Effects of chlorine and exercise on the unified airway in adolescent elite Scottish swimmers

TY - JOUR

T1 - Effects of chlorine and exercise on the unified airway in adolescent elite Scottish swimmers

AU - Clearie, K. L.

AU - Vaidyanathan, S.

AU - Williamson, P. A.

AU - Goudie, A.

AU - Short, P.

AU - Schembri, S.

AU - Lipworth, Brian

PY - 2010/2

Y1 - 2010/2

N2 - P>Background:Chlorine metabolites and high training load may produce exercise-induced bronchospasm (EIB) in elite swimmers. The aim of this study was to assess the combined effects of chlorine and exercise on the unified airway of adolescent elite swimmers.Methods:The Scottish Midlands District squad were assessed during an indoor pool session at the National Swimming Academy. Athletes trained at least 8 h per week. Subjects underwent tidal (T-NO) and nasal (N-NO) exhaled NO and peak nasal inspiratory flow (PNIF) pre and post a 2 h session. A physiological exercise challenge assessed EIB in n = 36 swimmers (> 10% fall in forced expiratory volume in 1 s (FEV1)).Results:Combined and free chlorine levels (mg/l) were 1.66 and 0.3 respectively. n = 36 swimmers (mean age 13.3 years) were assessed: n = 8 (22%) had known asthma; n = 13 (36%) had a positive physiological challenge; 18 (50%) complained of symptoms suggestive of EIB. n = 10/28 (36%) who did not have asthma were found to have a positive exercise challenge. There was no significant association between reported exercise symptoms and positive exercise test. There was no significant change in T-NO or N-NO for pre vs postexposure, irrespective of asthma diagnosis or AHR. n = 15 (42%) swimmers complained of worsening nasal symptoms postexposure, but only n = 7 (14%) had a demonstrable fall in PNIF (mean 33 l/min). No significant association was found between PNIF and symptoms.Conclusions:Combined exposure to chlorine and exercise did not affect surrogate markers of inflammation in the unified airway. There was a high prevalence of undiagnosed EIB.

AB - P>Background:Chlorine metabolites and high training load may produce exercise-induced bronchospasm (EIB) in elite swimmers. The aim of this study was to assess the combined effects of chlorine and exercise on the unified airway of adolescent elite swimmers.Methods:The Scottish Midlands District squad were assessed during an indoor pool session at the National Swimming Academy. Athletes trained at least 8 h per week. Subjects underwent tidal (T-NO) and nasal (N-NO) exhaled NO and peak nasal inspiratory flow (PNIF) pre and post a 2 h session. A physiological exercise challenge assessed EIB in n = 36 swimmers (> 10% fall in forced expiratory volume in 1 s (FEV1)).Results:Combined and free chlorine levels (mg/l) were 1.66 and 0.3 respectively. n = 36 swimmers (mean age 13.3 years) were assessed: n = 8 (22%) had known asthma; n = 13 (36%) had a positive physiological challenge; 18 (50%) complained of symptoms suggestive of EIB. n = 10/28 (36%) who did not have asthma were found to have a positive exercise challenge. There was no significant association between reported exercise symptoms and positive exercise test. There was no significant change in T-NO or N-NO for pre vs postexposure, irrespective of asthma diagnosis or AHR. n = 15 (42%) swimmers complained of worsening nasal symptoms postexposure, but only n = 7 (14%) had a demonstrable fall in PNIF (mean 33 l/min). No significant association was found between PNIF and symptoms.Conclusions:Combined exposure to chlorine and exercise did not affect surrogate markers of inflammation in the unified airway. There was a high prevalence of undiagnosed EIB.

KW - Bronchial challenge

KW - Exercise-induced asthma

KW - Nitric oxide

KW - Rhinitis

KW - Exhaled nitric oxide

KW - Induced asthma

KW - Bronchial responsiveness

KW - Rhinitis

KW - Inflammation

KW - Diagnosis

KW - Symptoms

KW - Sputum

U2 - 10.1111/j.1398-9995.2009.02173.x

DO - 10.1111/j.1398-9995.2009.02173.x

M3 - Article

C2 - 19793061

SN - 0105-4538

VL - 65

SP - 269

EP - 273

JO - Allergy

JF - Allergy

IS - 2

ER -