Apparent but not real increase in asthma prevalence during the 1990s

Graham Stuart Devereux, R. M. Barraclough, D. J. Hendrick, S. C. Stenton

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55 Citations (Scopus)

Abstract

The authors investigated changes in asthma prevalence and perception of bronchoconstriction over 6 yrs in adults of Newcastle-upon-Tyne.

Postal questionnaires were sent to 6,000 subjects aged 20-44 yrs in 1992-1993 and 1998-1999. Random samples of 600 responders had assessments of atopy, airway responsiveness, and their ability to perceive methacholine-induced bronchoconstriction. The prevalences of asthmatic symptoms, physician-diagnosis, and medication use increased by an average of 4.4%, particularly in subjects aged <30 yrs (8.7 versus 2.7). Atopy prevalence increased from 25% to 31% but atopics and nonatopics had similar mean changes in questionnaire data (5.2 versus 3.4). The probability of a positive methacholine test decreased as did the mean methacholine dose/response slope (0.00527 to 0.00379), indicating lower levels of airway responsiveness. This can be largely explained by an increase in use of inhaled corticosteroids (5.0-9.3%). The proportion of subjects perceiving bronchoconstriction during methacholine tests increased from 63 to 77%.

The authors conclude that current changes in asthma epidemiology in adults may result from increased awareness of symptoms (and/or an increased willingness to report them), and from an increased willingness of physicians to make the diagnosis and prescribe treatment, not from increased disease prevalence.

Original languageEnglish
Pages (from-to)826-833
Number of pages7
JournalEuropean Respiratory Journal
Volume20
DOIs
Publication statusPublished - 2002

Keywords

  • airway responsiveness
  • asthma
  • atopy
  • epidemiology
  • METHACHOLINE-INDUCED BRONCHOCONSTRICTION
  • RESPIRATORY-HEALTH-SURVEY
  • ABERDEEN SCHOOLCHILDREN
  • AIRWAYS RESPONSIVENESS
  • AEROSOL OUTPUT
  • 20-YEAR TRENDS
  • EAST-GERMANY
  • HAY-FEVER
  • SYMPTOMS
  • ADULTS

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