Physicians with elite athlete patients dealing with EIA and exercise-induced bronchoconstriction have challenging decisions to make regarding medications. They have to consider each anti-allergic and anti-asthmatic drug in light of its status set by the World Anti-Doping Agency, and whether they are prescribing both in and out of competition. For example, the wide and increasing use of β2-adrenergic agents by athletes must be done in response to strict criteria issued by that agency. According to Sergio Bonini and Timothy Craig (J Allergy Clin Immunol 2008;122:249), the anti-doping agency has banned oral β2-agonists and ephedrine, either prohibited or restricted oral corticosteroids and topical corticosteroids, and inhaled β2-agonists. Athletes are permitted to use antihistamines, antileukotrienes, and immunotherapy both in and out of competition.
With the 2008 Olympics in the history books, physicians specializing in EIA can relax, at least until gearing up for the next winter games in Vancouver. They will continue to play an important role in helping to keep elite athletes on top of their games.
Marlene Piturro Reports from Beijing
Chinese censors did an excellent job of controlling what the television viewers around the world saw and heard about Beijing’s air quality during the Olympics. Although Chinese authorities took draconian measures for six months before the summer games, including keeping two-thirds of Beijing’s 3.3 million cars off the road on alternate days, stopping all commercial construction, and shutting down polluters in outlying Tianjin, Hebei, Shanxi, and Shandong provinces and Inner Mongolia, air quality was problematic on four out of the eight days I was in Beijing.