective. 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name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">bjsports</journal-id><journal-id journal-id-type="nlm-ta">Br J Sports Med</journal-id><journal-id journal-id-type="publisher-id">bjsm</journal-id><journal-title>British Journal of Sports Medicine</journal-title><abbrev-journal-title abbrev-type="publisher">Br J Sports Med</abbrev-journal-title><abbrev-journal-title>Br J Sports Med</abbrev-journal-title><issn pub-type="ppub">0306-3674</issn><issn pub-type="epub">1473-0480</issn><publisher><publisher-name>BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">bjsports-2012-091056</article-id><article-id pub-id-type="doi">10.1136/bjsports-2012-091056</article-id><article-id pub-id-type="other">bjsports;46/7/471</article-id><article-id pub-id-type="other">bjsports;bjsports-2012-091056</article-id><article-id pub-id-type="pmid">22522585</article-id><article-id pub-id-type="other">471</article-id><article-id pub-id-type="other">bjsports-2012-091056</article-id><article-categories><subj-group subj-group-type="heading"><subject>Highlight papers</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Unlocked</subject></subj-group></article-categories><title-group><article-title>Respiratory health of elite athletes – preventing airway injury: a critical review</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kippelen</surname><given-names>Pascale</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Fitch</surname><given-names>Kenneth D</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Anderson</surname><given-names>Sandra Doreen</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Bougault</surname><given-names>Valerie</given-names></name><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Boulet</surname><given-names>Louis-Philippe</given-names></name><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Rundell</surname><given-names>Kenneth William</given-names></name><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><name><surname>Sue-Chu</surname><given-names>Malcolm</given-names></name><xref ref-type="aff" rid="A7">7</xref><xref ref-type="aff" rid="A8">8</xref></contrib><contrib contrib-type="author"><name><surname>McKenzie</surname><given-names>Donald C</given-names></name><xref ref-type="aff" rid="A9">9</xref></contrib></contrib-group><aff id="A1"><label>1</label>Centre for Sports Medicine & Human Performance, Brunel University, Uxbridge, UK</aff><aff id="A2"><label>2</label>School of Sports Science, Exercise and Health, Faculty of Life Sciences, University of Western Australia, Crawley, Western Australia, Australia</aff><aff id="A3"><label>3</label>Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia</aff><aff id="A4"><label>4</label>Faculté des Sciences du Sport, Université Droit et Santé de Lille 2, Lille, France</aff><aff id="A5"><label>5</label>Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada</aff><aff id="A6"><label>6</label>Medical Affairs, Pharmaxis, Exton, Pennsylvania, USA</aff><aff id="A7"><label>7</label>Department of Thoracic Medicine, St Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway</aff><aff id="A8"><label>8</label>Department of Circulation and Imaging, Norwegian University of Science and Technology, Trondheim, Norway</aff><aff id="A9"><label>9</label>Division of Sports Medicine, School of Human Kinetics, University of British Columbia, Vancouver, Canada</aff><author-notes><corresp><label>Correspondence to</label> Pascale Kippelen, Brunel University, Centre for Sports Medicine & Human Performance, Uxbridge UB8 3PH, UK; <email xlink:type="simple">pascale.kippelen@brunel.ac.uk</email></corresp></author-notes><pub-date pub-type="ppub"><month>6</month><year>2012</year></pub-date><pub-date pub-type="epub-original"><day>29</day><month>4</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>20</day><month>4</month><year>2012</year></pub-date><volume>46</volume><volume-id pub-id-type="other">46</volume-id><volume-id pub-id-type="other">46</volume-id><issue>7</issue><issue-id pub-id-type="other">bjsports;46/7</issue-id><issue-id pub-id-type="other">7</issue-id><issue-id pub-id-type="other">46/7</issue-id><fpage>471</fpage><history><date date-type="received"><day>9</day><month>2</month><year>2011</year></date><date date-type="accepted"><day>6</day><month>3</month><year>2012</year></date></history><permissions><copyright-statement>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement><copyright-year>2012</copyright-year><license license-type="open-access"><p>This paper is freely available online under the BMJ Journals unlocked scheme, see <ext-link xlink:href="http://bjsm.bmj.com/info/unlocked.dtl" ext-link-type="uri">http://bjsm.bmj.com/info/unlocked.dtl</ext-link></p></license></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="bjsports-46-471.pdf"></self-uri><abstract><p>Elite athletes, particularly those engaged in endurance sports and those exposed chronically to airborne pollutants/irritants or allergens, are at increased risk for upper and lower airway dysfunction. Airway epithelial injury may be caused by dehydration and physical stress applied to the airways during severe exercise hyperpnoea and/or by inhalation of noxious agents. This is thought to initiate an inflammatory cascade/repair process that, ultimately, could lead to airway hyperresponsiveness (AHR) and asthma in susceptible athletes. The authors review the evidence relating to prevention or reduction of the risk of AHR/asthma development. Appropriate measures should be implemented when athletes exercise strenuously in an attempt to attenuate the dehydration stress and reduce the exposure to noxious airborne agents. Environmental interventions are the most important. Non-pharmacological strategies can assist, but currently, pharmacological measures have not been demonstrated to be effective. Whether early prevention of airway injury in elite athletes can prevent or reduce progression to AHR/asthma remains to be established.</p></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Respiratory health of elite athletes – preventing airway injury: a critical review</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Respiratory health of elite athletes – preventing airway injury: a critical review</title></titleInfo><name type="personal"><namePart type="given">Pascale</namePart><namePart type="family">Kippelen</namePart><affiliation>Centre for Sports Medicine & Human Performance, Brunel University, Uxbridge, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kenneth D</namePart><namePart type="family">Fitch</namePart><affiliation>School of Sports Science, Exercise and Health, Faculty of Life Sciences, University of Western Australia, Crawley, Western Australia, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sandra Doreen</namePart><namePart type="family">Anderson</namePart><affiliation>Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Valerie</namePart><namePart type="family">Bougault</namePart><affiliation>Faculté des Sciences du Sport, Université Droit et Santé de Lille 2, Lille, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Louis-Philippe</namePart><namePart type="family">Boulet</namePart><affiliation>Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kenneth William</namePart><namePart type="family">Rundell</namePart><affiliation>Medical Affairs, Pharmaxis, Exton, Pennsylvania, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Malcolm</namePart><namePart type="family">Sue-Chu</namePart><affiliation>Department of Thoracic Medicine, St Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway</affiliation><affiliation>Department of Circulation and Imaging, Norwegian University of Science and Technology, Trondheim, Norway</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Donald C</namePart><namePart type="family">McKenzie</namePart><affiliation>Division of Sports Medicine, School of Human Kinetics, University of British Columbia, Vancouver, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine</publisher><dateIssued encoding="w3cdtf">2012-06</dateIssued><dateCreated encoding="w3cdtf">2012-04-20</dateCreated><copyrightDate encoding="w3cdtf">2012</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract>Elite athletes, particularly those engaged in endurance sports and those exposed chronically to airborne pollutants/irritants or allergens, are at increased risk for upper and lower airway dysfunction. 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