Exercise Induced Asthma: Facts About EIA

The Problem: According to the American Academy of Allergy Asthma and Immunology (AAAAI), as many as seven out of every 100 people in the U.S. suffer from asthma. That's around 20 million people.

Most of those people will notice that asthma symptoms often develop – or grow worse – with exercise. In addition, about 13 percent of the rest of the population have a condition known as exercise-induced asthma, or EIA for short.

What It Is: Exercise induced asthma is a condition where your lungs and airways overreact to exercise, resulting in airway inflammation. This response results in the typical symptoms of asthma:

• coughing
• chest tightness
• difficulty breathing
• increased mucus in the airways
• wheezing

These symptoms generally occur within 15 to 20 minutes after exercise.

What's Going On: When you have EIA, your airways tend to be overly sensitive to sudden changes in temperature and humidity. This sensitivity is especially acute when you breathe cold, dry air. Exercise – particularly strenuous exercise – exposes you to these types of changes. When you exercise, you tend to breathe through your mouth. That allows cold, dry air to get into your lower airways without passing through nose first, which would have warmed and moistened the air.

When you mouth breathe, the air you take in is moistened only about 60 to 70 percent. But breathing through your nose warms and moistens the air to about 80 to 90 percent humidity before it reaches the lungs.

What Can Make It Worse: Obviously, if your asthma is not under control in the first place, exercise may further worsen your symptoms. Here are a few other things that may increase the intensity of EIA:

• Mouth breathing
• High pollen counts
• Pollution in the air, such as diesel fumes
• High mold counts
• Viral respiratory infections

Who Is at Risk: Most of the usual risk factors for asthma apply to EIA as well. In particular, if you have a parent or siblings with asthma or nasal allergies, your risk is higher for developing EIA. Or, if you have nasal allergies yourself, your risk is also higher for EIA.

How It Is Diagnosed: Doctors will use the following methods for diagnosing EIA:

• Taking a medical history
• Taking a breathing test, using a spirometer or peak flow meter, when you are at rest
• Then, taking a breathing test after exercise

When you have a decrease after exercise in the volume of air you can blow out from your resting rate, then the doctor may diagnose exercise-induced asthma. The following levels of decrease are necessary for a positive diagnosis:

• At least 12 to 15 percent, if using a spirometer
• 15 to 20 percent, if using a peak flow meter

How It's Treated: The best way to handle exercise induced asthma is through a combination of self-care and medical treatment:

1. Take time to warm up before and cool down after exercise. Knowing how to pace yourself can also go a long way towards minimizing the symptoms of EIA.


2. Take an inhaled medication about 15 minutes before exercise. Talk to your doctor about which type of inhaled asthma medicine is right for you. Many people have success with short-acting beta 2 agonist bronchodilator sprays. Effects last for up to four to six hours. But other types of asthma medicines may also work well.

The Best Activities: Choose the right kinds of exercise. Swimming is a great choice, because of the warm, humid air involved. Other choices that are less likely to trigger EIA are walking, leisure biking, hiking and downhill skiing.

You can also stick with sports that require short bursts of energy. They are less likely to trigger asthma than sports that require nonstop activity. So baseball, football, wrestling, golf, and surfing are better choices than soccer, basketball, field hockey or long-distance running.

If exercising outdoors, wearing a scarf or a surgical mask over your nose and mouth will help warm the air you are breathing.

Limit your exercise when you have viral infections, when temperatures are extremely low, or when pollen and air pollution levels are high.

In Summary: Exercise-induced asthma doesn't have to limit what you can do in life. With the right medication and conditioning, many people continue to pursue the sports and activities they enjoy. In fact, even world-class athletes can successfully compete even though they have EIA. According to a recent study reported by the AAAAI, at least one in six athletes from the U.S. in the 1996 Olympic Games had a history of asthma.

Some famous athletes who have asthma include:

• Jerome Bettis, professional football player
• Jackie Joyner-Kersee, Olympic medalist in track
• Greg Louganis, Olympic medalist in diving
• Dennis Rodman, professional basketball player

So, don't use asthma as an excuse not to exercise.

Sources:

American Academy of Allergy Asthma & Immunology, "Tips to Remember: Exercise-induced asthma." AAAAI. 2006. AAAAI. 14 Feb 2007 <http://www.aaaai.org/patients/publicedmat/tips/exerciseinducedasthma.stm>.

National Jewish Medical and Research Center, "Exercise-Induced Asthma." National Jewish Medical and Research Center. February 2006. National Jewish. 14 Feb 2007 <http://www.nationaljewish.org/disease-info/diseases/asthma/living/healthy/exercise.aspx>.