Cold-Induced Bronchospasms

Objective: Analyze the effects of disease on function and structure of the respiratory system.

If you have ever had an asthma attack or bronchospasm hours from an inhaler or emergency care, you will never forget the pain and terror. I had my first cold-induced bronchospasms a couple winters ago when I was riding my bicycle at -40F. At first, I questioned whether what I was experiencing was actually preventing me from getting enough air in my lungs. I thought that maybe my shallow breaths were because I was subconsciously protecting myself from the cold air, but I was wrong. That initial subtle struggle to get a full breath was soon followed by a tightness in my chest. It felt like a boa constrictor had wrapped itself around my bronchial tubes right in the middle of my chest. I headed back to my car as soon as the first symptom surfaced, but my judgment started to fade within twenty minutes. I imagined myself curling up alongside the trail and taking a nap as it got more and more difficult to get enough oxygen. World-famous cyclist Lael Wilcox spoke to me in an interview about her experience with asthma. Anecdotally, she said her asthma is much worse in the cold than the heat, although she says she is going to start wearing a face cover in hotter climates to protect her lungs from dust (Wilcox, 2025).  This paper will examine the precise temperatures people tend to experience lung problems and the physiological response of the body during bronchospasms. My art depicts bronchospasms.

Kennedy and Faulhaber examined the effects of fit women running in a climate-controlled box at various temperatures and a fixed humidity of 40%. The temperatures they tested athletes at are 0C, -5C, -10C, and -20C. That means that the coldest temperature in Fahrenheit was -4. They tested women because women have a higher prevalence of hyperpnea and bronchial hyperresponsiveness (BHR). This is because women are more mechanically constrained, which leads to a greater likelihood of exercise-induced bronchoconstriction (EIB). The women they studied were all fit with a VO2 max of 40 mL/kg and no history of breathing problems. The study found that people can exercise intensely at -20C, but it is a greater effort and they saw coughing with transient acute bronchoconstriction after exercises in temperatures colder than -15C. They got both subjective and objective measures, including the participants’ reports 3, 6, 10, 15, and 20 minutes before and after the run test in addition to measurements of lung capacities. The air measurements included forced expiratory volume, rating of perceived effort, forced vital capacity, and forced expiratory flow. The study stated that prolonged high ventilation and more exposure to cold air would increase the likelihood of experiencing problems, including coughing, wheezing, chest tightness, and excess mucus (2018).

Beyond the acute effects of cold air exposure are the numerous people who work in the cold. In a study of the one-year effects of working 6 hours a day in cold stores (3C to 10C), they found that 6 out of 11 participants experienced increased rhinitis, sore throat, and cough. Even at 6 months, they experienced airflow limitation and bronchial hyperresponsiveness (Jammes et. al., 2002). Another study on workers found that 30-minute intermittent exposure to -55C did NOT have irreversible deleterious changes to lung function in healthy workers (Rentel et. al., 2023). 

 Cleveland Clinic describes bronchospasms. They are caused by the muscles surrounding the bronchi tightening (2022). My art shows the red bronchi tubes, which branch off and end in alveoli (air sacs). The white and black yarn represents the muscles that tighten and cause airway constriction. Tightness in the chest, shortness of breath, wheezing, coughing, tiredness, and dizziness are symptoms of bronchospasms. Bronchospasms are a symptom of asthma, but not all people who experience bronchospasms have asthma, which has more diagnostic criteria (Cleveland Clinic, 2022). 

The interview with Lael Wilcox in an example of how some athletes deal with their chronic lung issues. She relies on her riding for income and it has become a lifestyle, so she tolerates way more symptoms than I do. Part of my bronchospasm management plan is to get six to eight hours of sleep per night and to breathe as much warm air as possible. This means that I sleep inside, when possible, and wear something over my face when it is below zero. I also do not work hard in the cold. Lael, who is competitive, forgoes sleep and rides to her absolute full capacity. My management system results in almost no symptoms. Lael has underlying asthma that she described as severe and is unable to ride without considerable issues in winter endurance races (2025). Extreme winter athletes must rely on trusting their instincts for self-care as more research is done on the effects of cold air on the lungs. Even as more research is done, there will always be people who push the limits.

References

Cleveland Clinic. (2022, March 18). Bronchospasm: Symptoms, Treatment & What it Is. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22620-bronchospasm

Jammes, Y., Delvolgo-Gori, M. J., Badier, M., Guillot, C., Gazazian, G., & Parlenti, L. (2002). One-Year occupational exposure to a cold environment alters lung function. Archives of Environmental Health: An International Journal, 57(4), 360–365. https://doi.org/10.1080/00039890209601422

Kennedy, M. D., & Faulhaber, M. (2018). Respiratory function and symptoms post cold air exercise in female high and low ventilation sport athletes. Allergy, Asthma & Immunology Research, 10(1), 43. https://doi.org/10.4168/aair.2018.10.1.43

Rentel, N., Herold, R., Harth, V., Preisser, A. M., & Garrido, M. (2023). Does working in an extremely cold environment affects lung function?: 10 years follow-up. International Archives of Occupational and Environmental Health, 96(7), 1039–1048. https://doi.org/10.1007/s00420-023-01988-3

Wilcox, L. (2025, March 21). Iditarod trail invitational update – 03 31 2025, interview with Lael Wilcox, co-host Alexandria M. (A. Manley & L. Gruhn, Interviewers) [Personal communication].