Asthma in Finnish competitive cross-country skiers

Mäki-Heikkilä Rikhard¹, Karjalainen Jussi^1,2, Parkkari Jari³,
Valtonen Maarit⁴, Lehtimäki Lauri^1,2

¹Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; ²Allergy Centre, Tampere University Hospital, Tampere, Finland; ³Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland; ⁴KIHU – Research Institute for Olympic Sports, Jyväskylä, Finland

Cross-country skiing causes strain in the airways and athletes train and compete in cold and dry conditions during the winter. The aim of this postal questionnaire was to investigate the prevalence of asthma, use of asthma medication and asthma control in Finnish cross-country skiers competing at national level.

A postal questionnaire was sent in May 2019 to all cross-country skiers who had enrolled in national championships at age categories 13–40 years (n=1282). The response rate was 27 % (n=351) and 58 % of the responders were women. The mean age was 18.8 (SD 6.1) years.

The prevalence of asthma was 26 % in the whole responder population and 56 % in the most successful quartile of skiers. Any use of asthma medication was reported by 35 % of the skiers. Of skiers with asthma, 82 % used inhaled corticosteroids regularly while 60 % and 35 % of them used short-acting bronchodilators pre-emptively before exercise or only after having symptoms, respectively. Of skiers with no asthma diagnosis, 13 % used asthma medication, mostly short-acting bronchodilators before exercise or during infections. In skiers with asthma, mean Asthma Control Test score was 22.2, (SD 2.0) and 89 % had ACT ≥ 20. The peak incidence age of asthma onset was between 12 and 18 years of age.

Asthma is more prevalent and diagnosed later in life in cross-country skiers compared to general population in Finland. Skiers with asthma use mostly inhaled corticosteroids, as recommended, and short-acting relievers are used more often before exercise than after having asthma-related symptoms. Asthma is mainly well controlled among skiers and the most prevalent among the most successful skiers, suggesting that well-controlled asthma does not prevent success.