Which sport is most likely to precipitate bronchospasm in a patient with exercise-induced asthma?

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From the Guidelines

Cross-country skiing is most likely to precipitate bronchospasm in a patient with exercise-induced asthma. This is due to the extreme cold and dry air that cross-country skiers are exposed to, which can increase the prevalence of exercise-induced bronchospasm (EIB) to 30% to 50% 1. The cold and dry air can trigger bronchospasm in susceptible individuals, making it a high-risk sport for patients with exercise-induced asthma. Other high-risk sports include winter sports like ice hockey and endurance sports such as long-distance running, but cross-country skiing has been shown to have a particularly high prevalence of EIB 1.

Some key points to consider:

  • The prevalence of EIB can vary depending on factors such as environmental conditions, type of testing, and demographics 1
  • Certain populations, such as skaters and cross-country skiers, have a higher than expected prevalence of EIB due to unique circumstances such as high emission pollution from ice-cleaning equipment and cold dry air 1
  • Patients with exercise-induced asthma should use a short-acting beta-agonist like albuterol (2 puffs) 15-30 minutes before exercise for prevention, and consider adding a daily inhaled corticosteroid or leukotriene modifier for better control 1
  • It is essential to anticipate and diagnose EIB in patients with asthma, and to develop a treatment plan that allows patients to participate in their chosen activities without experiencing asthma symptoms 1

From the Research

Sports and Exercise-Induced Bronchospasm

The sports most likely to precipitate bronchospasm in a patient with exercise-induced asthma include:

  • Cold-weather sports
  • Indoor sports

Specific Sports

Some specific sports that may precipitate bronchospasm include:

  • Nordic skiing (also known as cross-country skiing) 2
  • Ice-skating
  • Swimming

Comparison of Sports

Among the options provided (cross-country skiing, gymnastics, marathon running, platform diving, rowing), cross-country skiing is the most likely to precipitate bronchospasm in a patient with exercise-induced asthma due to its classification as a cold-weather sport 2.

Key Factors

Key factors that contribute to the likelihood of bronchospasm include:

  • Airway cooling and drying during exercise 3
  • Baseline bronchial hyperreactivity
  • Intensity of exercise 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Exercise-induced bronchospasm.

Sports health, 2010

Research

Exercise-induced bronchospasm: epidemiology, pathophysiology, and therapy.

Medicine and science in sports and exercise, 1992

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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