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Prevalence of Allergy and Upper Respiratory Tract Symptoms in Runners of the London Marathon


Medicine & Science in Sports & Exercise: June 2012 - Volume 44 - Issue 6 - p 999–1004
doi: 10.1249/MSS.0b013e318243253d
Clinical Sciences

Background The prevalence of self-reported upper respiratory tract (URT) symptoms in athletes has been traditionally associated with opportunistic infection during the temporal suppression of immune function after prolonged exercise. There is little evidence for this, and a competing noninfectious hypothesis has been proposed, whereby the exercise-induced immune system modulations favor the development of atopy and allergic disease, which manifests as URT symptoms. The aim of this study was to examine the association between allergy and URT symptoms in runners after an endurance running event.

Methods Two hundred eight runners from the 2010 London Marathon completed the validated Allergy Questionnaire for Athletes (AQUA) and had serum analyzed for total and specific immunoglobulin E response to common inhalant allergens. Participants who completed the marathon and nonrunning controls who lived in the same household were asked to complete a diary on URT symptoms.

Results Forty percent of runners had allergy as defined by both a positive AQUA and elevated specific immunoglobulin E. Forty-seven percent of runners experienced URT symptoms after the marathon. A positive AQUA was a significant predictor of postmarathon URT symptoms in runners. Only 19% of nonrunning controls reported symptoms.

Conclusions The prevalence of allergy in recreational marathon runners was similar to that in elite athletes and higher than that in the general population. There was a strong association between a positive AQUA and URT symptoms. The low proportion of households in which both runners and nonrunners were symptomatic suggests that the nature of symptoms may be allergic or inflammatory based rather than infectious. Allergy is a treatable condition, and its potential effect on performance and health may be avoided by accurate clinical diagnosis and management. Both athletes’ and coaches’ awareness of the potential implications of poorly managed allergy needs to be raised.

1School of Life Sciences, Northumbria University, Newcastle-upon-Tyne, UNITED KINGDOM; 2Department of Physiological Sciences, Stellenbosch University, Matieland, SOUTH AFRICA; 3Centre for Aquatic Research, University of Johannesburg, Johannesburg, SOUTH AFRICA; 4Medical Research Council and Asthma UK Centre in Allergic Mechanisms of Asthma, Division of Asthma, Allergy and Lung Biology, School of Medicine, King’s College London, Guy’s and St. Thomas’ National Health Service, Foundation Trust, London, UNITED KINGDOM; and 5National Pollen and Aerobiology Research Unit, University of Worcester, Worcester, UNITED KINGDOM

Address for correspondence: Paula Robson-Ansley, PhD, School of Life Sciences,Northumbria University, Newcastle-upon-Tyne NE1 8ST, United Kingdom; E-mail:

Submitted for publication July 2011.

Accepted for publication October 2011.

©2012The American College of Sports Medicine