Thirteen days of “live high–train low” does not affect prooxidant/antioxidant balance in elite swimmers

We investigated the impact of 13 days of “living high–training low” (LHTL) on the antioxidant/prooxidant balance in elite endurance swimmers. Eighteen elite swimmers from the French Swimming Federation were submitted to a 13-day endurance training and divided into two groups: one group trained at 1,200 m and lived in hypoxia (2,500–3,000 m simulated altitude) and the second group trained and lived at 1,200 m. The subjects performed an acute hypoxic test (10 min at 4,800 m) before and 1 day after the training period. Plasma levels of advanced oxidation protein products (AOPP), malondialdehydes (MDA), ferric reducing antioxidant power (FRAP), and lipid-soluble antioxidants were measured before and after the 4,800 m tests. After the training, MDA and AOPP responses to the 4,800 m test were lower than before training for both groups (+10 vs. +2%; P = 0.01 for MDA and +80 vs. +14%; P = 0.01 for AOPP). Thirteen days of LHTL did not modify antioxidant status (FRAP and lipid-soluble antioxidants) despite intakes in vitamins A and E below the recommended daily allowances. The LHTL did not affect the antioxidant status in elite swimmers; however, the normoxic endurance training induced preconditioning mechanisms in response to the 4,800 m test.     

Living high–training low: effect on erythropoiesis and aerobic performance in highly-trained swimmers

The “living high–training low” model (LHTL), i.e., training in normoxia but sleeping/living in hypoxia, is designed to improve the athletes performance. However, LHTL efficacy still remains controversial and also little is known about the duration of its potential benefit. This study tested whether LHTL enhances aerobic performance in athletes, and if any positive effect may last for up to 2 weeks after LHTL intervention. Eighteen swimmers trained for 13 days at 1,200 m while sleeping/living at 1,200 m in ambient air (control, n=9) or in hypoxic rooms (LHTL, n=9, 5 days at simulated altitude of 2,500 m followed by 8 days at simulated altitude of 3,000 m, 16 h day⁻¹). Measures were done before 1–2 days (POST-1) and 2 weeks after intervention (POST-15). Aerobic performance was assessed from two swimming trials, exploring and endurance performance (2,000-m time trial), respectively. Reticulocyte, serum EPO and soluble transferrin receptor responses were not altered by LHTL, whereas reticulocytes decreased in controls. In POST-1 (vs. before): red blood cell volume increased in LHTL only (+8.5%, P=0.03), tended to increase more in LHTL (+8.1%, P=0.09) than in controls (+2.5%, P=0.21) without any difference between groups (P=0.42) and 2,000-m performance was unchanged with LHTL. In POST-15, both performance and hematological parameters were similar to initial levels. Our results indicate that LHTL may stimulate red cell production, without any concurrent amelioration of aerobic performance. The absence of any prolonged benefit after LHTL suggests that this LHTL model cannot be recommended for long-term purposes.     

Interactions between exposure to hypoxia and the training-induced autonomic adaptations in a “live high–train low” session

The autonomic and cardiovascular adaptations to hypoxia are opposite to those resulting from aerobic training. We investigated (1) whether exposure to hypoxia in a live high–train low (LHTL) session limits the autonomic and cardiovascular adaptations to training, and (2) whether such interactions remain 15 days after the end of the LHTL. Eighteen national swimmers trained for 13 days at 1,200 m, living (16 h day⁻¹) either at 1,200 m (live low–train low, LLTL) or at a simulated height of 2,500–3,000 m (LHTL). Subjects were investigated at 1,200 m before and at the end of the training session, and after the following 15 days of sea-level training. Cardiovascular parameters and the autonomic control assessed by spectral analysis of R–R and diastolic blood pressure (DBP) variability were obtained in the resting supine position and in response to an orthostatic test. At the end of the 13-day training, resting heart rate (HR) and sympathetic modulation on heart decreased in LLTL (−10.1% and −25.4%, P<0.01, respectively) but not in LHTL (−5.8, −15.5%, respectively). Total peripheral resistance (TPR) and DBP became higher in LHTL than in LLTL (P<0.05). Stroke index decreased in both groups during the tilt test, counteracted by an increase in HR and sympathetic modulation to the heart and vasculature, and a decrease in vagal modulation to the heart. After the following 15-day sea-level training, differences in TPR and DBP between groups disappeared. During an LHTL session, adaptations to hypoxia interacted with the autonomic and cardiovascular adaptations to training. However, these interactions did not limit the adaptations to the following sea-level training.     

Increased left ventricular muscle mass after long-term altitude training in athletes

The effects of long-term altitude training on altitude and sea-level physiological characteristics in elite endurance athletes were investigated. Seven Swedish elite cross-country skiers (five men, two women; mean age 27 years) spent 1 month training at 1900 m above sea level in Italy. Rollerski treadmill tests were performed before and 5 and 11 days after the altitude sojourn; three tests were also performed at altitude. Before and 1, 11 and 35 days after the altitude camp, echocardiographic and blood volume measurements were performed. The heart rates at both maximal (P < 0.05) and submaximal (P < 0.01) work loads were decreased by 5–9 beats min^?1 at altitude. The haemoglobin concentration and haematocrit increased quickly at altitude with a corresponding decrease on return to sea level. The blood volume (7%) and total haemoglobin (3%) tended to be higher day 11 post-altitude (NS). There were no significant changes in diastolic internal diameter or wall thickness of the left ventricle, but the calculated cardiac left ventricular muscle mass was increased post-altitude (9–10%, P < 0.01). The maximal oxygen uptake increased in six of the seven skiers after the altitude training (day 11, mean 3%, NS). In conclusion, training at moderate altitude may cause a reduction in heart rates during exercise. Moreover, after long-term training at altitude, there may be an increase in the cardiac left ventricular muscle mass.     

Living high-training low: tolerance and acclimatization in elite endurance athletes

The “living high-training low” (LHTL) model is frequently used to enhance aerobic performance. However, the clinical tolerance and acclimatization process to this intermittent exposure needs to be examined. Forty one athletes from three federations (cross-country skiers, n=11; swimmers, n=18; runners, n=12) separately performed a 13 to 18-day training at the altitude of 1,200 m, by sleeping either at 1,200 m (CON) or in hypoxic rooms (HYP), with an O₂ fraction corresponding to 2,500 m (5 nights for swimmers and 6 for skiers and runners), 3,000 m (6 nights for skiers, 8 for swimmers and 12 for runners) and 3,500 m (6 nights for skiers). Measurements performed before, 1 or 15 days after training were ventilatory response (HVRe) and desaturation (ΔSaO₂e) during hypoxic exercise, an evaluation of cardiac function by echocardiography, and leukocyte count. Lake Louise AMS score and arterial O₂ saturation during sleep were measured daily for HYP. Subjects did not develop symptoms of AMS. Mean nocturnal SaO₂ decreased with altitude down to 90% at 3,500 m and increased with acclimatization (except at 3,500 m). Leukocyte count was not affected except at 3,500 m. The heart function was not affected by LHTL. Signs of ventilatory acclimatization were present immediately after training (increased HVRe and decreased ΔSaO₂e) and had disappeared 15 days later. In conclusion, LHTL was well tolerated and compatible with aerobic training. Comparison of the three patterns of training suggests that a LHTL session should not exceed 3,000 m, for at least 18 days, with a minimum of 12 h day⁻¹ of exposure.     

Total haemoglobin mass and red blood cell profile in endurance-trained and non-endurance-trained adolescent athletes

To evaluate differences in total haemoglobin mass (tHb mass) and in red blood cell profile between elite endurance-trained (END) and non-endurance-trained (nEND) male and female adolescent athletes, tHb mass (CO rebreathing) and specific variables of red blood cell profile (haemoglobin concentration, haematocrit, erythrocyte indices) were determined in 59 elite junior athletes (29 END, 30 nEND). We hypothesized that at the age of 15–17 years, regular endurance training might induce a significant increase in tHb mass and changes in red blood cell profile. Therefore, all parameters were again determined after 6, 12 and 18 months in a subset of 27 subjects (17 END, 10 nEND). In END, tHb mass related to body weight was ~15% greater than in nEND (11.2 ± 1.6  vs. 9.7 ± 1.3 g kg⁻¹, P < 0.001), whereas no significant differences were observed for the red blood cell profile. In both groups, tHb mass related to body weight and the variables of red blood cell profile had not changed significantly after 6, 12 and 18 months of regular training. In conclusion, in elite junior athletes, differences in tHb mass between END and nEND were similar, however, smaller compared with previously in adult athletes reported values. At the age of 15–17 years, 18 months of regular training did not induce significant changes in tHb mass beyond alterations explained by physical growth and also variables of red blood cell profile did not change significantly.     

Implications of moderate altitude training for sea-level endurance in elite distance runners

Elite distance runners participated in one of two studies designed to investigate the effects of moderate altitude training (inspiratory partial pressure of oxygen ≈115–125?mmHg) on submaximal, maximal and supramaximal exercise performance following return to sea-level. Study 1 (New Mexico, USA) involved 14 subjects who were assigned to a 4-week altitude training camp (1500–2000?m) whilst 9 performance-matched subjects continued with an identical training programme at sea-level (CON). Ten EXP subjects who trained at 1640?m and 19 CON subjects also participated in study 2 (Krugersdorp, South Africa). Selected metabolic and cardiorespiratory parameters were determined with the subjects at rest and during exercise 21 days prior to (PRE) and 10 and 20 days following their return to sea-level (POST). Whole blood lactate decreased by 23% (P?P?P?may have been implicated in the increased incidence of infectious illness.     

The effects of classic altitude training on hemoglobin mass in swimmers

Aim of the study was to determine the influence of classic altitude training on hemoglobin mass (Hb-mass) in elite swimmers under the following aspects: (1) normal oscillation of Hb-mass at sea level; (2) time course of adaptation and de-adaptation; (3) sex influences; (4) influences of illness and injury; (5) interaction of Hb-mass and competition performance. Hb-mass of 45 top swimmers (male 24; female 21) was repeatedly measured (~6 times) over the course of 2 years using the optimized CO-rebreathing method. Twenty-five athletes trained between one and three times for 3–4 weeks at altitude training camps (ATCs) at 2,320 m (3 ATCs) and 1,360 m (1 ATC). Performance was determined by analyzing 726 competitions according to the German point system. The variation of Hb-mass without hypoxic influence was 3.0 % (m) and 2.7 % (f). At altitude, Hb-mass increased by 7.2 ± 3.3 % (p < 0.001; 2,320 m) and by 3.8 ± 3.4 % (p < 0.05; 1,360 m). The response at 2,320 m was not sex-related, and no increase was found in ill and injured athletes (n = 8). Hb-mass was found increased on day 13 and was still elevated 24 days after return (4.0 ± 2.7 %, p < 0.05). Hb-mass had only a small positive effect on swimming performance; an increase in performance was only observed 25–35 days after return from altitude. In conclusion, the altitude (2,320 m) effect on Hb-mass is still present 3 weeks after return, it decisively depends on the health status, but is not influenced by sex. In healthy subjects it exceeds by far the oscillation occurring at sea level. After return from altitude performance increases after a delay of 3 weeks.     

Time course of haemoglobin mass during 21 days live high:train low simulated altitude

The aim of this study was to determine the time course of changes in haemoglobin mass (Hb_mass) in well-trained cyclists in response to live high:train low (LHTL). Twelve well-trained male cyclists participated in a 3-week LHTL protocol comprising 3,000 m simulated altitude for ~14 h/day. Prior to LHTL duplicate baseline measurements were made of Hb_mass, maximal oxygen consumption (VO_2max) and serum erythropoietin (sEPO). Hb_mass was measured weekly during LHTL and twice in the week thereafter. There was a 3.3% increase in Hb_mass and no change in VO_2max after LHTL. The mean Hb_mass increased at a rate of ~1% per week and this was maintained in the week after cessation of LHTL. The sEPO concentration peaked after two nights of LHTL but there was only a trivial correlation (r = 0.04, P = 0.89) between the increase in sEPO and the increase in Hb_mass. Athletes seeking to gain erythropoietic benefits from moderate altitude need to spend >12 h/day in hypoxia. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Training-induced increases in sea-level performance are enhanced by acute intermittent hypobaric hypoxia

The goal of this study was to investigate to what extent intermittent exposure to altitude in a hypobaric chamber can improve performance at sea-level. Over a 10-day period, elite male triathletes trained for 2 h each day on a cycle ergometer placed in a hypobaric chamber. Training intensity was 60–70% of the heart rate reserve. Eight subjects trained at a simulated altitude of 2.500 m (hypoxia group), the other eight remained at sea-level (sea-level group). Baseline measurements were done on a cycle ergometer at sea-level, which included an incremental test until exhaustion and a Wingate Anaerobic Test. Nine days after training in hypoxia, significant increases were seen in all important parameters of the maximal aerobic as well as the anaerobic test. A significant increase of 7.0% was seen in the mean maximal oxygen uptake per kilogram body weight ( ), and the mean maximal power output per kilogram body weight (W _max) increased significantly by 7.4%. The mean values of both mean power per kilogram body weight and peak power per kilogram body weight increased significantly by 5.0%, and the time-to-peak decreased significantly by 37.7%. In the sea-level group, no significant changes were seen in the above-mentioned parameters of both the maximal aerobic and the maximal anaerobic test at the second post-test. The results of this study indicate that intermittent hypobaric training can improve both the aerobic and the anaerobic energy-supply systems. Electronic Publication     

Living high–training low altitude training: effects on mucosal immunity

Secretory immunoglobulin A (sIgA) is the major immunoglobulin of the mucosal immune system. Whereas the suppressive effect of heavy training on mucosal immunity is well documented, little is known regarding the influence of hypoxia exposure on sIgA during altitude training. This investigation examined the impact of an 18-day Living high–training low (LHTL) training camp on sIgA levels in 11 (six females and five males) elite cross-country skiers. Subjects from the control group (n=5) trained and lived at 1,200 m of altitude, whereas, subjects from the LHTL group (n=6) trained at 1,200 m, but lived at a simulated altitude of 2,500, 3,000 and 3,500 m (3×6-day, 11 h day^–1) in hypoxic rooms. Saliva samples were collected before, after each 6-day phases and 2 weeks thereafter (POST). Salivary sIgA, protein and cortisol were measured. There was a downward trend in sIgA concentrations over the study, which reached significance in LHTL (P<0.01), but not in control (P=0.08). Salivary IgA concentrations were still lower baseline at POST (P<0.05). Protein concentration increased in LHTL (P<0.05) and was negatively correlated with sIgA concentration after the 3,000 and 3,500 m-phase and at POST (P<0.05 all). Cortisol concentrations were unchanged over the study and no relationship was found between cortisol and sIgA. In summary, data were strongly suggestive of a cumulative negative effect of physical exercise and hypoxia on sIgA levels during LHTL training. Two weeks of active recovery did not allow for proper sIgA recovery. The mechanism underlying this depression of sIgA could be mediated by neural factors.     

Performance and physiological responses to a 5-week synchronized swimming technical training programme in humans

A synchronized swimming team routine (TR) is composed of figures of varying degrees of difficulty. Swimmers able to perform these figures separately underwent a 5-week technical training programme (TTP) to assemble a TR. Little is known about the physiological responses to this kind of TTP. A group of 13 trained synchronized swimmers [mean age 14 (SD 1) years] were tested before and after a 5-week TTP. The TR lasted 5?min, and 45% of that time was spent underwater. The swimmers' technique scores in the TR improved significantly from 4.5 (SD 1.9) before to 5.8 (SD 2.3) points after the TTP (P?V˙O_2peak), blood lactate concentration, and heart rate measured during a 400-m swim were lower after the TTP. The improvement in the technique scores correlated negatively with the change in V˙O_2peak (r?=??0.57; P?V˙O_2peak. The overall synchronized swimming skill was assessed by the best score the swimmers obtained in four to six competitions over a season. This score was related to the 400-m swimming performance, V˙O_2peak, maximal distance covered in apnoea, and the breath-hold time. The 5-week TTP therefore improved technical performance during the TR without improving physiological, swimming or apnoea performances. However, the physiological profile of each swimmer was linked to the synchronized swimming skill.     

Association between ACE D allele and elite short distance swimming

The influence of ACE gene on athletic performance has been widely explored, and most of the published data refers to an I/D polymorphism leading to the presence (I allele) or absence (D allele) of a 287-bp sequence in intron 16, determining ACE activity in serum and tissues. A higher I allele frequency has been reported among elite endurance athletes, while the D allele was more frequent among those engaged in more power-orientated sports. However, on competitive swimming, the reproducibility of such associations is controversial. We thus compared the ACE genotype of elite swimmers with that of non-elite swimming cohort and of healthy control subjects. We thus sought an association of the ACE genotype of elite swimmers with their competitive distance. 39 Portuguese Olympic swimming candidates were classified as: short (<200 m) and middle (400–1,500 m) distance swimmers, respectively. A group of 32 non-elite swimmers were studied and classified as well, and a control group (n = 100) was selected from the Portuguese population. Chelex 100 was used for DNA extraction and genotype was determined by PCR-RFLP methods. We found that ACE genotype distribution and allelic frequency differs significantly by event distance only among elite swimmers (P ≤ 0.05). Moreover, the allelic frequency of the elite short distance swimmers differed significantly from that of the controls (P = 0.021). No associations were found between middle distance swimmers and controls. Our results seem to support an association between the D allele and elite short distance swimming.     

The ACE gene insertion/deletion polymorphism and elite endurance swimming

Human physical performance is influenced by genetic factors. A variation in the human angiotensin I-converting enzyme (ACE) gene has been identified, in which the insertion (I) variant may be associated with elite endurance performance, and the deletion (D) variant seems overrepresented amongst elite sprinters and short-distance swimmer status. We might thus anticipate I-allele frequency to be elevated amongst swimmers competing over very much greater distances, and have examined this hypothesis. Thirty-five truly elite very-long-distance swimmers were classified as better at 1- to 10-km distances (n=19, SLD group) or those best at 25-km races (n=16, LLD group). Genotype frequencies (II versus ID versus DD) differed between the two groups: 6% versus 47% versus 47% for SLD, and 18.8% versus 75% versus 6.2% for LLD (P=0.01). I-allele frequency was 0.29 for the shorter distance swimmers, and 0.59 for the 25 km group. These data are consistent with an association of ACE I allele with longer distance swimming, and the ACE D allele with swimming shorter distances.     

Effects of a 12-day “live high, train low” camp on reticulocyte production and haemoglobin mass in elite female road cyclists

The aim of this study was to document the effect of “living high, training low” on the red blood cell production of elite female cyclists. Six members of the Australian National Women's road cycling squad slept for 12 nights at a simulated altitude of 2650?m in normobaric hypoxia (HIGH), while 6 team-mates slept at an altitude of 600?m (CONTROL). HIGH and CONTROL subjects trained and raced as a group throughout the 70-day study. Baseline levels of reticulocyte parameters sensitive to changes in erythropoeisis were measured 21 days and 1 day prior to sleeping in hypoxia (D1 and D20, respectively). These measures were repeated after 7 nights (D27) and 12 nights (D34) of simulated altitude exposure, and again 15 days (D48) and 33 days (D67) after leaving the altitude house. There was no increase in reticulocyte production, nor any change in reticulocyte parameters in either the HIGH or CONTROL groups. This lack of haematological response was substantiated by total haemoglobin mass measures (CO-rebreathing), which did not change when measured on D1, D20, D34 or D67. We conclude that in elite female road cyclists, 12 nights of exposure to normobaric hypoxia (2650?m) is not sufficient to either stimulate reticulocyte production or increase haemoglobin mass.     

Gender differences in post-exercise sagittal knee translation: a comparison between elite volleyball players and swimmers

BACKGROUND: There is an increased risk for anterior cruciate ligament injury during the last part of a match or training session and one reason for that could be a post-exercise increase in tibial translation. PURPOSE: To investigate if sagittal tibial translation is affected after a workout session in volleyball or swimming in elite athletes. In addition, gender differences in sagittal tibial translation after the workout session were investigated. METHOD: Thirty-one elite volleyball players (16 male) and 33 elite swimmers (15 male) participated in this study. Measurements of total tibial translation were taken before and after a workout session in either volleyball or swimming with the use of a KT-1000 arthrometer. RESULTS: Total tibial translation increased by 1.1 mm (SD 1.9) in the group consisting of both male and female volleyball players (p=0.003) and remained unchanged in the swimmers. Male athletes increased their tibial translation with 1.8 mm (SD 1.8) and 0.6 mm (SD 1.1) in the two sports, respectively, while the tibial translation did not increase in the female athletes. CONCLUSION: Impact sports such as volleyball training leads to a post-exercise increase in tibial translation in male athletes. The increase in tibial translation in swimmers, that is a non-impact sport, was small and may not be clinically significant for the functional stability of the joint. It has been shown that female athletes have an increased risk for injury. Our results show no support for an increase in tibial translation being an important factor for this increased risk, and suggest that the difference between males and females in this regard should be sought elsewhere.     

Increase in serum vascular endothelial growth factor levels during altitude training

The present study was performed to evaluate the effects of physical exercise at altitudes on serum vascular endothelial growth factor (VEGF) levels. Eight subjects underwent intensive swimming training for 21 days at 1886 m. After altitude training commenced, red blood cell (RBC) counts and erythropoietin levels increased, but both haemoglobin and haematocrit levels did not change significantly. The serum level of VEGF, measured by means of a highly sensitive chemiluminescence (ELISA), showed a transient decrease 10 days after start of the altitude training, thereafter increasing significantly to reach a peak level 19 days later, rising from 23.0 ± 5.3 to 46.0 ± 14.6 pg mL^?1 (P < 0.05 vs. before). On return to low altitude in Japan, the level of VEGF decreased, and 1 month later had returned to initial levels. Endurance training at altitudes increases serum VEGF levels; this could be an adaptive reaction to hypoxic conditions. This result suggests that VEGF may provide a new physiological parameter for hypoxic stress imposed by high altitude training.     

“Live High–Train High” increases hemoglobin mass in Olympic swimmers

Purpose

This study tested whether 3–4 weeks of classical “Live High–Train High” (LHTH) altitude training increases swim-specific VO_2max through increased hemoglobin mass (Hb_mass).

Methods

Ten swimmers lived and trained for more than 3 weeks between 2,130 and 3,094 m of altitude, and a control group of ten swimmers followed the same training at sea-level (SL). Body composition was examined using dual X-ray absorptiometry. Hb_mass was determined by carbon monoxide rebreathing. Swimming VO_2peak was determined and swimming trials of 4 × 50, 200 and 3,000 m were performed before and after the intervention.

Results

Hb_mass (n = 10) was increased (P < 0.05)after altitude training by 6.2 ± 3.9 % in the LHTH group, whereas no changes were apparent in the SL group (n = 10). Swimming VO_2peak was similar before and after training camps in both groups (LHTH: n = 7, SL: n = 6). Performance of 4 × 50 m at race pace was improved to a similar degree in both groups (LHTH: n = 10, SL: n = 10). Maximal speed reached in an incremental swimming step test (P = 0.051), and time to complete 3,000 m tended (P = 0.09) to be more improved after LHTH (n = 10) than SL training (n = 10).

Conclusion

In conclusion, 3–4 weeks of classical LHTH is sufficient to increase Hb_mass but exerts no effect on swimming-specific VO_2peak. LHTH may improve performance more than SL training.     

Pneumococcal antibody responses in elite swimmers

The ability of elite swimmers to mount an antibody response to the pneumococcal vaccine, Pneumovax 23, was assessed at the end of an intensive 12-week training programme. Antibody titres to six pneumococcal polysaccharide types were measured in 20 elite swimmers (10 male, 10 female) aged 17–23 years and 19 sedentary age- and sex-matched students (eight male, 11 female) aged 18–23 years. Blood samples were tested 14 days apart to assess the magnitude of the antibody response and changes in serum immunoglobulin isotypes and IgG subclasses. There were no significant differences in any of the pneumococcal antibody responses to the Pneumovax between swimmers and controls, and no gender effect, either before or after vaccination. The clinically adequate response to the vaccine was greatest for the pneumococcal serotype 4, which was 97% for the total study population. There were no significant correlations between the magnitude of any of the pneumococcal antibody responses and (i) changes in the scores for the swimmers’ international performance; (ii) infection rates in either swimmers or controls; (iii) any psychological variables, assessed by the Profile of Mood States (POMS) questionnaire for either swimmers or controls. Swimmers had significantly lower concentrations of serum IgG2 (P = 0·04) and IgG3 (P = 0·002) before pneumococcal vaccination. The swimmers had an increase in all immunoglobulin isotypes and IgG subclasses post-vaccination, suggesting a polyclonal response to the vaccine that was not observed in control subjects. The magnitude of the subclass responses after vaccination was significantly greater in swimmers compared with controls for IgG1 (P = 0·04), IgG3 (P = 0·04) and IgG4 (P = 0·01). The data indicated that elite swimmers undertaking an intensive training programme were capable of mounting an antibody response to pneumococcal antigens equivalent to that of age- and sex-matched sedentary control subjects, despite the swimmers having lower prevaccination levels of serum immunoglobulins.     

Respiratory symptoms, bronchial responsiveness, and cellular characteristics of induced sputum in elite swimmers

To investigate respiratory symptoms, increased bronchial responsiveness, and signs of airway inflammation in elite swimmers, we examined 29 swimmers from the Finnish national team and 19 healthy control subjects (nonasthmatic, symptom-free). They answered a questionnaire and were interviewed for respiratory symptoms. Lung volumes were measured and bronchial responsiveness assessed by a histamine challenge test. Induced sputum samples were also collected. Fourteen (48%) of the swimmers and three (16%) of the control subjects showed increased bronchial responsiveness (P<0.05). The sputum cell differential counts of eosinophils (mean 2.7% vs 0.2%) and neutrophils (54.7% V5 29.9%) from swimmers were significantly higher than those from controls (P<0.01). Eosinophilia (sputum differential eosinophil count of >4%) was observed in six (21%) of the swimmers and in none of the controls (P<0.05). Symptomatic swimmers had significantly more sputum eosinophils than did the symptom-free. The concentrations of sputum eosinophil peroxidase (EPO) and human neutrophil lipocalin (HNL) were significantly higher in swimmers than control subjects (P<0.001 and P=0.05). We conclude that elite swimmers had significantly more often increased tjronchial responsiveness than control subjects. Sputum from swimmers contained a higher percentage of eosinophils and neutrophils, and higher concentrations of EPO and HNL than sputum from controls. Long-term and repeated exposure to chlorine compounds in swimming pools during training and competition may contribute to the increased occurrence of bronchial hyperresponsiveness and airway inflammation in swimmers.