Millions of Americans are affected by some degree of exercise-induced asthma (EIA), including most people with chronic asthma and perhaps one-third of people with allergies, such as hay fever. The symptoms—tightness in the chest, shortness of breath, coughing, and wheezing—usually begin during exercise or shortly afterwards.
Aerobic exercise is most likely to set off an attack, especially when the air is cold and dry. Some people are able to continue exercising after an EIA attack abates—usually within an hour or so—but others have to end their workouts and/or take medication. Some may get discouraged or scared and simply give up on exercise.
EIA may occur because when you breathe rapidly during exercise, you replace warm, moist air in your bronchial tubes with cold, dry air. This can trigger the release of chemicals (similar to those involved in inflammation) that cause constriction of the airway, making breathing difficult. Or an allergen or air pollutant, such as chlorine byproducts from swimming pools, combined with rapid breathing, may set off the attack.
Don't give up on exercise
If you think exercise is causing you to have asthma attacks, consult a doctor to make sure that’s what it is. If you’re middle-aged or older and have never had an attack before and suddenly start having symptoms such as tightness in the chest while doing any kind of exercise, seek medical help, since it may be heart-related.
You don’t have to give up exercise if you have EIA. It can be treated and controlled. The following steps may help:
- If you exercise outdoors in cold weather, breathe through your nose when possible, since that helps warm and humidify the air you inhale. Wearing a face mask or scarf around your face can also accomplish this. When it’s very cold, avoid outdoor exercise.
- Check the air quality when exercising outdoors. If pollen or air pollution levels are high, exercise indoors.
- If you suspect that chlorinated pools trigger breathing problems, swim in an outdoor pool or at the beach, weather permitting. Or at least look for an indoor pool that is well ventilated and well maintained. If you smell lots of chlorine, speak with the person in charge of maintenance, who may be able to improve ventilation (especially the air flow just above the water) and check that the chlorine is being properly diluted. In addition, the staff at the pool should encourage good hygiene, such as showering before swimming and bathroom breaks for children, to reduce the contaminants that chlorine reacts with. Some pools use other disinfectants, such as ozone or copper/ silver ionizers, which may be less of a problem for people with EIA (the ozone is not released into the air). The same advice holds for chlorinated hot tubs or whirlpools, particularly since heat increases the vaporization of chlorine by-products.
- If you have EIA, talk to your doctor about a quick-acting bronchodilator. Used 15 to 30 minutes before exercising, it can help prevent symptoms.