Reported use of anti-asthmatic medication in doping control forms from 2015 to 2019 - mapping retrospective data

Asthma and bronchial hyperresponsiveness is common in athletes, particularly in sports with high ventilatory demands or exposure to irritants such as cold, dry air, polluted air, or trichloramines. The mechanisms behind asthma in athletes remain unclear, but repeated high-volume ventilation and exposures to irritants, as well as airway inflammation and remodelling likely contribute. Symptoms resemble those of asthma, and airway hyperresponsiveness plays a key role, even in athletes with no other classic asthma features. Treatment of asthma in athletes follows the same approach as asthma in the general population. Use of asthma medication is commonly reported by athletes on doping control forms (DCFs). Thus, this study aimed to investigate the use of different anti-asthmatic medications among doping-controlled athletes.

This was an observational cross-sectional study, evaluating retrospective data from athletes' DCFs obtained during 2015-2019 as part of Anti-doping Norway's national testing program in Norwegian sport, some of whom reappearing in the data set with multiple forms.

Of 10 418 DCFs, 1702 (16.3%) contained one or more anti-asthmatic medications. Bronchodilators were most frequently reported, with anticholinergics being most common. DCFs reported from females, national level athletes, and athletes with high risk of asthma contained significantly more anti-asthmatic medications compared to their counterparts (p < 0.01). Usage was highest among athletes aged 30-34, and in those in endurance sports.

Despite the limitation of athletes' reappearance in the dataset, this study provides insight into guideline adherence and asthma medication use among athletes in Norway. Further research is needed in this area.