Article

Asthma and Swimming: A Meta-Analysis

Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
Journal of Asthma (Impact Factor: 1.83). 11/2008; 45(8):639-47. DOI: 10.1080/02770900802165980
Source: PubMed

ABSTRACT In this meta-analysis, studies on swimming and asthma were divided into four groups: Group I compared frequency of asthma among elite swimmers to that of other athletes; Group II examined the association between asthma and swimming during childhood; Group III evaluated effects of swimming programs on asthma severity and pulmonary function; and Group IV compared immediate respiratory effects of swimming to those of other types of exercise. The summary results were expressed as meta-odds ratios (ORs) for binary endpoints such as presence of asthma, and meta-differences for continuous endpoints such as changes in post-exercise pulmonary function tests (PFTs). All summary measures of effect were calculated using random effects models accompanied by a corresponding 95% confidence interval (CI) and a test for heterogeneity. In the analysis comparing frequency of asthma among elite swimmers to that among other athletes (Group I), meta-ORs ranged from 2.3 to 2.6 with all 95% CIs excluding 1.0. The corresponding meta-ORs reflecting the association between asthma and swimming pool use during childhood (Group II) were in the 0.63-0.82 range and were not statistically significant. In comparison to swimming, running and/or cycling was associated with a statistically significant four-to six-fold increase in exercise induced bronchospasm. Although asthma is more commonly found among elite swimmers than among other high-level athletes, it is premature to draw conclusions about the causal link between swimming and asthma because most studies available to date used cross-sectional design, because the association is not confirmed among non-competitive swimmers, and because asthmatics may be more likely to select swimming as the activity of choice because of their condition.

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    • "Athletes who participate in endurance sports seem to be at an increased risk for asthma than other athletes, possibly due to the vigorous activity and regularly repeated higher ventilation rates over prolonged periods of time associated with their discipline [7] [8]. Swimmers might also be at high risk, as previous studies have suggested that pool athletes are predisposed to airway dysfunctions, including asthma, due to their exposure to irritants such as chlorine and derived by-products in the pool environment [9] [10]. This international cross-sectional study offered a unique opportunity to assess differences in asthma prevalence between the European general population and European summer athletes from a wide range of sport disciplines across various geographical areas. "
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    ABSTRACT: Some studies have shown a higher prevalence of asthma in elite athletes as compared to the general population. It is inconclusive to what extent certain sport categories are especially affected. The present study offered a unique opportunity to assess these differences in asthma prevalence in the general population and elite summer athletes from a wide range of sport disciplines across various geographical areas. Cross-sectional data for 1568 general population participants from the European Community Respiratory Health Survey II and 546 elite athletes from the Global Allergy and Asthma European Network Olympic study from three European countries were analyzed. Using logistic regression, the asthma risks associated with athlete sport practice, endurance level and aquatic sport practice, respectively, were investigated. Athletes in the highest endurance category had increased risk of doctor-diagnosed asthma (OR 3.5; 95% CI 1.7-7.5), asthma symptoms (OR 3.0; CI 1.5-6.0) and asthma symptoms or medication use (OR 3.5; CI 1.8-6.7) compared to the general population. Aquatic athletes were at increased risk of doctor-diagnosed asthma (OR 2.0; CI 1.1-3.9), asthma symptoms (OR 2.6; CI 1.3-5.0) and asthma symptoms or medication use (OR 2.3; CI 1.2-4.4) when compared to individuals not involved in aquatic sports. Regarding the entire athlete population, no increase in asthma was found when compared to the general population. Practice of very high endurance and aquatic sports may be associated with increased asthma risks. Athlete participation as such showed no association with asthma risk. Copyright © 2015 Elsevier Ltd. All rights reserved.
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    • "In addition, there is evidence that associates asthma risk and swimming. However, the risk depends on the target population [54]. It was found that those who are occupationally exposed to the pool environment are at high risk of respiratory symptoms including asthma, although the causality of this association is uncertain. "
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    • "Older swimmers tend to have spent less time at indoor swimming pools during childhood , as there were fewer indoor pools available ( García Ferrando & Llopis Coig , 2011 ) . Neverthe - less , some authors suggest further studies to confirm this hypothesis ( Goodman & Hays , 2008 ) . It should also be considered that the majority of subjects in the younger age group usually swim more intensely so are more susceptible to inhaling greater quantities of DBPs ( Bonetto et al . "
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