ObjectiveTo assess change in symptoms, quality of life (QOL), and performance ability before, during, and after treatment with budesonide in a group of Olympic and Paralympic athletes with seasonal allergic rhinoconjunctivitis (SAR/C).DesignBecause budesonide has already been proven to be an effective and well-tolerated treatment of SAR/C,1an open-label treatment format was used.SettingThe study was community-based with participating athletes preparing for Olympic competition.ParticipantsOlympic and Paralympic athletes were screened for the presence of SAR/C using history and positive skin test results for pollen allergens.InterventionsAll were offered treatment with intranasal budesonide, applied to each nostril, once daily for eight weeks.Outcome MeasurementsSymptom and medication diaries were completed before treatment and after 4 and 8 weeks of treatment. Similarly, Quality of Life (QOL) was measured with the Rhinoconjunctivitis Quality of Life Questionnaire. As a secondary outcome measure, the ability to train and compete was assessed using a performance diary.ResultsOf the 236 athletes eligible for the study, 145 (61%) agreed to participate. Forty-six percent of the athletes who were dispensed treatment did not return questionnaires. For those returning questionnaires, scores between baseline (week 0) and weeks 4 and 8 were calculated for total symptoms, QOL, and performance scores.There were statistically significant improvements in symptoms, QOL, and performance scores in athletes who used intranasal budesonide.ConclusionSAR/C is a common condition and has demonstrable negative effects on athletes. Better education of coaches and athletes is necessary to ensure that the condition is correctly diagnosed and treated, with safe, effective, permitted medication.