Asthma, sports, and death

The impact of asthma on the general population has been described in detail in medical literature. However, asthma also has a significant impact on the pediatric and adult athlete. This is rarely reported in either the lay press or the medical literature. In 2003, Becker and coworkers conducted a retrospective analysis of the incidence of asthma as a direct cause of death in competitive athletes across the United States between 1993 and 2000. They sought to raise awareness that severe asthma exacerbations and even death can occur during sports from asthma in athletes, while still supporting the concept of maximal participation in sporting activities. To their knowledge, this remains the only published study looking specifically at this issue. Fortunately, fatal asthma events are infrequent in either the adult or the pediatric populations. Those rare cases involving athletes are commonly highlighted in the lay press when they do occur, e.g., when the victim is a college football player such as Rashidi Wheeler. Wheeler died of a fatal asthma exacerbation on August 3, 2002, during a conditioning drill as a member of the Northwestern University football team. Although he was known to have chronic asthma with no obvious barriers to health care, he nevertheless succumbed to his condition. Here, we report a similar, although less well-known, case of an adolescent who died as a direct result of an asthma exacerbation during a high school physical education class. We also offer a brief review of the literature regarding morbidity and mortality in athletes.