Screening adolescent athletes for exercise-induced asthma.

OBJECTIVE

To pilot test an exercise-induced asthma (EIA) screening program using a submaximal step-test and pulmonary function test (PFT) to identify athletes with EIA and to determine if a physical examination or self-reported history could be used to predict the existence of EIA.

DESIGN

Screening and diagnostic testing using a convenience sample.

SETTING

Birmingham, Alabama, during athletic preparticipation examination (PPE).

SUBJECTS

Fifty-two African-American, male football players aged 14-18 years being evaluated for participation in scholastic athletics. No athlete refused participation. Four were excluded because of need for further evaluation unrelated to any pulmonary condition.

INTERVENTION

Each athlete completed a medical history, allergy history, physical examination, preexercise pulmonary function test (PFT), submaximal step-test, and a series of postexercise PFTs.

MAIN OUTCOME MEASURES

Major outcome measurements were changes in forced expiration volume in 1s (FEV1) or peak expiratory flow rate (PEFR) after completing an exercise challenge.

RESULTS

Seventeen of 48 athletes had a > or = 15% decrease in PEFR after exercise. Nine of 48 athletes had a > or = 15% decrease in FEV1 after exercise. The only self-reported item that differentiated subjects with normal and abnormal PFTs was a personal history of asthma (p < 0.05).

CONCLUSION

Many athletes can be identified as having abnormal PFTs by use of a submaximal step-test as an exercise challenge. Self-reporting questionnaires and PPEs do not appear to be sensitive enough to identify athletes with this condition. If validated by future studies, this protocol could be used for the diagnosis of EIA.