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<title>Exercise-induced bronchoconstriction</title>
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<span id="openzim-page-title" class="mw-page-title-main"><span class="mw-page-title-main">Exercise-induced bronchoconstriction</span></span>
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</style><table class="infobox infobox-has-images-with-white-backgrounds"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Exercise-induced Bronchoconstriction</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">EIA</td></tr><tr><th scope="row" class="infobox-label"><a href="Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="Pulmonology" title="Pulmonology">Pulmonology</a>&nbsp;<span class="penicon autoconfirmed-show"></span></td></tr><tr><th scope="row" class="infobox-label"><a href="Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data">Shortness of breath on vigorous exercise</td></tr><tr><th scope="row" class="infobox-label">Usual onset</th><td class="infobox-data">Rapid, on exercise</td></tr><tr><th scope="row" class="infobox-label">Duration</th><td class="infobox-data">For the duration of activity and some time afterwards</td></tr><tr><th scope="row" class="infobox-label"><a href="Cause_(medicine)" title="Cause (medicine)">Causes</a></th><td class="infobox-data">Moderate to high intensity exercise</td></tr></tbody></table><style data-mw-deduplicate="TemplateStyles:r1236303919">
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<p><b>Exercise-induced bronchoconstriction</b> (<b>EIB</b>) occurs when the airways narrow as a result of exercise. This condition has been referred to as <b>exercise-induced asthma</b> (<b>EIA</b>); however, this term is no longer preferred.<sup id="cite_ref-:0_1-0" class="reference"><a href="#cite_note-:0-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> While exercise does not cause <a href="Asthma" title="Asthma">asthma</a>, it is frequently an <a href="Asthma_trigger" title="Asthma trigger">asthma trigger</a>.<sup id="cite_ref-:0_1-1" class="reference"><a href="#cite_note-:0-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup>
</p><p>It might be expected that people with EIB would present with <a href="Dyspnea" class="mw-redirect" title="Dyspnea">shortness of breath</a>, and/or an <a href="Tachypnea" title="Tachypnea">elevated respiratory rate</a> and <a href="Wheezing" class="mw-redirect" title="Wheezing">wheezing</a>, consistent with an asthma attack. However, many will present with decreased stamina, or difficulty in recovering from exertion compared to team members, or paroxysmal coughing from an irritable airway.<sup id="cite_ref-Parsons_2-0" class="reference"><a href="#cite_note-Parsons-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Similarly, examination may reveal wheezing and prolonged expiratory phase, or may be quite normal. Consequently, a potential for under-diagnosis exists. Measurement of airflow, such as <a href="Peak_expiratory_flow" title="Peak expiratory flow">peak expiratory flow</a> rates, which can be done inexpensively on the track or sideline, may prove helpful. In athletes, symptoms of <a href="Bronchospasm" title="Bronchospasm">bronchospasm</a> such as chest discomfort, breathlessness, and fatigue are often falsely attributed to the individual being out of shape, having asthma, or possessing a hyperreactive airway rather than EIB.<sup id="cite_ref-Parsons_&amp;_Mastronade_3-0" class="reference"><a href="#cite_note-Parsons_&amp;_Mastronade-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup>
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<div class="mw-heading mw-heading2"><h2 id="Cause">Cause</h2></div>
<p>While the potential triggering events for EIB are well recognized, the underlying pathogenesis is poorly understood.<sup id="cite_ref-CAAR_4-0" class="reference"><a href="#cite_note-CAAR-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> It usually occurs after at least several minutes of vigorous, <a href="Aerobic_exercise" title="Aerobic exercise">aerobic</a> activity, which increases oxygen demand to the point where breathing through the nose (<a href="Nasal_breathing" class="mw-redirect" title="Nasal breathing">nasal breathing</a>) must be supplemented by <a href="Mouth_breathing" title="Mouth breathing">mouth breathing</a>. The resultant inhalation of air that has not been warmed and humidified by the nasal passages seems to generate increased blood flow to the linings of the bronchial tree, resulting in <a href="Edema" title="Edema">edema</a>. Constriction of these small airways then follows, worsening the degree of obstruction to airflow. There is increasing evidence that the smooth muscle that lines the airways becomes progressively more sensitive to changes that occur as a result of injury to the airways from dehydration. The chemical mediators that provoke the muscle spasm appear to arise from <a href="Mast_cell" title="Mast cell">mast cells</a>.<sup id="cite_ref-CAAR_4-1" class="reference"><a href="#cite_note-CAAR-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Mouth breathing as a result of decreased nasal breathing also increases lung surface exposure to irritants, pollutants, and allergens, causing <a href="Neutrophil" title="Neutrophil">neutrophilic</a> inflammation in response to reactive oxygen species formation; research has found that individuals with genetically hindered <a href="Glutathione" title="Glutathione">glutathione</a> counteraction of this <a href="Oxidative_stress" title="Oxidative stress">oxidative stress</a> are likely at a higher risk of developing EIB.<sup id="cite_ref-TIFL_5-0" class="reference"><a href="#cite_note-TIFL-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup>
</p>
<div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2></div>
<p>Exercise-induced <a href="Bronchoconstriction" title="Bronchoconstriction">bronchoconstriction</a> can be difficult to diagnose clinically given the lack of specific symptoms<sup id="cite_ref-Parsons_2-1" class="reference"><a href="#cite_note-Parsons-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> and frequent misinterpretation as manifestations of vigorous exercise. There are many mimics that present with similar symptoms, such as <a href="Vocal_cord_dysfunction" title="Vocal cord dysfunction">vocal cord dysfunction</a>, <a href="Cardiac_arrhythmias" class="mw-redirect" title="Cardiac arrhythmias">cardiac arrhythmias</a>, <a href="Cardiomyopathies" class="mw-redirect" title="Cardiomyopathies">cardiomyopathies</a>, and <a href="Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">gastroesophageal reflux disease</a>. It is also important to distinguish those who have asthma with exercise worsening, and who consequently will have abnormal testing at rest, from true exercise-induced bronchoconstriction, where there will be normal baseline results. Because of the wide differential diagnosis of exertional respiratory complaints, the diagnosis of exercise-induced bronchoconstriction based on history and self-reported symptoms alone has been shown to be inaccurate<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> and to result in an incorrect diagnosis more than 50% of the time.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> An important and often overlooked differential diagnosis is <a href="Exercise-induced_laryngeal_obstruction" title="Exercise-induced laryngeal obstruction">exercise-induced laryngeal obstruction (EILO)</a>. The latter can co-exist with EIB and is best differentiated using objective testing and continuous laryngoscopy during exercise (CLE) testing.
</p>
<div class="mw-heading mw-heading3"><h3 id="Spirometry">Spirometry</h3></div>
<p>Objective testing should begin with <a href="Spirometry" title="Spirometry">spirometry</a> at rest. In true exercise-induced bronchoconstriction, the results should be within normal limits. Should resting values be abnormal, then asthma, or some other chronic lung condition, is present. There is, of course, no reason why asthma and exercise-induced bronchoconstriction should not co-exist but the distinction is important because without successful treatment of underlying asthma, treatment of an exercise component will likely be unsuccessful. If baseline testing is normal, some form of exercise or pharmacologic stress will be required, either on the sideline or practice venue, or in the laboratory.<sup id="cite_ref-ERS_9-0" class="reference"><a href="#cite_note-ERS-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup>
</p>
<div class="mw-heading mw-heading3"><h3 id="Exercise_testing">Exercise testing</h3></div>
<p>Treadmill or ergometer-based testing in lung function laboratories are effective methods for diagnosing exercise-induced bronchoconstriction, but may result in false negatives if the exercise stimulus is not intense enough.
</p>
<div class="mw-heading mw-heading3"><h3 id="Field-exercise_challenge">Field-exercise challenge</h3></div>
<p>Field-exercise challenge tests that involve the athlete performing the sport in which they are normally involved and assessing <a href="FEV1/FVC_ratio" title="FEV1/FVC ratio">FEV<sub>1</sub></a> after exercise are helpful if abnormal but have been shown to be less sensitive than eucapnic voluntary hyperventilation.<sup id="cite_ref-pmid10084470_10-0" class="reference"><a href="#cite_note-pmid10084470-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup>
</p>
<div class="mw-heading mw-heading4"><h4 id="Eucapnic_voluntary_hyperventilation_challenge">Eucapnic voluntary hyperventilation challenge</h4></div>
<p>The <a href="International_Olympic_Committee" title="International Olympic Committee">International Olympic Committee</a> recommends the eucapnic voluntary hyperventilation (EVH) challenge as the test to document exercise-induced asthma in <a href="Olympic_Games" title="Olympic Games">Olympic</a> athletes.<sup id="cite_ref-McKeagMoeller2007_11-0" class="reference"><a href="#cite_note-McKeagMoeller2007-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> In the EVH challenge, the patient voluntarily, without exercising, rapidly breathes dry air enriched with 5% CO<sub style="font-size: 80%;vertical-align: -0.35em">2</sub> for six minutes. The presence of the enriched CO<sub style="font-size: 80%;vertical-align: -0.35em">2</sub> compensates for the CO<sub style="font-size: 80%;vertical-align: -0.35em">2</sub> losses in the expired air, not matched by metabolic production, that occurs during hyperventilation, and so maintains CO<sub style="font-size: 80%;vertical-align: -0.35em">2</sub> levels at normal.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup>
</p>
<div class="mw-heading mw-heading4"><h4 id="Medication_challenge">Medication challenge</h4></div>
<p>Medication challenge tests, such as the <a href="Methacholine" title="Methacholine">methacholine</a> challenge test, have a lower sensitivity for detection of exercise-induced bronchoconstriction in athletes and are also not a recommended first-line approach in the evaluation of exercise-induced asthma.<sup id="cite_ref-pmid17433829_13-0" class="reference"><a href="#cite_note-pmid17433829-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup>
</p><p><a href="Mannitol" title="Mannitol">Mannitol</a> inhalation<sup id="cite_ref-pmid9769270_14-0" class="reference"><a href="#cite_note-pmid9769270-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid18756011_15-0" class="reference"><a href="#cite_note-pmid18756011-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> has been recently approved for use in the United States.
</p><p>A relatively recent review of the literature has concluded that there is currently insufficient available evidence to conclude that either mannitol inhalation or eucapnic voluntary hyperventilation are suitable alternatives to exercise challenge testing to detect exercise-induced bronchoconstriction and that additional research is required.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup>
</p>
<div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2></div>
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</style><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="Asthma#Management" title="Asthma">Asthma §&nbsp;Management</a></div>
<div class="mw-heading mw-heading3"><h3 id="Lifestyle">Lifestyle</h3></div>
<p>The best treatment is avoidance of conditions predisposing to attacks, when possible. In athletes who wish to continue their sport or do so in adverse conditions, preventive measures include altered training techniques and medications.
</p><p>Some take advantage of the <a href="Refractory_period_(physiology)" title="Refractory period (physiology)">refractory period</a> by precipitating an attack by "warming up," and then timing competition such that it occurs during the refractory period. Step-wise training works in a similar fashion. Warm up occurs in stages of increasing intensity, using the refractory period generated by each stage to reach a full workload.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup>
</p>
<div class="mw-heading mw-heading3"><h3 id="Medication">Medication</h3></div>
<p>There is no evidence supporting different treatment for EIB in asthmatic athletes and nonathletes.<sup id="cite_ref-ERS2_18-0" class="reference"><a href="#cite_note-ERS2-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> The most common medication used is a <a href="Beta_agonist" class="mw-redirect" title="Beta agonist">beta agonist</a> taken about 20 minutes before exercise.<sup id="cite_ref-ERS2_18-1" class="reference"><a href="#cite_note-ERS2-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> Some physicians prescribe inhaled anti-inflammatory mists such as <a href="Corticosteroids" class="mw-redirect" title="Corticosteroids">corticosteroids</a> or <a href="Leukotriene_antagonist" class="mw-redirect" title="Leukotriene antagonist">leukotriene antagonists</a>, and <a href="Mast_cell_stabilizer" title="Mast cell stabilizer">mast cell stabilizers</a> have also proven effective.<sup id="cite_ref-ERS2_18-2" class="reference"><a href="#cite_note-ERS2-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup>
</p><p>In May 2013, the <a href="American_Thoracic_Society" title="American Thoracic Society">American Thoracic Society</a> issued the first treatment guidelines for EIB, recommending use of "a short-acting β2-agonist before exercise in all patients with EIB. For patients who continue to have symptoms of EIB despite the administration of a short-acting β2-agonist before exercise, strong recommendations were made for a daily inhaled corticosteroid, a daily leukotriene receptor antagonist, or a mast cell stabilizing agent before exercise."<sup id="cite_ref-ATS2013_19-0" class="reference"><a href="#cite_note-ATS2013-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup>
</p><p>There is conflicting information about the value of <a href="Theophylline" title="Theophylline">theophylline</a> and other <a href="Methylxanthines" title="Methylxanthines">methylxanthines</a> as prophylaxis against exercise-induced bronchoconstriction.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup>
</p>
<div class="mw-heading mw-heading3"><h3 id="Research">Research</h3></div>
<p>A <a href="Crossover_study" title="Crossover study">crossover study</a> compared oral <a href="Montelukast" title="Montelukast">montelukast</a> with inhaled <a href="Salmeterol" title="Salmeterol">salmeterol</a>, both given two hours before exercise, showing that the drugs had similar benefit.<sup id="cite_ref-pmid17573489_21-0" class="reference"><a href="#cite_note-pmid17573489-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup>
</p><p>A <a href="Meta-analysis" title="Meta-analysis">meta-analysis</a> of preliminary research indicated that <a href="Vitamin_C" title="Vitamin C">vitamin C</a> may be useful to relieve respiratory symptoms such as cough during exercise.<sup id="cite_ref-Hemila2013_22-0" class="reference"><a href="#cite_note-Hemila2013-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup>
</p>
<div class="mw-heading mw-heading2"><h2 id="Prevalence_in_athletes">Prevalence in athletes</h2></div>
<p>Olympic swimmers <a href="Tom_Dolan" title="Tom Dolan">Tom Dolan</a>, <a href="Amy_Van_Dyken" title="Amy Van Dyken">Amy Van Dyken</a>, and <a href="Nancy_Hogshead" class="mw-redirect" title="Nancy Hogshead">Nancy Hogshead</a>, Olympic track star <a href="Jackie_Joyner-Kersee" title="Jackie Joyner-Kersee">Jackie Joyner-Kersee</a>, baseball Hall of Famer <a href="Catfish_Hunter" title="Catfish Hunter">Catfish Hunter</a>, and American football player <a href="Jerome_Bettis" title="Jerome Bettis">Jerome Bettis</a> are among the many who have the condition. Tour de France winner <a href="Chris_Froome" title="Chris Froome">Chris Froome</a> reported that he suffers from the condition, after being spotted using a nasal inhaler during race.<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> Other athletes with EIB include racing cyclist <a href="Simon_Yates_(cyclist)" title="Simon Yates (cyclist)">Simon Yates</a>, distance runner <a href="Paula_Radcliffe" title="Paula Radcliffe">Paula Radcliffe</a><sup id="cite_ref-graun_24-0" class="reference"><a href="#cite_note-graun-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> and cross-country skier <a href="Marit_Bj%C3%B8rgen" title="Marit Bjørgen">Marit Bjørgen</a>.<sup id="cite_ref-cnn_25-0" class="reference"><a href="#cite_note-cnn-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> Research by sports scientist John Dickinson found that 70 percent of UK-based members of the British swimming team had some form of asthma, as did a third of <a href="Ineos_Grenadiers" title="Ineos Grenadiers">Team Sky</a> cyclists, compared to a national asthma rate of eight to ten percent,<sup id="cite_ref-graun_24-1" class="reference"><a href="#cite_note-graun-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> whilst a study by the <a href="United_States_Olympic_Committee" class="mw-redirect" title="United States Olympic Committee">United States Olympic Committee</a> in 2000 found that half of cross-country skiers had EIB.<sup id="cite_ref-cnn_25-1" class="reference"><a href="#cite_note-cnn-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup>
</p>
<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>
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<li id="cite_note-20"><span class="mw-cite-backlink"><b><a href="#cite_ref-20">^</a></b></span> <span class="reference-text"><cite id="CITEREFPigakisStavrouPantazopoulosDaniil2022" class="citation journal cs1">Pigakis, Konstantinos M; Stavrou, Vasileios T; Pantazopoulos, Ioannis; Daniil, Zoe; Kontopodi, Aggeliki K; Gourgoulianis, Konstantinos (3 January 2022). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8807463">"Exercise-Induced Bronchospasm in Elite Athletes"</a>. <i>Cureus</i>. <b>14</b> (1): e20898. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.7759%2Fcureus.20898">10.7759/cureus.20898</a></span>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&nbsp;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8807463">8807463</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&nbsp;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/35145802">35145802</a>.</cite></span>
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<li id="cite_note-pmid17573489-21"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid17573489_21-0">^</a></b></span> <span class="reference-text"><cite id="CITEREFPhilipPearlmanVillarán2007" class="citation journal cs1">Philip G, Pearlman DS, Villarán C, et&nbsp;al. (2007). "Single-dose montelukast or salmeterol as protection against exercise-induced bronchoconstriction". <i>Chest</i>. <b>132</b> (3): <span class="nowrap">875–</span>83. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1378%2Fchest.07-0550">10.1378/chest.07-0550</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&nbsp;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17573489">17573489</a>.</cite></span>
</li>
<li id="cite_note-Hemila2013-22"><span class="mw-cite-backlink"><b><a href="#cite_ref-Hemila2013_22-0">^</a></b></span> <span class="reference-text"><cite id="CITEREFHemilä2013" class="citation journal cs1">Hemilä, H (7 June 2013). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3686214">"Vitamin C may alleviate exercise-induced bronchoconstriction: a meta-analysis"</a>. <i><a href="BMJ_Open" title="BMJ Open">BMJ Open</a></i>. <b>3</b> (6): e002416. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fbmjopen-2012-002416">10.1136/bmjopen-2012-002416</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&nbsp;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3686214">3686214</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&nbsp;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23794586">23794586</a>.</cite> <span style="position:relative; top: -2px;"><span typeof="mw:File"><a href="Open_access" title="open access publication – free to read"></a></span></span></span>
</li>
<li id="cite_note-23"><span class="mw-cite-backlink"><b><a href="#cite_ref-23">^</a></b></span> <span class="reference-text"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://www.cyclingnews.com/news/froome-surprised-at-controversy-over-in-race-inhaler-use">"Froome surprised at controversy over in-race inhaler use"</a>. 10 June 2014.</cite></span>
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<li id="cite_note-graun-24"><span class="mw-cite-backlink">^ <a href="#cite_ref-graun_24-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-graun_24-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFWalker2016" class="citation web cs1">Walker, Peter (29 April 2016). <a rel="nofollow" class="external text" href="https://www.theguardian.com/sport/2016/apr/29/elite-athletes-asthma-simon-yates-team-sky-swimmers">"Why do so many elite athletes have asthma?"</a>. <i><a href="Theguardian.com" class="mw-redirect" title="Theguardian.com">theguardian.com</a></i><span class="reference-accessdate">. Retrieved <span class="nowrap">29 April</span> 2016</span>.</cite></span>
</li>
<li id="cite_note-cnn-25"><span class="mw-cite-backlink">^ <a href="#cite_ref-cnn_25-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-cnn_25-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFGardner2010" class="citation web cs1">Gardner, Amanda (17 February 2010). <a rel="nofollow" class="external text" href="http://edition.cnn.com/2010/HEALTH/02/17/exercise.asthma.winter/">"For Olympians and weekend warriors, winter sports can trigger asthma"</a>. <i><a href="Cnn.com" class="mw-redirect" title="Cnn.com">cnn.com</a></i><span class="reference-accessdate">. Retrieved <span class="nowrap">29 April</span> 2016</span>.</cite></span>
</li>
</ol></div></div>
<div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2></div>
<ul><li><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://www.aaaai.org/patients/publicedmat/tips/exerciseinducedasthma.stm">"Tips to Remember: Exercise-induced asthma"</a>. <a href="American_Academy_of_Allergy%2C_Asthma%2C_and_Immunology" title="American Academy of Allergy, Asthma, and Immunology">American Academy of Allergy, Asthma, and Immunology</a><span class="reference-accessdate">. Retrieved <span class="nowrap">2007-04-12</span></span>.</cite></li>
<li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20120922025912/http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0033704/">Fact sheet: Exercise-induced asthma</a></li></ul>
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</style><div id="Diseases_of_the_respiratory_system378" style="font-size:114%;margin:0 4em"><a href="Respiratory_disease" title="Respiratory disease">Diseases of the respiratory system</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Upper_respiratory_tract_infection" title="Upper respiratory tract infection">Upper RT</a><br>(including <a href="Upper_respiratory_tract_infection" title="Upper respiratory tract infection">URTIs</a>,<br><a href="Common_cold" title="Common cold">common cold</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Human_head" title="Human head">Head</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<dl><dt><i><a href="Paranasal_sinuses" title="Paranasal sinuses">sinuses</a></i></dt>
<dd></dd>
<dd><a href="Sinusitis" title="Sinusitis">Sinusitis</a></dd></dl>
<dl><dt><i><a href="Human_nose" title="Human nose">nose</a></i></dt>
<dd></dd>
<dd><a href="Rhinitis" title="Rhinitis">Rhinitis</a>
<dl><dd><a href="Nonallergic_rhinitis" title="Nonallergic rhinitis">Vasomotor rhinitis</a></dd>
<dd><a href="Chronic_atrophic_rhinitis" title="Chronic atrophic rhinitis">Atrophic rhinitis</a></dd>
<dd><a href="Allergic_rhinitis" title="Allergic rhinitis">Hay fever</a></dd></dl></dd>
<dd><a href="Nasal_polyp" title="Nasal polyp">Nasal polyp</a></dd>
<dd><a href="Rhinorrhea" title="Rhinorrhea">Rhinorrhea</a></dd>
<dd><i><a href="Nasal_septum" title="Nasal septum">nasal septum</a></i>
<dl><dd><a href="Nasal_septum_deviation" title="Nasal septum deviation">Nasal septum deviation</a></dd>
<dd><a href="Nasal_septum_perforation" title="Nasal septum perforation">Nasal septum perforation</a></dd>
<dd><a href="Cocaine-induced_midline_destructive_lesions" title="Cocaine-induced midline destructive lesions">Cocaine-induced midline destructive lesions</a> (CIMDL)</dd>
<dd><a href="Nasal_septal_hematoma" title="Nasal septal hematoma">Nasal septal hematoma</a></dd></dl></dd></dl>
<dl><dt><i><a href="Tonsil" title="Tonsil">tonsil</a></i></dt>
<dd></dd>
<dd><a href="Tonsillitis" title="Tonsillitis">Tonsillitis</a></dd>
<dd><a href="Adenoid_hypertrophy" title="Adenoid hypertrophy">Adenoid hypertrophy</a></dd>
<dd><a href="Peritonsillar_abscess" title="Peritonsillar abscess">Peritonsillar abscess</a></dd></dl>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Neck" title="Neck">Neck</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<dl><dt><i><a href="Pharynx" title="Pharynx">pharynx</a></i></dt>
<dd></dd>
<dd><a href="Pharyngitis" title="Pharyngitis">Pharyngitis</a>
<dl><dd><a href="Streptococcal_pharyngitis" title="Streptococcal pharyngitis">Strep throat</a></dd></dl></dd>
<dd><a href="Laryngopharyngeal_reflux" title="Laryngopharyngeal reflux">Laryngopharyngeal reflux</a> (LPR)</dd>
<dd><a href="Retropharyngeal_abscess" title="Retropharyngeal abscess">Retropharyngeal abscess</a></dd></dl>
<dl><dt><i><a href="Larynx" title="Larynx">larynx</a></i></dt>
<dd></dd>
<dd><a href="Croup" title="Croup">Croup</a></dd>
<dd><a href="Laryngomalacia" title="Laryngomalacia">Laryngomalacia</a></dd>
<dd><a href="Laryngeal_cyst" title="Laryngeal cyst">Laryngeal cyst</a></dd>
<dd><a href="Laryngitis" title="Laryngitis">Laryngitis</a></dd>
<dd><a href="Laryngopharyngeal_reflux" title="Laryngopharyngeal reflux">Laryngopharyngeal reflux</a> (LPR)</dd>
<dd><a href="Laryngospasm" title="Laryngospasm">Laryngospasm</a></dd></dl>
<dl><dt><i><a href="Vocal_cords" title="Vocal cords">vocal cords</a></i></dt>
<dd></dd>
<dd><a href="Laryngopharyngeal_reflux" title="Laryngopharyngeal reflux">Laryngopharyngeal reflux</a> (LPR)</dd>
<dd><a href="Vocal_cord_nodule" title="Vocal cord nodule">Vocal fold nodule</a></dd>
<dd><a href="Vocal_cord_paresis" title="Vocal cord paresis">Vocal fold paresis</a></dd>
<dd><a href="Vocal_cord_dysfunction" title="Vocal cord dysfunction">Vocal cord dysfunction</a></dd></dl>
<dl><dt><i><a href="Epiglottis" title="Epiglottis">epiglottis</a></i></dt>
<dd></dd>
<dd><a href="Epiglottitis" title="Epiglottitis">Epiglottitis</a></dd></dl>
<dl><dt><i><a href="Trachea" title="Trachea">trachea</a></i></dt>
<dd></dd>
<dd><a href="Tracheitis" title="Tracheitis">Tracheitis</a></dd>
<dd><a href="Laryngotracheal_stenosis" title="Laryngotracheal stenosis">Laryngotracheal stenosis</a></dd></dl>
</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Lower_respiratory_tract" class="mw-redirect" title="Lower respiratory tract">Lower RT</a>/<br><a href="Respiratory_disease" title="Respiratory disease">lung disease</a><br>(including <a href="Lower_respiratory_tract_infection" title="Lower respiratory tract infection">LRTIs</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Bronchus" title="Bronchus">Bronchial</a>/<br><a href="Obstructive_lung_disease" title="Obstructive lung disease">obstructive</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<dl><dt><i>acute</i></dt>
<dd></dd>
<dd><a href="Acute_bronchitis" title="Acute bronchitis">Acute bronchitis</a></dd></dl>
<dl><dt><i>chronic</i></dt>
<dd></dd>
<dd><a href="Chronic_obstructive_pulmonary_disease" title="Chronic obstructive pulmonary disease">COPD</a>
<dl><dd><a href="Bronchitis#Chronic_bronchitis" title="Bronchitis">Chronic bronchitis</a></dd>
<dd><a href="Acute_exacerbation_of_chronic_obstructive_pulmonary_disease" title="Acute exacerbation of chronic obstructive pulmonary disease">Acute exacerbation of COPD</a>)</dd>
<dd><a href="Asthma" title="Asthma">Asthma</a> (<a href="Status_asthmaticus" class="mw-redirect" title="Status asthmaticus">Status asthmaticus</a></dd>
<dd><a href="Aspirin-exacerbated_respiratory_disease" title="Aspirin-exacerbated respiratory disease">AERD</a></dd>
<dd><a href="Exercise-induced_asthma" class="mw-redirect" title="Exercise-induced asthma">Exercise-induced</a></dd></dl></dd>
<dd><a href="Bronchiectasis" title="Bronchiectasis">Bronchiectasis</a></dd>
<dd><a href="Cystic_fibrosis" title="Cystic fibrosis">Cystic fibrosis</a></dd></dl>
<dl><dt><i>unspecified</i></dt>
<dd></dd>
<dd><a href="Bronchitis" title="Bronchitis">Bronchitis</a></dd>
<dd><a href="Bronchiolitis" title="Bronchiolitis">Bronchiolitis</a>
<dl><dd><a href="Bronchiolitis_obliterans" title="Bronchiolitis obliterans">Bronchiolitis obliterans</a></dd></dl></dd>
<dd><a href="Diffuse_panbronchiolitis" title="Diffuse panbronchiolitis">Diffuse panbronchiolitis</a></dd></dl>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Interstitial_lung_disease" title="Interstitial lung disease">Interstitial</a>/<br><a href="Restrictive_lung_disease" title="Restrictive lung disease">restrictive</a><br>(<a href="Pulmonary_fibrosis" title="Pulmonary fibrosis">fibrosis</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">External agents/<br><a href="Occupational_disease" title="Occupational disease">occupational</a><br><a href="Occupational_lung_disease" title="Occupational lung disease">lung disease</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<dl><dd><a href="Pneumoconiosis" title="Pneumoconiosis">Pneumoconiosis</a>
<dl><dd><a href="Aluminosis" title="Aluminosis">Aluminosis</a></dd>
<dd><a href="Asbestosis" title="Asbestosis">Asbestosis</a></dd>
<dd><a href="Baritosis" title="Baritosis">Baritosis</a></dd>
<dd><a href="Bauxite_fibrosis" title="Bauxite fibrosis">Bauxite fibrosis</a></dd>
<dd><a href="Berylliosis" title="Berylliosis">Berylliosis</a></dd>
<dd><a href="Caplan's_syndrome" title="Caplan's syndrome">Caplan's syndrome</a></dd>
<dd><a href="Chalicosis" title="Chalicosis">Chalicosis</a></dd>
<dd><a href="Coalworker's_pneumoconiosis" class="mw-redirect" title="Coalworker's pneumoconiosis">Coalworker's pneumoconiosis</a></dd>
<dd><a href="Siderosis" title="Siderosis">Siderosis</a></dd>
<dd><a href="Silicosis" title="Silicosis">Silicosis</a></dd>
<dd><a href="Pulmonary_talcosis" title="Pulmonary talcosis">Talcosis</a></dd>
<dd><a href="Byssinosis" title="Byssinosis">Byssinosis</a></dd></dl></dd></dl>
<dl><dd><a href="Hypersensitivity_pneumonitis" title="Hypersensitivity pneumonitis">Hypersensitivity pneumonitis</a>
<dl><dd><a href="Bagassosis" title="Bagassosis">Bagassosis</a></dd>
<dd><a href="Bird_fancier's_lung" title="Bird fancier's lung">Bird fancier's lung</a></dd>
<dd><a href="Farmer's_lung" title="Farmer's lung">Farmer's lung</a></dd>
<dd><a href="Lycoperdonosis" title="Lycoperdonosis">Lycoperdonosis</a></dd></dl></dd></dl>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Acute_respiratory_distress_syndrome" title="Acute respiratory distress syndrome">ARDS</a></li>
<li><a href="Combined_pulmonary_fibrosis_and_emphysema" title="Combined pulmonary fibrosis and emphysema">Combined pulmonary fibrosis and emphysema</a></li>
<li><a href="Pulmonary_edema" title="Pulmonary edema">Pulmonary edema</a></li>
<li><a href="L%C3%B6ffler's_syndrome" title="Löffler's syndrome">Löffler's syndrome</a>/<a href="Eosinophilic_pneumonia" title="Eosinophilic pneumonia">Eosinophilic pneumonia</a></li>
<li><a href="Respiratory_hypersensitivity" class="mw-redirect" title="Respiratory hypersensitivity">Respiratory hypersensitivity</a>
<ul><li><a href="Allergic_bronchopulmonary_aspergillosis" title="Allergic bronchopulmonary aspergillosis">Allergic bronchopulmonary aspergillosis</a></li></ul></li>
<li><a href="Hamman%E2%80%93Rich_syndrome" class="mw-redirect" title="Hamman–Rich syndrome">Hamman–Rich syndrome</a></li>
<li><a href="Idiopathic_pulmonary_fibrosis" title="Idiopathic pulmonary fibrosis">Idiopathic pulmonary fibrosis</a></li>
<li><a href="Sarcoidosis" title="Sarcoidosis">Sarcoidosis</a></li>
<li><a href="Vaping-associated_pulmonary_injury" title="Vaping-associated pulmonary injury">Vaping-associated pulmonary injury</a></li></ul>
</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Obstructive /<br> Restrictive</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Pneumonia" title="Pneumonia">Pneumonia</a>/<br><a href="Pneumonitis" title="Pneumonitis">pneumonitis</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">By pathogen</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Viral_pneumonia" title="Viral pneumonia">Viral</a></li>
<li><a href="Bacterial_pneumonia" title="Bacterial pneumonia">Bacterial</a>
<ul><li><a href="Pneumococcal_infection" title="Pneumococcal infection">Pneumococcal</a></li>
<li><a href="Klebsiella_pneumoniae#Klebsiella_pneumonia" title="Klebsiella pneumoniae">Klebsiella</a></li></ul></li>
<li><a href="Atypical_pneumonia" title="Atypical pneumonia">Atypical bacterial</a>
<ul><li><a href="Mycoplasma_pneumonia" title="Mycoplasma pneumonia">Mycoplasma</a></li>
<li><a href="Legionellosis" class="mw-redirect" title="Legionellosis">Legionnaires' disease</a></li>
<li><a href="Chlamydiota" title="Chlamydiota">Chlamydiae</a></li></ul></li>
<li><a href="Fungal_pneumonia" title="Fungal pneumonia">Fungal</a>
<ul><li><a href="Pneumocystis_pneumonia" title="Pneumocystis pneumonia">Pneumocystis</a></li></ul></li>
<li><a href="Parasitic_pneumonia" title="Parasitic pneumonia">Parasitic</a></li>
<li><i>noninfectious</i>
<ul><li><a href="Chemical_pneumonia" class="mw-redirect" title="Chemical pneumonia">Chemical</a>/<a href="Mendelson's_syndrome" title="Mendelson's syndrome">Mendelson's syndrome</a></li>
<li><a href="Aspiration_pneumonia" title="Aspiration pneumonia">Aspiration</a>/<a href="Lipid_pneumonia" title="Lipid pneumonia">Lipid</a></li></ul></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">By vector/route</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Community-acquired_pneumonia" title="Community-acquired pneumonia">Community-acquired</a></li>
<li><a href="Healthcare-associated_pneumonia" class="mw-redirect" title="Healthcare-associated pneumonia">Healthcare-associated</a></li>
<li><a href="Hospital-acquired_pneumonia" title="Hospital-acquired pneumonia">Hospital-acquired</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">By distribution</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Bronchopneumonia" title="Bronchopneumonia">Broncho-</a></li>
<li><a href="Lobar_pneumonia" title="Lobar pneumonia">Lobar</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Idiopathic_interstitial_pneumonia" title="Idiopathic interstitial pneumonia">IIP</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Usual_interstitial_pneumonia" title="Usual interstitial pneumonia">UIP</a></li>
<li><a href="Desquamative_interstitial_pneumonia" title="Desquamative interstitial pneumonia">DIP</a></li>
<li><a href="Bronchiolitis_obliterans_organizing_pneumonia" class="mw-redirect" title="Bronchiolitis obliterans organizing pneumonia">BOOP-COP</a></li>
<li><a href="Nonspecific_interstitial_pneumonia" class="mw-redirect" title="Nonspecific interstitial pneumonia">NSIP</a></li>
<li><a href="Respiratory_bronchiolitis" title="Respiratory bronchiolitis">RB</a></li></ul>
</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Atelectasis" title="Atelectasis">Atelectasis</a></li>
<li><i>circulatory</i>
<ul><li><a href="Pulmonary_hypertension" title="Pulmonary hypertension">Pulmonary hypertension</a></li>
<li><a href="Pulmonary_embolism" title="Pulmonary embolism">Pulmonary embolism</a></li></ul></li>
<li><a href="Lung_abscess" title="Lung abscess">Lung abscess</a></li></ul>
</div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Pleural_cavity" title="Pleural cavity">Pleural cavity</a>/<br><a href="Mediastinum" title="Mediastinum">mediastinum</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Pleural_disease" title="Pleural disease">Pleural disease</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Pleurisy" title="Pleurisy">Pleuritis/pleurisy</a></li></ul>
<ul><li><a href="Pneumothorax" title="Pneumothorax">Pneumothorax</a>/<a href="Hemopneumothorax" title="Hemopneumothorax">Hemopneumothorax</a></li></ul>
<dl><dt><a href="Pleural_effusion" title="Pleural effusion">Pleural effusion</a></dt>
<dd></dd>
<dd><a href="Hemothorax" title="Hemothorax">Hemothorax</a></dd>
<dd><a href="Hydrothorax" title="Hydrothorax">Hydrothorax</a></dd>
<dd><a href="Chylothorax" title="Chylothorax">Chylothorax</a></dd>
<dd><a href="Pleural_empyema" title="Pleural empyema">Empyema/pyothorax</a></dd>
<dd><a href="Malignant_pleural_effusion" title="Malignant pleural effusion">Malignant</a></dd></dl>
<dl><dd><a href="Fibrothorax" title="Fibrothorax">Fibrothorax</a></dd></dl>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Mediastinal_disease" class="mw-redirect" title="Mediastinal disease">Mediastinal disease</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Mediastinitis" title="Mediastinitis">Mediastinitis</a></li>
<li><a href="Pneumomediastinum" title="Pneumomediastinum">Mediastinal emphysema</a></li></ul>
</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other/general</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Respiratory_failure" title="Respiratory failure">Respiratory failure</a></li>
<li><a href="Influenza" title="Influenza">Influenza</a></li>
<li><a href="Common_cold" title="Common cold">Common cold</a></li>
<li><a href="Severe_acute_respiratory_syndrome" class="mw-redirect" title="Severe acute respiratory syndrome">SARS</a></li>
<li><a href="COVID-19" title="COVID-19">COVID-19</a></li>
<li><a href="Idiopathic_pulmonary_haemosiderosis" title="Idiopathic pulmonary haemosiderosis">Idiopathic pulmonary haemosiderosis</a></li>
<li><a href="Pulmonary_alveolar_proteinosis" title="Pulmonary alveolar proteinosis">Pulmonary alveolar proteinosis</a></li></ul>
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This article is issued from <a class="external text" title="Last edited on 2025-07-17" href="https://en.wikipedia.org/wiki/?title=Exercise-induced_bronchoconstriction&amp;oldid=1301010088">Wikipedia</a>. The text is available under <a class="external text" href="https://creativecommons.org/licenses/by-sa/4.0/deed.en">Creative Commons Attribution-Share Alike 4.0</a> unless otherwise noted. Additional terms may apply for the media files.
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