Unrecognized exercise-induced bronchospasm in adolescent athletes
N. T. Rupp, M. F. Guill and D. S. Brudno
Department of Pediatrics, Medical College of Georgia, Augusta 30912.
OBJECTIVE--As part of their preparticipation physical examinations, 1241
middle and high school student athletes completed a questionnaire and were
interviewed to elicit risk factors for unrecognized exercise-induced
bronchospasm (EIB). Spirometry was then performed when the students were at
rest. RESEARCH DESIGN--All participants completed a questionnaire, were
interviewed, and underwent baseline testing to determine forced expiratory
volume in 1 second (FEV1). SETTING--All testing was performed in a school
setting. SELECTION PROCEDURES--Athletes known to have EIB who were
receiving appropriate treatment (46 athletes [4%]) and athletes with no
risk factors based on medical history and normal results of spirometry (847
athletes [68%]) were eliminated from further evaluation. Students with
medical histories indicating risk of unrecognized EIB and students with
abnormal results of spirometry were eligible for exercise challenge by
standard treadmill protocol. MEASUREMENTS AND RESULTS--Of the 348 eligible
students, 230 (66%) completed the exercise challenge. Sixty-six of the 230
students had greater than 15% reduction in FEV1, and 50 of the 66 students
had greater than 20% reduction, representing a 29% occurrence of previously
undiagnosed EIB in a population of students identified with screening to be
at risk of unrecognized EIB. Of the 179 students identified to be at risk
based on medical history only, 28% had EIB. Of 33 students with positive
results of spirometry but no medical history that put them at risk, 15% had
EIB. Of the 18 students with medical histories that put them at risk and
positive results of spirometry, 61% had EIB. Including the subpopulation
with reduction in FEV1 of greater than 15%, students shown to be at risk
after screening, and students previously identified as having EIB, 145
students were identified as having EIB (12%). CONCLUSIONS--These data are
in accord with results of previously reported studies of college and
Olympic athletes. The data may have implications for more extensive
screening in the adolescent population.
