Exercise as it relates to Disease/Exercise in extreme cold and asthma

Background:
Cold is an environment which provides many challenges for humans, not least obvious cold injuries such as frostbite and hypothermia. However there is another issue that arises from long-term cold exposure that seems to be exacerbated by exercise in cold environments: exercise-induced asthma (EIA). This is particularly prevalent in elite winter sports athletes who spend long periods of time training and competing in cold environments. This may lead to many complications regarding both present and future health if not treated carefully. EIA can be diagnosed through a drop in Forced Expiratory Volume in 1 second (FEV1) of greater than 10%. It is caused by an inflammatory response to the environment resulting in the narrowing of the bronchioles from a reaction to cold air and exercise, thus leading to decreased FEV1 and resulting in coughing, difficulty breathing and hypoxia.

When is the greatest risk?
The greatest risk of triggering or developing EIA is during periods of exercise in very cold, dry environmental conditions.

The most crucial factor is a very low humidity, which normally accompanies extremely cold temperatures in cold climates.

If the person is identified as being at risk of developing EIA during exercise in cold environments through a Eucapnic Voluntary Hyperventilation test.

Prevention and Treatment
An EIA episode can be prevented or treated through use of standard asthma preventers and inhalers (Beta-2 Angonists).

Use of a humidifying mask or covering of the mouth and nose to create a moisture trapping layer is recommended when training in cold, dry temperatures so as to prevent development of symptoms.

Studies have shown that maintaining skin temperature, especially on the face and neck can help to prevent an EIA attack.