Epidemiology of asthma, rhinitis and conjunctivitis in elite athletes

Allergy and its clinical manifestations at the lung, nose and eye level have a very high and increasing prevalence all over the world and an even greater one in elite athletes. The prevalence of asthma in athletes is higher than in the general population; in summer sports, it ranges between 3.7 and 22.8%, in winter sports, the prevalence is even higher, ranging from 2.8 to 54.8%. Asthma is most commonly found in athletes performing endurance activities and is also closely associated with atopy and its severity. In endurance athletes with atopy the relative risk of asthma can be up to 97 fold in comparison with control subjects. The prevalence of rhinitis varies according to the criteria used for diagnosis and athletes from aquatic sports are more likely to have symptoms than those from other sports. Criteria for conjunctivitis are even less standardized and it is difficult to define a reliable occurrence rate. Because of the high prevalence and effects on performances, allergy should be routinely investigated in athletes, with a careful history taking or structured validated questionnaires, skin tests and accurate medical examination of target organs.