By Robert Grabko, R.P.F.T., B.S.

Managing asthma triggers is important for athletes with asthma. To be successful, athletes must identify and avoid triggers that are specific to their sensitivities. Here are some common triggers:

· Allergens – This is an immunoglobulin E (IgE) immune system condition that can result in airway inflammation. IgE is an antibody produced in the body that helps to protect it against environmental allergens. When IgE is triggered, it can result in hypersensitivity to such allergens as tree pollen (spring), grass pollen (summer), weed pollen (fall), dust mites, furry animals, fungus and molds, and foods/beverages with sulfite preservative that include shrimp, dried fruit, beer and wine.

· Irritants – This is not an allergen-specific response and can affect everyone at high enough exposure. Examples of irritants include tobacco smoke, exhaust fumes, perfumes/colognes, odors and sprays. These irritants can lead to airway inflammation and airway tightening in people who have asthma.

· Air temperature and humidity – The temperature of inhaled air is critical for athletes with asthma. Inhaling cold air is problematic because it cools the airway, causing tightening. Inspired air should be warmed first with a mask to prevent airway tightening. Humid air is more resistant to air flow, increasing the breathing work effort and airway tightening.

· Exercise – Exercise-induced asthma (EIA) is caused by leukotriene modifiers that are released with activity. Leukotrienes produce allergic reactions that are similar to those of histamine. In the body, leukotrienes break down mast cell walls and histamine is released, causing inflammation and airway tightening. A proper warm-up can also be effective. For more information about a proper warm-up, see Asthma With Athletes: Warm-up Routines. In addition to a proper warm-up, EIA can be treated effectively with the medications commonly known as Cromolyn™ and Nedocromil™. These medications are delivered in an inhaler and can be effective in preventing mast cell breakdown and histamine release.

· Infections – Athletes with asthma are more susceptible to colds and flu and should use common sense precautions. Athletes of any age who have asthma should receive a flu shot to prevent infections. Universal precautions should always be practiced (wash hands, avoid coughers and sneezers), lots of rest and fluids.

· Medications - Some medications can trigger an asthma attack. Watch out for beta blockers (Metaprolol™, Atenolol™, Inderal™) as well as aspirin, ibuprofen and Naproxen™.

Every effort should be made to identify and avoid asthma triggers to prevent airway inflammation. Asthma can be well controlled if athletes adhere to a comprehensive treatment plan that includes: triggers management; proper nutrition and hydration; breathing and muscle relaxation exercises; management of airway tightness once it occurs; proper warm-up prior to workouts; medicat ions, and adequate fitness levels.

This information is produced by Athletes With Asthma, a Fairview Southdale Hospital  program dedicated to improving the performance of athletes with asthma.

For an appointment with a respiratory therapist or more information, call 952-924-1451.