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Friday, May 16, 2008
To Breathe Or Not To Breathe In the Beijing Olympics, That Is The Question (Part 1)
As a pediatric pulmonologist*, I'll be seeking to add my own unique perspective to the many differing "medical experts" commenting on and analyzing the potential respiratory and performance risks to 2008 Olympic athletes with asthma.

Thus far, the majority of those perspectives have come from other disciplines, including exercise physiology and environmental medicine.

The absurdity of the situation for the Beijing Olympics is that the most elite athletes in the world, some of whom have been training for upwards of four years, will be performing and competing in the very type of air quality conditions that we pulmonologists advise our respiratory patients to absolutely avoid.

Let's briefly review what we know to date about the situation facing top Olympic athletes with asthma as they train for and eventually head to Beijing:

China is the world title-holder for 16 of the world's 20 most polluted cities. Beijing, one of China's cities world-renowned for its toxic haze of ozone and particulate matter, is playing host to the Summer Olympics August 8-24. And, August is probably the worst month of the year because the air is hot, humid and often stagnant.

Due to pollution and smoking, respiratory disease is the #1 leading cause of death in China. It is reported that there are over 75 million asthma attacks each year and this is probably an underestimation. Simply put, there's no such thing as easy breathing there. Since many highly competitive athletes, and Olympic athletes in particular, have asthma (up to 20-25%), there are several real legitimate short and long-term health concerns.

Jacques Rogge, the president of the International Olympic Committee (IOC) has said that he does not believe Beijing's air quality could endanger the athletes' health-though he acknowledges that their performance levels could be "slightly reduced." He also has said that long-distance competitions (where the amount of polluted air breathed in is greater) such as mountain biking, cycling road races, the marathon and triathlon may need to be postponed based on the day's pollution levels.

Surprisingly, some Olympic coaches and athletes with asthma appear to be relatively unconcerned about the breathing conditions during the games. Britain's Paula Radcliffe, the women's marathon world-record holder, thinks that the risks concerning Beijing's air quality have been exaggerated. Jeannette Bolden, the U.S. Olympics women's track and field coach and former Olympic gold medalist, also does not think air quality will be a big factor,

On the other hand, the men's marathon world record holder, Ethiopian Haile Gebrselassie, who has asthma, has decided not to run in the 42-kilometer event due to serious health concerns. He believes it would be very difficult-even injurious to his long-term health- to run the marathon in conditions of extreme pollution, heat and humidity. He has chosen to run in the far shorter 10,000 meter event.

Justine Henin, the recently retired world's top ranked female tennis player, who won the gold medal in 2004, had expressed similar concern. As an athlete with asthma, Henin had indicated that she might not have played in Beijing due to the potentially adverse health conditions.

So, are Gebrselassie and Henin concerned without good reason? Hardly. Should Radcliffe and Bolden be far more concerned than they appear to be? Absolutely.

The "3-H" days of Beijing in August-Heat, Haze and Humidity-are typically days on which there is are ozone alerts and there are repeated media health advisories and warnings against outdoor exertion for ANYONE with lung and heart disease as well as the very young and elderly.

It has been well documented that high ozone and airborne pollution concentrations lead to increased respiratory symptoms including shortness of breath, chest tightness, cough, wheeze, phlegm production as well as headaches, eye and throat irritation. In turn, manifestations of these symptoms lead to more asthma attacks, an increased need for rescue asthma medications, and many more emergency room visits and hospitalizations.

And the most objective scientific piece of evidence? Lung function declines as air pollution increases.

The bottom line: Beijing's air quality puts athletes at risk for short term health problems and decreased performance.

What is China doing and what can individual athletes and Olympic teams do to mitigate the "worst case scenario" situation that potentially awaits competitive athletes with asthma?

I'll have concrete "medical" and practical suggestions in Part 2: Running with Running with the 3Hs--Maximize Performance, Minimize Health Impact

Then stay tuned for Part 3: No Particulate Place to Go: Why the Air is so Ob(Noxious) in Beijing. Yes, let's get (enjoyably) medical and scientific here about pollution, particles and health.

* Youth and Young Adult Lung Specialist


Part 2 - Running with the 3Hs: Maximizing Performance and Minimizing Short-Term Health Risks

Part 3 - No Particulate Place To Go: Why the Air is So (Ob)Noxious in Beijing
Friday, May 16, 2008 in Blogs & Articles | Permalink | E-Mail
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