Cold air exercise screening for exercise induced bronchoconstriction in cold weather athletes.

Exercise Induced Bronchoconstriction (EIB) prevalence in cold weather athletes is high. Currently, no standardized cold air exercise provocation test exists. Thus we aimed to determine EIB prevalence using a Cold Air Test (CAT; 5 km outdoor running; -15 °C) compared to the most common EIB screen the Eucapnic Voluntary Hyperpnea (EVH) test in cold weather athletes. Sixteen (9 male; 20-35 years old) cold weather athletes completed EVH 72 h before CAT. Spirometry, Fractional Expired Nitric Oxide (FENO), respiratory symptoms were measured and atopy status was determined. Five and 7 participants were EIB + on the EVH and CAT, respectively. Level of agreement was 50% between tests. FEV recovery was significantly prolonged and Peak Expiratory Flow was decreased after CAT compared to EVH. Predictive characteristics of EIB + included FENO >12 ppb, FEV/FVC ratio (<0.75) and BMI < 20. EVH does not always reflect EIB triggered by cold weather exercise. More research is required to understand the best EIB screens for cold weather athletes.