Swimmers have a high prevalence of exercise-induced bronchoconstriction (EIB), which may be associated with repeated exposure to chlorinated pool water. The eucapnic voluntary hyperpnea (EVH) test is used to diagnose EIB; however, it fails to replicate the environmental conditions experienced by swimmers. The relationship between the composition of the EVH inspired gas and the development of EIB from swim exercise remains unclear. Purpose: This study aimed to compare the bronchoconstrictive effect of a chlorinated inspirate EVH test and swim test to a laboratory-based EVH test in swimmers. Methods: Fifteen collegiate swimmers ( n = 5 male, n = 10 female; 21 ± 2 yr) completed 3 d of testing in pseudorandom order; a standard EVH test (EVH L ), a pool air EVH test (EVH Cl ), and a swimming test (Swim). Spirometry was measured at baseline, and 3, 5, 10, 15, and 20 min after each test. Results: EVH L elicited a forced expired volume in 1 s (FEV 1 ) fall index of -9.7% ± 6.4% compared with -6.6% ± 9.2% and -3.0% ± 7.5% after EVH Cl and Swim, respectively ( P < 0.05). Using Bland-Altman analysis, we found good agreement between EVH L and EVH Cl (bias = -2.8, r = 0.79; P < 0.05) with poor agreement between EVH L and Swim (bias = -6.7, r = 0.20) and between EVH Cl and Swim (bias = -3.9, r = 0.50; both P < 0.05). Forced expired flow between 25% and 75% lung volume and peak expired flow were significantly reduced by the EVH L compared with the EVH Cl and Swim tests ( P < 0.05). Conclusions: EVH L elicits a greater forced expired volume in 1-s fall index compared with EVH Cl and Swim. The unique aquatic environment of swimmers potentially protects against bronchoconstriction and should be considered in the determination of EIB.
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