CDC states that 1 in 13 people in America has asthma (Asthma Facts). According to Rishi Desai, asthma is a chronic disease which inflames the airways in the lungs (Desai). This leads the patients to experience dyspnea: wheezing, coughing, chest tightness, and shortness of breath.
Asthma exacerbations are type 1 hypersensitivity reactions caused by exposure to allergens, airborne substances, medication, physical activities, stress and more (Asthma). The trigger causes the Th2 cells (immune cell subtypes) to react. The allergens caught by dendritic cells (antigen-presenting cells) are given to Th2 cells, producing cytokines. This leads the smooth muscle around the bronchial spasm, to be surrounded by increased mucus secretion, which narrows the airway, causing dyspnea. Over the years, edema, scarring, fibrosis build up, result in the thickening of the basement membrane, permanently narrowing the airway. This makes asthma a long-lasting and detrimental condition.
AAFA comments that “there is no cure for asthma, but symptoms can be controlled with effective asthma treatment” (Asthma Facts).
One of the treatment is reliever inhalers. The inhalers are taken to ease asthmatic symptoms, typically after an exacerbation. AAAAI states that the medicine in the inhalers:beta-2 agonists are used to preventing bronchospasm: spasm of the bronchial smooth muscles which causes constricted bronchi (Beta2-Agonists). Beta-2 receptors on the smooth muscles are activated by the medication, causing it to relax, opening wider. This medication has helped many asthmatic patients, particularly those with exercise-induced asthma (EIA). According to the ABC News, in the 2008 Olympics, 29% of the cycling and 33% of the swimmer individual medals recipients had EIA and used these inhalers (Ward). This has lead the ethical investigation of whether asthma medications can give EIA athletes an unfair advantage.
Although the World Anti-Doping Agency has prohibited beta-2 agonists medications with the exception of asthmatic athletes, who are allowed to take up to 1600 micrograms a day, Runner’s World states that many believe the increased oxygen consumption (VO2 max) through the use of these medications give an advantage (Hutchinson). BBC reports that the increased oxygen rate reduces the amount of oxygen debt; temporary shortage of oxygen during an anaerobic respiration (GCSE 4). To test this, the University of British Columbia conducted an experiment where they measured the time of 48 cyclists (14 with EIA) took to cycle two 10km. An hour before, they inhaled salbutamol; short-term beta-2 agonist, or a placebo. The results showed that although taking the medication improved lung function, it did not change the time measured, meaning the medication did not enhance their performances (Hutchinson).
In conclusion, inhalers can not only improve the quality of life but also save asthmatics – Doctor Samy Suissa believes that “almost 6000 people die from asthma each year, but the consensus is most of those deaths are unnecessary… with [inhalers], we can save many of these lives” (Schorr). And, because there was no proof of performance-related improvement, I believe that not only is allowing beta-2 agonist infused inhalers in the athletic field ethically and medically tolerable, but also necessary to give asthmatics a better quality of life. However, we must keep in mind that other forms of asthmatic medication have not been evaluated, which could give unfair advantages for athletes with EIA.
“Asthma Facts and Figures.” Asthma Facts | AAFA.org, Asthma and Allergy Foundation of America, Feb. 2018, www.aafa.org/page/asthma-facts.aspx.
“Asthma.” National Heart Lung and Blood Institute, U.S. Department of Health and Human Services, 18 Sept. 2014, www.nhlbi.nih.gov/health-topics/asthma.
“Beta2-Agonists (Bronchodilators) | AAAAI.” The American Academy of Allergy, Asthma & Immunology, The American Academy of Allergy, Asthma & Immunology, 2018, www.aaaai.org/conditions-and-treatments/conditions-dictionary/beta2-agonists-(bronchodilators).
Desai, Rishi. “Asthma.” Osmosis, Osmosis, www.osmosis.org/learn/Asthma.
“GCSE Bitesize: Anaerobic Respiration.” BBC, BBC, www.bbc.co.uk/schools/gcsebitesize/science/add_aqa/respiration/respirationrev4.shtml.
Hutchinson, Alex. “Do Asthma Meds Make You Faster?” Runner’s World, Runner’s World, 25 May 2018, www.runnersworld.com/health-injuries/a20806356/do-asthma-meds-make-you-faster/.
Schorr, Melissa. “Asthma Inhalers Prevent Deaths.” ABC News, ABC News Network, 2AD, abcnews.go.com/Health/story?id=118087&page=1.
Ward, Airlie. “Asthma Treatment Scrutinised as Sports Performance Enhancer.” ABC News, Australian Broadcasting Corporation, 21 Nov. 2015, www.abc.net.au/news/2015-11-21/asthma-treatment-scrutinised-for-sports-performance-enhancer/6961068.