How to prevent breathing issues during extreme cold Yesterday I rode to work in -2°F / -19°C temps.  When I got to my destination (only about 3.5 miles), my lungs felt terrible.  My voice was hoarse and I was coughing a lot. All this despite the fact that I was wearing several wool and fleece layers, a thick balaclava and was completely toasty the whole ride. 

The ride may have triggered some exercise induced asthma due to the extreme cold. I tried to cover my face with the balaclava, but there was not enough ventilation and was getting short of breath trying to breath through the fleece, especially when climbing hills.

This sort of thing is something that should not be repeated for the health of my lungs.  What gear or techniques can I use to prevent this kind of lung irritation during extreme cold?
A scientific Journal, Chest Journal, published an article about the efficiency of heat exchange masks on asthmatic subjects during cold weather exercise.  They found that the heat exchanger masks were at least as effective as pre-treatment with albuterol in preventing decline in lung function.

I found several commercial heat exchange masks which could potentially be used for cycling:
Airtrim AirTrim Heat/Moisture Exchange Masks - seems to be the most athlete focused product and would likely be effective.

N-Ferno 6970 Extreme Balaclava with Hot Rox

Polarwrap, The Exchanger Mask

Talus Outdoor Technologies ColdAvenger Pro Soft Shell Mask or  ColdAvenger Expedition Balaclava

AirGuard Medical CT Mask for COPD or Asthma - May not be designed for high levels of activity

However, for less extreme temperatures, simply breathing through some medium, like fleece, which captures the moisture you exhale and passes inhaled air back over it may work as a less efficient, but still potentially effective heat exchange in warmer temps. For me, breathing through the balaclava helps a bit in temps over 15F, but is less effective at lower temps.  

Anti-Pollution masks may provide a similar effect as well, but may not capture as much heat if they use exhalation valves which remove some of the exhaled air without capturing the heat.