Allergies and asthma are frequent in elite athletes. Previous studies have shown that the prevalence of allergic rhinitis in elite athletes is between 15% and 29% [1–5] and that wheezing is reported by 6% to 15% of athletes [2, 3, 6]. The prevalence of asthma in athletes was reported to be different, based on the methods used and the athletes included in the study. E.g., in the US, the prevalence differed from 12% among athletes (football players) in 1984 to 15% among athletes participating in the 1996 Olympic Summer Games and up to 22% among athletes who participated in the 1998 Olympic Winter Games [2, 7, 8]. In Australia the prevalence of diagnosed asthma in Olympic athletes rose from 10% in 1976 up to 21% in 2000 . A five-year follow-up in Finnish swimmers showed that prevalence of current asthma increased from 31% at baseline to 44% at follow-up . Overall, between 7-18% of top athletes seem to use asthma medication [4, 7, 11–13].
In comparison to non-athletes (medical students, volunteers, general population sample), some earlier studies have observed a higher prevalence of asthma and allergies in top athletes [3, 6, 13–16]. However, a recent Australian study could not show such differences between the prevalence of asthma among athletes and the general population .
Results of previous studies in top athletes indicated that the prevalence of asthma is associated with specific types of sport. Self-reported and doctors diagnosed asthma was most common in athletes in endurance sports like swimming, cycling and cross-country skiing [2, 5, 6, 12–14, 16–18]. Furthermore, some studies observed that medical treatment for asthma is also higher in athletes in endurance sports [5, 11, 13]. In comparison to other athletes, those performing in endurance sports might be at higher risk as they inhale a large amount of allergens and irritants (e.g. swimmers are exposed to chlorine and chloramine) and because the ventilation is increased for a longer period of time [15, 19, 20].
The knowledge about asthma and allergies in top athletes is essential as the diseases influencing the performance of the athletes. Furthermore, therapy during training and competition has to be optimised. However, some asthma medications are bounded to the anti-doping regulations. Therefore, athletes who need to use inhaled β2-agonists (e.g. Formoterol, Terbutalin) have to be diagnosed with current asthma using standardized protocols to obtain a therapeutic use exemption (TUE) from the grating anti-doping Organizations (e.g. National-Anti-Doping-Organization, International Sport Federation, International Olympic Committee) [21–23].
So far, no data on German top athletes are available. Therefore, one aim of the study was to assess the prevalence of allergic and respiratory diseases and information about medical treatment in German top athletes. Furthermore, we compared the prevalence of self-reported asthma symptoms, allergies and medical treatment in German top athletes to the general population in Germany. In addition, we estimated the associations between types of sports and level of endurance and the self-reported outcomes. These results should help to define which groups of German athletes are at increased risk for asthma and allergies and to provide some insights in the quality of asthma surveillance in athletes and non-athletes.