High incidence rate of asthma among elite endurance athletes: a prospective 4-year survey.

Objective: The prevalence of asthma among elite endurance athletes is high, but less is known about the incidence of asthma among athletes. The aim of this study was to examine the incidence rate of physician-diagnosed asthma among elite endurance athletes.Method: An annual postal questionnaire was sent to an open prospective cohort of elite endurance athletes between 2011 and 2015. Athletes from Swedish National teams, students at universities with elite sport partnership, and pupils at Swedish National elite sport schools, competing in cross-country skiing, biathlon, ski orienteering, or orienteering were invited (n = 666). Incidence rate of physician-diagnosed asthma was calculated among those without asthma at baseline (n = 449). Risk factors for incident physician-diagnosed asthma were identified using a multivariate logistic regression analysis.Results: Response rate was 88.7% (n = 591) at baseline. The median age of participants was 17 (range 15-36) years at inclusion. The study population included 407 (69%) skiers and 184 (31%) orienteers. The prevalence of asthma at baseline was 23.9% (n = 141). Incidence rate (95% confidence interval [CI]) of physician-diagnosed asthma was 61.2 (45.7-80.3) per 1,000 person-years. Risk factors (odds ratio [OR (95% CI)]) for incident physician-diagnosed asthma were family history of asthma (1.97 [1.04-3.68]), being a skier (3.01 [1.42-7.21]), and wheezing without having a cold (4.15 [1.81-9.26]).Conclusion: The incidence rate of physician-diagnosed asthma is high among Swedish elite endurance athletes.