743 FO13 – Preventing respiratory illness in elite rowers: outcome from a systematic assessment of respiratory health

Background The prevention of time-loss from respiratory illness is a key priority for clinicians concerned with the health of elite athletes, including rowers. Objective To evaluate the respiratory health of a cohort of elite rowers, using a systematic assessment of respiratory health in athletes (SARAH) model of assessment. Design Single visit, cross-sectional evaluation. Setting International rowing team, within an Olympic preparation cycle. Patients Adult Elite rowers. Interventions and outcome Report of prevalence of respiratory issues, as identified by a SARAH process, that employs multiple physiological tools, including validated questionnaires and measures of nasal flow and detailed asthma testing [including fractional exhaled nitric oxide (FeNO), spirometry with bronchodilator reversibility testing, eucapnic voluntary hyperventilation (EVH) testing] and allergy testing. Results In total, 48 athletes (50% female, aged 27 ± 3 years) completed assessment. At least one significant respiratory issues was identified in 81% (n=39) of athletes, and two or more problems in 54% (n=26). Sinus and nasal problems were the most prevalent issue, present in 44% of athletes, followed by allergy (42%) and evidence of a breathing pattern disorder (42%). Four (8%) athletes had a positive EVH test, confirming the presence of asthma. A high prevalence of exercise-associated cough was found (n=35, 73%), but only 14% (n=5) of these athletes had evidence of asthma, based on EVH test results. Conclusions A systematic approach to the assessment of respiratory issues in competitive rowers, provides important health insight and is justified, given the high prevalence of issues identified and burden and impact of illness. This study reveals exercise-associated cough is a highly prevalent issue in elite rowers but is not explained by asthma. This underpins the need to perform testing in symptomatic athletes, to avoid defaulting to the use of asthma-based treatment.