INTRODUCTION: Asthma is a common problem among elite athletes and represents a health risk interfering with the athlete`s performance status. This study aimed to evaluate the asthma prevalence in Norwegian summer and winter elite athletes and asthma prevalence across sport categories. We also aimed to examine if bronchial hyperresponsiveness (BHR), lung function, fraction of exhaled nitric oxide (FENO) and allergy differed between asthmatic and non-asthmatic elite athletes. METHODS: We included Norwegian athletes qualifying for the Beijing Olympic Summer games 2008 (n=80) and the Vancouver Olympic Winter Games 2010 (n=55). The athletes performed clinical respiratory examination including lung function measurement, methacholine bronchial challenge for assessment of BHR, FENO and allergy assessed with skin prick test. Asthma was diagnosed based on respiratory symptoms and clinical examination including objective measurements. RESULTS: Asthma was more prevalent among winter athletes (50%) than summer athletes (20%). Thirty-three (52%) endurance athletes, 3 (6%) team sport athletes and 7 (33%) technical sport athletes had doctor diagnosed asthma. Significantly lower lung function (p<0,001) and significantly higher prevalence of severe BHR (p<0,001) were shown in asthmatic athletes compared to non-asthmatic athletes. Allergy and FENO did not differ between asthmatic and non-asthmatic athletes. CONCLUSION: Asthma prevalence is high in Norwegian elite athletes, with winter athletes and endurance athletes showing the highest prevalence. Asthmatic athletes were characterized by lower lung function and more severe BHR compared to non-asthmatic athletes. The high asthma prevalence in winter sport athletes and endurance athletes demonstrate a need for increased attention to prevent and reduce the prevalence of asthma among those athletes. Athletes, medical staff, and coaches should be aware of the high asthma prevalence among athletes training in unfavourable environmental conditions such as cold and dry air, polluted air and in swimming pools with high concentration of chlorine combined with poor ventilation. However, it is still unclear if asthma, BHR and reduced lung function are persistent in elite athletes after retirement from elite sport and if respiratory health may be a limitation for physical activity and exercise after career end. Follow up studies are needed to evaluate how athletes` respiratory health are over time, and if the asthma diagnosis is reversible.
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