Aim. The aim of the present study was to describe the clinical characteristics and, particularly, the spirometric findings in Italian asthmatic athletes taking part in the Beijing Olympic Games. Methods. Thirty-four asthmatics underwent basal and post-salbutamol inhalation spirometry. The athletes were divided into three groups on the basis of pre- and post-drug data. Results. Group A: 16 subjects with bronchial obstruction (FEV1/VC 78% of predicted value) and significant reversibility after salbutamol (FEV1 post: +17.6% and +790 mL): in 11 the obstruction normalised completely, in five only partially. Group B: 6 subjects with normal basal spirometry (FEV1/VC 91.1 % p.v.) but equally significant response after salbutamol. Group C: 12 subjects with normal basal spirometry (FEV1/VC 96.5% p.v.) and with no significant increment of FEV1 after salbutamol; these subjects were positive in a broncho-stimulation test. In 30/34 athletes, the prick test revealed positivity to at least one allergen; 26/34 athletes stated they frequently suffered from exercise-induced bronchospasm (EIB): 7 of these in spring-time only. A diagnosis of bronchial obstruction in athletes must be based only on the FEV1/VC% ratio and not on a reduction in FEV1 with respect to predicted value. In 11/16 athletes, bronchial obstruction proved significantly reversible, but not in 5 athletes in whom a remodelling of the airways induced by chronic inflammation can be presumed. It is also demonstrated that spirometry may only be apparently normal and hide an overlooked bronchial obstruction. In 12 athletes who did not respond to salbutamol, a high bronchial hyper-responsivity to the broncho-stimulation test was observed. Conclusion. The presence of asthmatic athletes at the Olympics shows that adequate therapy enables sport to be practiced at the highest levels. Even EIB when appropriately treated is not a limit on performance.
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