Twitter has reacted quite badly, in the normal way expected to the piece on road.cc about ‘A third of Team Sky’s riders are asthmatic‘. It’s probably worth taking a look at some pretty obvious reasons why asthma diagnosis is higher in professional athletes than it is through a sedentary population.
For convenience, lets split the UK’s population into four groups, I’m going to make some estimates on percentages of the population, it’s not necessary to be precise on this small study, just indicative of what’s actually going on & where the statistics come from.
- The professional sportspeople. Lets be very generous & include the top amateurs in each sport too & give this lot 1% of the total population. These people test themselves to the limits in training & competition, if there’s any exercise induced asthma going on here, it’s going to be caught & diagnosed as such. It’s a condition that cannot go unnoticed at this level.
- The fun, competitive & hobby athlete. These may account for up to 10% of the population, I’m including people who take part in any sport, at any level other than elite. So runners, cyclists, martial arts, etc. These people probably push themselves quite hard, if they’re getting serious about their sport it’s likely that they’ve pushed themselves beyond the point where exercise induced asthma may kick in. So there’s a reasonably high chance that somebody in this category will have been to the doctor if it’s happened & got themselves an inhaler, but not nearly as many as in the category above, it may just not be that important to them or affect them that much for what they want to achieve.
- Obese & overweight sadly account for approximately 63% of the adult population according to studies. It’s highly unlikely that many of this lot actually push themselves to induce exercise induced asthma. We can assume if they did regular exercise, they wouldn’t be overweight. So I’m also assuming that the bulk of them don’t get diagnosed with asthma due to this. A very hefty part of the population who will be almost removed from the statistics based on this assumption.
- The normal fit & healthy part of the population. Unfortunately we’re left with only 26% of the population who fit into this category. I would imagine that they do some sort of exercise, so are reasonably likely to have been diagnosed if there is a problem.
I think asthma exists in many more than the 8 to 10% that have been diagnosed, probably more likely at the levels noticed in elite athletes. If we look at the groups above, I would assume that the same percentage across each group have exercise induced asthma, but the diagnosed percentage is very different. If Asthma is present in an individual, it probably has very little effect on groups 3 & 4, some effect on many in group 2 & would cause anybody in group 1 very big problems. So asthma is more likely to be diagnosed in groups 1,2 & 4, but less so in group 3. So we’re missing a huge proportion from the statistics, 8 to 10% is simply wrong, it’s much more prevalent than that.
You’ve probably noticed that in your bike club there’s plenty of folks using inhalers, probably more than that 10%. You wouldn’t assume that your club-mates are doping salbutamol in order to beat you on your local chain gang, would you? If you do, that’s the same mindset that assumes that somebody on team Sky is doping with salbutamol.
We can obviously discount the extremes here, there are some riders who have been caught with huge quantities of salbutamol in their bodies, they probably are cheating. As an asthmatic myself, I’ve found that if I felt a bit wheezy before a race I’d take a couple of puffs, that usually sorted it, but if not 2 more later. If I still felt wheezy I normally didn’t start. My peak flow was never more than 15% below what it should be for somebody like me, so even with 4 puffs I was still at a disadvantage to an ‘able bodied’ rider. I did experiment once to see if I could get my breathing level with a ‘normal’ person, I couldn’t, beyond 4 puffs across an hour it made no difference whatsoever, I was still well below average, plus the additional puffs made me feel particularly ill, probably not ideal if you were in a race.
If somebody’s cheating with salbutamol, they’re not going to be doing it with an inhaler, it’ll be injected in large quantities, an inhaler will make little difference, if at all to a non asthmatic. The guy in your club, Chris Froome, or any of the huge percentage of pro cyclists who use an inhaler & are diagnosed with asthma are not cheating, they’re still below the peak flow of a non asthmatic. The nonsense posted on twitter has probably got road.cc plenty of hits, which I suspect is what it’s all about, but it’s a non story.