Allergy Capital

Asthma: sport, travel, pregnancy & other issues

Many patients with asthma run into trouble when they play sport, and worry about the use of asthma medications when pregnant or travelling.

Revised 24 August 2003

IMPORTANT The information provided is of a general nature and should not be used as a substitute for professional advice. If you think you may suffer from an allergic or other disease that requires attention, you should discuss it with your family doctor.

Exercise asthma
The majority of people with asthma will have their symptoms provoked by vigorous exercise. The mechanisms appear to be reflex airway contraction induced by drying of the airways. Swimming is less likely to provoke attacks, because warm moist air is being inhaled. The following approaches may reduce severity:

Gentle warm-up exercises
Wearing a mask or balaclava will minimize heat and moisture loss
Short acting "relievers" (e.g. salbutamol) and "preventer medications" (e.g. cromoglycate or nedocromil) protect for 2 to 3 hours if taken just before exercise.
Longer-acting "symptom controllers" (e.g. salmeterol, eformoterol) are active for up to 12 hours.
Leucotriene antagonists can also be effective if taken regularly.

Competitive sport and asthma
Most asthma medications are approved for use in athletes participating in competitive sport. Other medications (such as inhaled steroids and leucotriene antagonists) are approved as long as their use is declared. Oral steroids are allowed between but not during competition. Athletes competing at state or higher levels of competition should contact their national sporting organization to obtain additional information. The Australian Sports Drug Agency operates a toll free hotline to provide current information, Tel 1800 020 256.

Pollen asthma
Pasture grasses rely on the distribution of numerous small pollen grains cast over a wide area to ensure reproduction. A single hectare of rye grass, for example, may release hundreds of kilograms of pollen per season. High-speed winds promote the distribution of pollen grains over many kilometres. Intuitively one would expect that rain would result in symptom relief by "washing"pollen out of the atmosphere. Paradoxically, some patients get worse when it rains. So-called "thunderstorm" asthma is explained by the finding that absorption of water by pollen grains can result in the release of up to 700 allergen-containing starch granules. These particles rise in concentration up to 50 fold after rain. These are small enough to get into the small airways of the lung. Attacks of "thunderstorm asthma" have been described in Wagga, Melbourne and London.

Pregnancy and asthma
Some increased shortness of breath is normal as the baby takes up some room in the belly. Asthma does not normally worsen in asthma. If it does, it is still important to treat the asthma, as uncontrolled asthma is a much greater risk to the baby than any theoretical risk of medication. There is little evidence that the medications used to treat asthma harm the developing baby in any way.

Travelling with asthma
Take sufficient medications not only for your expected needs, but extra in case you need to increase the dose if you get worse. Carry your main supplies in your hand luggage. Check that your travel insurance will cover you for "preexistent ailments".