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AQUA© as predictor of allergy in elite marathon runners

Renata N Teixeira1*, Felipe AR Mendes1, Milton A Martins2, Timothy D Mickleborough3 and Celso RF Carvalho1

Author Affiliations

1 Department of Physical Therapy, School of Medicine, University of Sao Paulo, Av. Dr Arnaldo, 455, Room 1210, 01246-903 São Paulo, SP, Brazil

2 Department of Medicine, School of Medicine, University of São Paulo, Av. Dr. Arnaldo 455 – room 1210, 01246-903 São Paulo, SP, Brazil

3 Department of Kinesiology, Indiana University, 1025 E. 7th Street, HPER 112, Bloomington, IN 47401, USA

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World Allergy Organization Journal 2014, 7:7  doi:10.1186/1939-4551-7-7

Published: 3 April 2014



The prevalence of allergy in athletes is increasing, and its risk varies across sports. The risk is dependent mainly on the ventilation rate and environmental factors; however, the prevalence of allergy in elite runners remains unknown. Therefore, the aim of this study was to screen allergy symptoms in elite marathon runners by using a validated questionnaire for screening allergy in athletes.


Two hundred and one elite marathoners, who participated in the most competitive Brazilian marathons and half-marathons during 2011, were invited to complete a validated self-report Allergy Questionnaire for Athletes (AQUA©), with additional questions pertaining to training history, such as running experience, running distance per week and their best race time in marathon or half-marathon events.


Sixty percent of the assessed athletes reported allergy symptoms as defined by a positive AQUA outcome (score [greater than or equal to] 5). No significant differences (p > 0.05) between groups (AQUA + and AQUA-) were observed for gender, age, running experience, weekly training volume and best performance time in the half-marathon and marathon. The most frequently reported symptoms were related to the respiratory tract and physical effort.


This study demonstrates that AQUA© can be used to predict allergy in elite marathon runners. In addition, these athletes have a higher prevalence of allergy symptoms to elite athletes from other sports.