The coughing and wheezing spells that have been coming from my household these last few days are not a result of an upper respiratory illness, but are caused by the cold, dry air--my children have asthma. The frigid winter months can trigger asthma symptoms in susceptible individuals, especially when they have been actively playing or exercising outdoors. The low temperatures and dry air are the precipitating factors.

Inhaled air is typically warmed and moistened through the nose. During exercise, most individuals switch from nose breathing to mouth breathing in order to meet the oxygen requirements of the activity. As a result, the air breathed in through the mouth while exercising in a cold environment does not get sufficiently warmed or moistened; thus, the cold, dry air reaches the lower airways and can cause bronchoconstriction and inflammation--both of which can trigger asthma symptoms. 

Tips to Manage Asthma While Participating in Cold Weather Sports:

• Take your asthma medications as directed by your physician.
• Use a short-acting beta-agonist inhaler, such as albuterol, about 15 minutes prior to exercising to prevent an attack.
• Have "rescue" asthma medications, such as albuterol or an EpiPen (for anaphylaxis) readily available during the activity.
• Include warm-up and cool-down phases in your exercise session.
• Wear a scarf or surgical mask over your nose and mouth to help warm inhaled air.
• Limit physical activity or take the day off of exercise if you have a viral infection/upper respiratory illness.
• Seek medical attention if your symptoms are not relieved or worsen.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

References
American Academy of Allergy, Asthma and Immunology

Journal of Athletic Training; 2005; pp. 224-245; "National Athletic Trainers' Association Position Statement: Management of Asthma in Athletes"; Michael G. Miller et al.,.

Physical Education Instructors, Coaches, and Athletic Trainers: Managing Asthma and Allergies in DC Schools Guide