High incidence rate of asthma among elite endurance athletes: a prospective 4-year survey

Objective: The prevalence of asthma among elite endurance athletes is high, but less is known about the incidence of asthma among athletes. The aim of this study was to examine the incidence rate of physician-diagnosed asthma among elite endurance athletes. Method: An annual postal questionnaire was sent to an open prospective cohort of elite endurance athletes between 2011 and 2015. Athletes from Swedish National teams, students at universities with elite sport partnership, and pupils at Swedish National elite sport schools, competing in cross-country skiing, biathlon, ski orienteering, or orienteering were invited (n = 666). Incidence rate of physician-diagnosed asthma was calculated among those without asthma at baseline (n = 449). Risk factors for incident physician-diagnosed asthma were identified using a multivariate logistic regression analysis. Results: Response rate was 88.7% (n = 591) at baseline. The median age of participants was 17 (range 15–36) years at inclusion. The study population included 407 (69%) skiers and 184 (31%) orienteers. The prevalence of asthma at baseline was 23.9% (n = 141). Incidence rate (95% confidence interval [CI]) of physician-diagnosed asthma was 61.2 (45.7–80.3) per 1,000 person-years. Risk factors (odds ratio [OR (95% CI)]) for incident physician-diagnosed asthma were family history of asthma (1.97 [1.04–3.68]), being a skier (3.01 [1.42–7.21]), and wheezing without having a cold (4.15 [1.81–9.26]). Conclusion: The incidence rate of physician-diagnosed asthma is high among Swedish elite endurance athletes.</p

Supplemental_Table_1_SS_pek_190510 – Supplemental material for The impact of comorbidities on mortality among men and women with COPD: report from the OLIN COPD study

Supplemental material, Supplemental_Table_1_SS_pek_190510 for The impact of comorbidities on mortality among men and women with COPD: report from the OLIN COPD study by Sami Sawalha, Linnea Hedman, Helena Backman, Nikolai Stenfors, Eva Rönmark, Bo Lundbäck and Anne Lindberg in Therapeutic Advances in Respiratory Disease</p

Author_response_v.1 – Supplemental material for The impact of comorbidities on mortality among men and women with COPD: report from the OLIN COPD study

Supplemental material, Author_response_v.1 for The impact of comorbidities on mortality among men and women with COPD: report from the OLIN COPD study by Sami Sawalha, Linnea Hedman, Helena Backman, Nikolai Stenfors, Eva Rönmark, Bo Lundbäck and Anne Lindberg in Therapeutic Advances in Respiratory Disease</p

Reviewer_2,_v.1. – Supplemental material for The impact of comorbidities on mortality among men and women with COPD: report from the OLIN COPD study

Supplemental material, Reviewer_2,_v.1. for The impact of comorbidities on mortality among men and women with COPD: report from the OLIN COPD study by Sami Sawalha, Linnea Hedman, Helena Backman, Nikolai Stenfors, Eva Rönmark, Bo Lundbäck and Anne Lindberg in Therapeutic Advances in Respiratory Disease</p

Reviewer_1,_v.1 – Supplemental material for The impact of comorbidities on mortality among men and women with COPD: report from the OLIN COPD study

Supplemental material, Reviewer_1,_v.1 for The impact of comorbidities on mortality among men and women with COPD: report from the OLIN COPD study by Sami Sawalha, Linnea Hedman, Helena Backman, Nikolai Stenfors, Eva Rönmark, Bo Lundbäck and Anne Lindberg in Therapeutic Advances in Respiratory Disease</p

Neutrophil responses in the proximal (bronchial wash) and distal (bronchoalveolar lavage) airway lumen, as well as the epithelium and submucosa of the bronchial airway in healthy subjects exposed to air and ozone.

<p>Data are given as means with standard deviation and comparisons of the post air and ozone neutrophil numbers at each time point were performed using a paired t-test. </p

Peripheral blood total leukocyte and neutrophil numbers at 1.5, 6 and 18 hours post air and ozone challenge.

<p>Data are illustrated as means with standard deviations. Comparisons of cell numbers post air and ozone challenge were performed using a paired t-test.</p

Cartoon of the exposure protocol employed in the current study, with three separate groups undergoing blood and bronchoscopy-based sampling at various times post a standardised two hour filtered air and ozone exposure.

<p>Cartoon of the exposure protocol employed in the current study, with three separate groups undergoing blood and bronchoscopy-based sampling at various times post a standardised two hour filtered air and ozone exposure.</p

Significant associations (Pearson correlation) between the observed systemic neutrophil response at 1.5, 6 and 18 hour post-exposure (parameter post ozone minus that post air) with that observed in the airway lumen (sampled by BW), the bronchial airway epithelium and submucosa at the equivalent sampling time point.

<p>The Pearson correlation coefficient (r) and the 2-tailed significance (P) for each association is illustrated together with a linear regression through the data.</p

Percentage (mean ± SD) of blood vessels immunostaining for P-selectin and ICAM in the submucosa of bronchial biopsies obtained 1.5, 6 and 18 hours after the end of a 2 hour exposure to air and 0.2 ppm ozone.

<p>Comparison of the extent of immunoreactivity was performed using a Students paired t-test.</p