Volume 29, Issue 155, January 2025

Asthma in cross-country and alpine skiing: Risks and prevention. A review of the literature

Jan Siemianowski^1♦, Weronika Kotnis², Sandra Prolejko², Michalina Doligalska³, Aleksandra Stremel⁴, Błażej Gajęcki¹, Greta Steć¹, Justyna Kopala⁵, Agata Brzyska¹, Magdalena Pawlak¹

¹Central Clinical Hospital of Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland
²Medical University of Lodz, Kościuszki 4, 90-419 Lodz, Poland
³Medical Hospital in Garwolin, Lubelska 50, 08-400 Garwolin, Poland
⁴Centre of Postgraduate Medical Education, Orłowski Hospital, Czerniakowska 231, 00-416, Warsaw, Poland
⁵University Clinical Hospital No.2 of the Medical University of Lodz, Żeromskiego 113, 90-549 Łódź, Poland

^♦Corresponding Author
Central Clinical Hospital of Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland

ABSTRACT

Asthma and exercise-induced bronchoconstriction (EIB) are prevalent among winter athletes, particularly cross-country and alpine skiers. These disciplines involve strenuous exercise in hostile environmental conditions (e.g., cold and dry air), exacerbating respiratory dysfunction. Although much is known about asthma in cross-country skiing, Alpine skiing has been less studied despite similar environmental and physiological risk factors for developing respiratory symptoms. This review collates evidence from consensus statements, systematic reviews, and observational studies to give a renewed perspective on the prevalence, risks, and management strategies of asthma and EIB in these skiing disciplines. The evidence shows that prolonged exposure to sub-zero temperatures, high-intensity training, and poor recovery periods increase the likelihood of airway inflammation and hyperresponsiveness. Preventative measures, such as structured pre-exercise warm-up or using heat-and-moistureexchanging devices (HMEDs), may help attenuate EIB symptoms, but their usefulness varies. Pharmacological interventions, such as bronchodilators, are essential in controlling EIB when non-pharmacological measures are inadequate. Similarly, asthma management may focus on tailored pharmacological interventions, including inhaled corticosteroids (ICS) and bronchodilators. Nonpharmacological strategies, such as managing environmental factors and implementing structured training programs, can also provide valuable support. This review highlights important gaps in the current research, particularly the need for long-term studies and personalized methods for diagnosis and treatment. Filling these gaps will help promote athlete health and performance while reducing respiratory risk.

Keywords: Asthma, exercise-induced bronchoconstriction, cross-country skiing, Alpine skiing, prevention, respiratory health

Medical Science, 2025, 29, e13ms3522

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DOI: https://doi.org/10.54905/disssi.v29i155.e13ms3522

Published: 21 January 2025