Aggarwal, Mulgirigama & Berend 2018, exercise-induced bronchoconstriction

NPJ Primary Care Respiratory Medicine review of exercise-induced bronchoconstriction (EIB): prevalence, pathophysiology, diagnosis and management. EIB affects roughly 5 to 20% of the general population and 30 to 70% of elite athletes depending on sport and environment, and is frequently present in athletes with no asthma diagnosis. Self-reported symptoms over- and under-diagnose it, so objective confirmation is needed: a fall in FEV₁ of at least 10% from baseline after an exercise or hyperpnoea challenge. Management combines a pre-exercise short-acting β₂-agonist (first line), daily inhaled corticosteroids where control is inadequate, and leukotriene receptor antagonists, with non-drug measures including a pre-exercise warm-up to induce a refractory period, a heat-and-moisture-exchange mask or scarf in cold air, and avoiding triggers.