The complicated relationship between asthma and swimming
DOI:
https://doi.org/10.12775/QS.2024.17.53375Keywords
Asthma, swimming, cold water swimming, exercise induced asthma, childhood asthmaAbstract
Introduction: Apart from pharmacological treatment, non-pharmacological strategies including physical activity play a significant role in the management of asthma. The aim of this paper is to examine various topics related to swimming and asthma. They include the detailed effect of swimming on asthma control,the potential role of swimming in early childhood asthma development, exercise induced asthma in swimmers as well as the relationship between asthma and cold water swimming.
Review methods: This article is based on the literature found in the PubMed Database from the period of 1971-2024 with the use of keywords such as “asthma”, “swimming”, “cold water swimming”, “exercise induced asthma”, “childhood asthma”
Description of the state of knowledge: Swimming is a safe form of physical activity for asthma patients.Swimming training enhances aerobic capacity, reduces exercise-induced bronchoconstriction and improves lung function in both pediatric and adult patients. However, there is a concern regarding indoor swimming pools that chlorine can potentially induce airway inflammation. There is research suggesting that early life swimming pool exposure may contribute to the asthma development in atopic children. There is some premise to the thought that cold water swimming may help alleviate asthma symptoms, but it also carries many risks.Swimming is a major cause of exercise induced asthma in professional athletes.
Conclusions: Alongside appropriate pharmacological treatment, swimming is a valuable strategy in asthma management in both pediatric and adult asthma patients. The risks of chlorinating pools are still not known to outweigh the benefits of swimming for asthmatics. Further research should be carried out on safety of early swimming in atopic children. Cold water swimming should also be evaluated in terms of safety and potential benefits for asthma patients.
References
Gina Scientific Committee. (2024). Global Strategy for Asthma Management and Prevention (2024 update).
World Health Organization. (2024, May 6). Asthma.
European Respiratory Society. (2019). The economic burden of lung disease. European Lung White Book. Retrieved from European Lung White Book
Johnson, S. B., Spin, P., Connolly, F., Stein, M., Cheng, T. L., & Connor, K. (2019). Asthma and Attendance in Urban Schools. Preventing Chronic Disease, 16, 190074. https://doi.org/10.5888/pcd16.190074
Hansen, E. S. H., Pitzner-Fabricius, A., Toennesen, L. L., Rasmusen, H. K., Hostrup, M., Hellsten, Y., Backer, V., & Henriksen, M. (2020). Effect of aerobic exercise training on asthma in adults: a systematic review and meta-analysis. European Respiratory Journal, 56(1), 2000146. https://doi.org/10.1183/13993003.00146-2020
McLoughlin, R. F., Clark, V. L., Urroz, P. D., Gibson, P. G., & McDonald, V. M. (2022). Increasing physical activity in severe asthma: a systematic review and meta-analysis. European Respiratory Journal, 60(6), 2200546. https://doi.org/10.1183/13993003.00546-2022
Beggs, S., Foong, Y. C., Le, H. C. T., Noor, D., Wood-Baker, R., & Walters, J. A. (2013). Swimming training for asthma in children and adolescents aged 18 years and under. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD009607.pub2
Bernard, A. (2010). Asthma and swimming: weighing the benefits and the risks. Jornal de Pediatria, 86(5). https://doi.org/10.1590/S0021-75572010000500002
Downing, L. (2011). Swimming pools and asthma: A new risk or premature concern? Contemporary Nurse, 37(2), 225–226. https://doi.org/10.1080/10376178.2011.11002511
Ramachandran, H. J., Jiang, Y., Shan, C. H., Tam, W. W. S., & Wang, W. (2021). A systematic review and meta-analysis on the effectiveness of swimming on lung function and asthma control in children with asthma. International Journal of Nursing Studies, 120, 103953. https://doi.org/10.1016/j.ijnurstu.2021.103953
Matsumoto, I., Araki, H., Tsuda, K., Odajima, H., Nishima, S., Higaki, Y., Tanaka, H., Tanaka, M., & Shindo, M. (1999). Effects of swimming training on aerobic capacity and exercise induced bronchoconstriction in children with bronchial asthma. Thorax, 54(3), 196–201. https://doi.org/10.1136/thx.54.3.196
Bougault, V., Loubaki, L., Joubert, P., Turmel, J., Couture, C., Laviolette, M., Chakir, J., & Boulet, L.-P. (2012). Airway remodeling and inflammation in competitive swimmers training in indoor chlorinated swimming pools. Journal of Allergy and Clinical Immunology, 129(2), 351-358.e1. https://doi.org/10.1016/j.jaci.2011.11.010
Thickett, K. M., McCoach, J. S., Gerber, J. M., Sadhra, S., & Burge, P. S. (2002). Occupational asthma caused by chloramines in indoor swimming-pool air. European Respiratory Journal, 19(5), 827–832. https://doi.org/10.1183/09031936.02.00232802
Goodman, M., & Hays, S. (2008). Asthma and Swimming: A Meta-Analysis. Journal of Asthma, 45(8), 639–647. https://doi.org/10.1080/02770900802165980
Andersson, M., Backman, H., Nordberg, G., Hagenbjörk, A., Hedman, L., Eriksson, K., Forsberg, B., & Rönmark, E. (2018). Early life swimming pool exposure and asthma onset in children – a case-control study. Environmental Health, 17(1), 34. https://doi.org/10.1186/s12940-018-0383-0
Andersson, M., Hedman, L., Nordberg, G., Forsberg, B., Eriksson, K., & Rönmark, E. (2015). Swimming pool attendance is related to asthma among atopic school children: a population-based study. Environmental Health, 14(1), 37. https://doi.org/10.1186/s12940-015-0023-x
Cavaleiro Rufo, J., Paciência, I., Silva, D., Martins, C., Madureira, J., Oliveira Fernandes, E. de, Padrão, P., Moreira, P., Delgado, L., & Moreira, A. (2018). Swimming pool exposure is associated with autonomic changes and increased airway reactivity to a beta-2 agonist in school aged children: A cross-sectional survey. PLOS ONE, 13(3), e0193848. https://doi.org/10.1371/journal.pone.0193848
Valeriani, F., Protano, C., Vitali, M., & Romano Spica, V. (2017). Swimming attendance during childhood and development of asthma: Meta‐analysis. Pediatrics International, 59(5), 614–621. https://doi.org/10.1111/ped.13230
Irahara, M., Yamamoto-Hanada, K., Yang, L., Saito-Abe, M., Sato, M., Inuzuka, Y., Toyokuni, K., Nishimura, K., Ishikawa, F., Miyaji, Y., Fukuie, T., Narita, M., & Ohya, Y. (2020). Impact of swimming school attendance in 3-year-old children with wheeze and rhinitis at age 5 years: A prospective birth cohort study in Tokyo. PLOS ONE, 15(6), e0234161. https://doi.org/10.1371/journal.pone.0234161
Lee, B.-A., & Oh, D.-J. (2015). Effect of regular swimming exercise on the physical composition, strength, and blood lipid of middle-aged women. Journal of Exercise Rehabilitation, 11(5), 266–271. https://doi.org/10.12965/jer.150242
Bar-Or, O., & Inbar, O. (1992). Swimming and Asthma: Benefits and Deleterious Effects. Sports Medicine: Evaluations of Research in Exercise Science and Sports Medicine. https://doi.org/10.2165/00007256-199214060-00006
Arandelović, M., Stanković, I., & Nikolić, M. (2007). Swimming and persons with mild persistant asthma. TheScientificWorldJournal, 7, 1182–1188. https://doi.org/10.1100/tsw.2007.221
Bougault V, Turmel J, Levesque B, Boulet LP. The respiratory health of swimmers. Sports Med. 2009;39(4):295–312. doi: 10.2165/00007256-200939040-00003.
Helenius IJ, Rytilä P, Metso T, Haahtela T, Venge P, Tikkanen HO. Respiratory symptoms, bronchial responsiveness, and cellular characteristics of induced sputum in elite swimmers. Allergy. 1998;53:346–352. doi: 10.1111/j.1398-9995.1998.tb03904.x.
Bar-Or O, Inbar O. Swimming and asthma. Benefits and deleterious effects. Sports Med. 1992;14(6):397–405. doi: 10.2165/00007256-199214060-00006
Fitch KD, Morton AR. Specificity of exercise in exercise-induced asthma. Br Med J. 1971;4(5787):577–581. doi: 10.1136/bmj.4.5787.577
Päivinen, M., Keskinen, K., Putus, T., Kujala, U. M., Kalliokoski, P., & Tikkanen, H. O. (2021). Asthma, allergies and respiratory symptoms in different activity groups of swimmers exercising in swimming halls. BMC Sports Science, Medicine and Rehabilitation, 13(1). https://doi.org/10.1186/s13102-021-00349-2
Angelo Deus, F., Castro, C. L. F. e, Oliveira, V. C., Figueiredo, P. H. S., Costa, H. S., Xavier, D. M., … Lima, V. P. (2024). Aquatic exercise for people with asthma: a systematic review with meta-analysis of randomized controlled trials. Journal of Asthma, 1–13. https://doi.org/10.1080/02770903.2024.2303776
Knechtle, B., Waśkiewicz, Z., Sousa, C. V., Hill, L., & Nikolaidis, P. T. (2020, December 1). Cold water swimming—benefits and risks: A narrative review. International Journal of Environmental Research and Public Health. MDPI AG. https://doi.org/10.3390/ijerph17238984
Greenfield, K., Verling, W., Larcombe, T., & Connett, G. J. (2023). Case report: Open water swimming as a possible treatment for asthma. Frontiers in Medicine, 10. https://doi.org/10.3389/fmed.2023.1169639
Diversi, T., Franks-Kardum, V., & Climstein, M. (2016). The effect of cold water endurance swimming on core temperature in aspiring English Channel swimmers. Extreme Physiology and Medicine, 5(1). https://doi.org/10.1186/s13728-016-0044-2
Knechtle, B., Christinger, N., Kohler, G., Knechtle, P., & Rosemann, T. (2009). Swimming in ice cold water. Irish Journal of Medical Science, 178(4), 507–511. https://doi.org/10.1007/s11845-009-0427-0
Castellani, J. W., Young, A. J., Kain, J. E., Rouse, A., & Sawka, M. N. (1999). Thermoregulation during cold exposure: Effects of prior exercise. Journal of Applied Physiology, 87(1), 247–252. https://doi.org/10.1152/jappl.1999.87.1.247
Shattock, M. J., & Tipton, M. J. (2012, July). “Autonomic conflict”: A different way to die during cold water immersion? Journal of Physiology. https://doi.org/10.1113/jphysiol.2012.229864
Hohmann, E., Glatt, V., & Tetsworth, K. (2018). Swimming induced pulmonary oedema in athletes – A systematic review and best evidence synthesis. BMC Sports Science, Medicine and Rehabilitation. BioMed Central Ltd. https://doi.org/10.1186/s13102-018-0107-3
Lund, K. L., Mahon, R. T., Tanen, D. A., & Bakhda, S. (2003). Swimming-induced pulmonary edema. Annals of Emergency Medicine, 41(2), 251–256. https://doi.org/10.1067/mem.2003.69
Dugué, B., & Leppänen, E. (2000). Adaptation related to cytokines in man: Effects of regular swimming in ice-cold water. Clinical Physiology, 20(2), 114–121. https://doi.org/10.1046/j.1365-2281.2000.00235.x
Lambrecht, B. N., Hammad, H., & Fahy, J. V. (2019, April 16). The Cytokines of Asthma. Immunity. Cell Press. https://doi.org/10.1016/j.immuni.2019.03.018
Carlsen, K. H. (2009, April). Asthma, airway inflammation and epithelial damage in elite athletes. European Respiratory Journal. https://doi.org/10.1183/09031936.00011909
Anderson, S. D., & Kippelen, P. (2010). Stimulus and mechanisms of exercise-induced bronchoconstriction. Breathe, 7(1), 25–33. https://doi.org/10.1183/18106838.0701.025
Levai, I. K., Hull, J. H., Loosemore, M., Greenwell, J., Whyte, G., & Dickinson, J. W. (2016). Environmental influence on the prevalence and pattern of airway dysfunction in elite athletes. Respirology, 21(8), 1391–1396. https://doi.org/10.1111/resp.12859
Dickinson, J., Amirav, I., & Hostrup, M. (2018, May 1). Nonpharmacologic Strategies to Manage Exercise-Induced Bronchoconstriction. Immunology and Allergy Clinics of North America. W.B. Saunders. https://doi.org/10.1016/j.iac.2018.01.012
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Karolina Czarnecka, Katarzyna Burda, Anna Korczak, Oliwia Szewczyk, Ewa Olek, Justyna Jędrzejczyk, Olga Łopacińska, Katarzyna Stańczyk, Aleksandra Korn, Emilia Wójcik
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 157
Number of citations: 0
