Asthma ski day: cold air sports safe with peak flow monitoring

The Colorado Asthma Ski Day, an annual cross-country and alpine skiing event, encourages children with asthma to participate fully in outdoor winter sports. Since cold air and exercise can trigger bronchospasm, we examined the peak expiratory flow rates of 80 children who attended Asthma Ski Day 1992 or Asthma Ski Day 1993 to establish a safety profile for this event. Peak expiratory flow rates were measured prior to skiing, at lunchtime, and at the end of the day's activities. We asked the children to pretreat with their regular medications, as prescribed by their physicians, to use their bronchodilator inhalers p.r.n., and to report to our medical station if an episode of acute asthma occurred. The average age of the participants was 9.5 years, and the average baseline daytime peak flow rate was 100.03% of predicted. The average percent change in peak flow rates during the day was an increase of 5.00%. Our results demonstrate that with medical supervision, peak expiratory flow rate monitoring, and properly administered medications, peak flow rates can be stabilized and even improve during cold-weather exercise to an extent that safety concerns need not restrict children with asthma from engaging in exercise or cold-weather sports. The Colorado Asthma Ski Day can serve as a model event for other organizations that want to promote outdoor activities for children with asthma.