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Asthma Issues: Sport, Travel and Pregnancy

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Many people with asthma can have breathing difficulty when playing sport. Some people may be concerned about the use of asthma medications when pregnant or travelling.

Exercise asthma can be controlled

Many people with asthma will have symptoms provoked by vigorous exercise. This appears to be due to reflex airway narrowing caused by drying of the airways. It is important to consider whether asthma is well-controlled at other times. For example, a person needing their reliever medication more than twice per week or with peak flow readings less than expected may benefit from regular preventer medication. This may help prevent or manage exercise-induced asthma.

Plan ahead to reduce exercise-induced asthma

The following approaches may help reduce symptoms that occur despite good asthma control at other times:

  • Choose your exercise. For example, swimming is less likely to provoke asthma attacks, because warm and moist air is being inhaled. Cycling and running are more likely to provoke symptoms.
  • Do warm-up exercises for at least 15-20 minutes before vigorous exercise.
  • Wear a mask or balaclava to reduce heat and moisture loss, particularly in winter.
  • Use prescribed medicines, including:
    • Short acting relievers and preventer medications protect for two to three hours if taken just before exercise. 
    • Longer-acting symptom controllers are active for up to 12 hours.
    • Leukotriene antagonists are also effective if taken regularly.

Elite athletes can also suffer from asthma

Even elite athletes can suffer from asthma. They tend to control it with warm-up exercises and careful use of medication. Some asthma medications are approved for use in athletes participating in competitive sport, although many sporting bodies require a doctor's letter confirming that the athlete has asthma.

Some medications must be declared

Some medications such as inhaled corticosteroid puffers (inhalers) and leukotriene antagonists are approved as long as they are declared. Oral corticosteroids must be declared and are not allowed within six weeks of competition.

As regulations change it is important to checkwhich medications are currently banned substances. Athletes competing at state or higher levels of competition should contact their national sporting organisation to obtain additional information. 

Contact the Australian Sports Anti-Doping Authority (ASADA) or Drug Free Sport New Zealand for current information.

Asthma should be controlled during pregnancy

Some increased shortness of breath during pregnancy is normal, as the baby takes up space in the body, which affects breathing space. Asthma does not normally worsen during pregnancy. However, if it does worsen, it is important to treat asthma. Uncontrolled asthma is a much greater risk to the baby than any theoretical risk of medication.

There is little evidence that the medications used to treat asthma harm the developing baby in any way, if taken according to the directions.

Flying with asthma

Pressurised aircraft have an oxygen pressure around 80 % of normal. This poses no problem to people with controlled asthma. As a rule of thumb, people able to walk 100 metres or climb one flight of stairs without getting puffed should experience no problems. Those experiencing shortness of breath at rest should seek medical advice before flying.

Be prepared when travelling

Travellers are often exposed to new infections or high levels of allergens while away from home. This may worsen asthma and increase the need for medication. It is therefore important to:

  • Take enough medications, for expected needs, and more in case increased doses are required.
  • Carry medications in hand luggage to ensure easy access.
  • Check if travel insurance will cover pre-existent ailments.

With planning, people with asthma can travel, play sport and lead active lives.

© ASCIA 2019

ASCIA is the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand.

ASCIA resources are based on published literature and expert review, however, they are not intended to replace medical advice. The content of ASCIA resources is not influenced by any commercial organisations.

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Updated August 2022