Burney PG, Chinn S, Rona RJHas the prevalence of asthma increased in children? Evidence from the National Study of Health and Growth, 1973-1986. BMJ 300:1306-1310

Department of Public Health Medicine, United Medical School of Guy's, London.
BMJ Clinical Research (Impact Factor: 14.09). 06/1990; 300(6735):1306-10. DOI: 10.1136/bmj.300.6735.1306
Source: PubMed


To estimate changes in the prevalence of reported symptoms of respiratory disease and reported diagnoses of asthma and bronchitis in primary school children in England between 1973 and 1986.
Mixed longitudinal survey.
Representative sample of English primary schools in 22 areas.
15,000 Boys and 14,156 girls each studied at least once between 1973 and 1986.
Whether, according to the parent or guardian, the child had wheezed, wheezed on most days or nights, or had attacks of bronchitis or asthma in the past year.
Within age groups trends in successive annual cohorts showed an increasing prevalence of asthma for each annual birth cohort (boys, 6.9%, p less than 0.001; girls, 12.8%, p less than 0.001) and of wheeze on most days or nights (boys, 4.3% per cohort, p less than 0.001; girls, 6.1% per cohort, p less than 0.001) and a falling prevalence of bronchitis (boys, -4.7% per cohort, p less than 0.001; girls, -5.8% per cohort, p less than 0.001). There was a smaller increase in the prevalence of wheeze whether or not it occurred on most days or nights, and this increase was significant only among the girls (boys, 1.0% per cohort, p greater than 0.05; girls, 1.7% per cohort, p less than 0.05). Although the rate of increase of "asthma" was greater than the rate of decrease in "bronchitis," the baseline prevalence of asthma was much lower than that of bronchitis, and the total proportion of children with either diagnosis declined slightly over the whole period. The main change was an increase in the proportion of children whose parents stated that they had persistent wheeze and yet did not have a report of either "asthma" or "bronchitis."
These results suggest that there has been a true increase in morbidity that is not simply due to changes in diagnostic fashion. The increase is large enough to explain much if not all of the increase in admission to hospital and mortality, and it underlines the importance of an understanding of the aetiology of asthma in tackling the causes of the recent increase.

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    • "Asthma is one of the most important diseases of childhood, causing substantial morbidity. A number of studies performed in industrialized countries in the 1990s showed prevalence rates of asthma symptoms increasing 1.41 - 1.56 fold compared with the same cohorts in the 1960s and 1970s [5-8]. There are different hypotheses about the etiology of asthma. "
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    ABSTRACT: The International Study on Asthma and Allergies in Childhood (ISAAC) reported a prevalence of asthma symptoms in 17 centers in nine Latin American countries that was similar to prevalence rates reported in non-tropical countries. It has been proposed that the continuous exposure to infectious diseases in rural populations residing in tropical areas leads to a relatively low prevalence of asthma symptoms. As almost a quarter of Latin American people live in rural tropical areas, the encountered high prevalence of asthma symptoms is remarkable. Wood smoke exposure and environmental tobacco smoke have been identified as possible risk factors for having asthma symptoms. We performed a cross-sectional observational study from June 1, 2012 to September 30, 2012 in which we interviewed parents and guardians of Warao Amerindian children from Venezuela. Asthma symptoms were defined according to the ISAAC definition as self-reported wheezing in the last 12 months. The associations between wood smoke exposure and environmental tobacco smoke and the prevalence of asthma symptoms were calculated by means of univariate and multivariable logistic regression analyses. We included 630 children between two and ten years of age. Asthma symptoms were recorded in 164 of these children (26%). The prevalence of asthma symptoms was associated with the cooking method. Children exposed to the smoke produced by cooking on open wood fires were at higher risk of having asthma symptoms compared to children exposed to cooking with gas (AOR 2.12, 95% CI 1.18 - 3.84). Four percent of the children lived in a household where more than ten cigarettes were smoked per day and they had a higher risk of having asthma symptoms compared to children who were not exposed to cigarette smoke (AOR 2.69, 95% CI 1.11 - 6.48). Our findings suggest that children living in rural settings in a household where wood is used for cooking or where more than ten cigarettes are smoked daily have a higher risk of having asthma symptoms.
    Full-text · Article · Jul 2013 · Respiratory research
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    • "For instance, in the USA, asthma increased 74% from 1980 to 1996 (Mannino et al., 2002). Asthma prevalence is also increasing in other industrialized countries (Aberg, 1989; Burney et al., 1990; Reijula et al., 1996). The rise in asthma prevalence is greatest in inner-city populations, and may be largely due to socioeconomic factors, such as underutilization of anti-inflammatory medications, poor access to care and high levels of environmental allergens in homes. "

    Preview · Chapter · Sep 2010
    • "Asthma is the most common inflammatory lung disease in children and is a major public health problem, showing steady increases in prevalence both in developing and in developed countries.[1] Globally, 150 million people are suffering from asthma.[2] In India, there is wide variation (4–19%) in the prevalence of asthma in school going children from different geographic areas.[3] "
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    ABSTRACT: Polycyclic aromatic hydrocarbons (PAH) originate from the incomplete combustion of organic matter and ambient air pollution by these is increasing. There is also an increase in the global prevalence of asthma, for which environmental pollution has been recognized as one of the important factors. Exposure to pollutants and other allergens induces chronic airway inflammation by generation of reactive oxygen species, causing oxidative stress. Therefore, the objective of the present study was to assess association, if any, between exposure to PAH and asthma as well as oxidative stress in children. In this hospital-based case control study, cases of bronchial asthma aged 1-14 years and healthy matched controls were included. Oxidative stress was measured by assessing the levels of enzymes catalase, superoxide dismutase, malondialdehyde (MDA), and reduced glutathione (GSH). Forty-two cases and 20 controls were enrolled. Mean blood level of phenanthrene, a PAH, was 63.11 ppb +/- 115.62 and 4.20 ppb +/- 10.68 ppb in cases and controls, respectively (P = 0.02). Mean blood levels of GSH was significantly lower in cases and controls (27.39 mug/ml +/- 11.09 versus 47.39 g/ml +/- 13.83; P-value = 0.001). Likewise, mean blood level of MDA in nanomole/ml was significantly higher in asthma as compared with controls (12.85 +/- 5.40 versus 8.19 +/- 5.16; P-value = 0.002), suggestive of increased oxidative stress. Because elevated blood level of phenanthrene is associated with bronchial asthma as well as with oxidative stress, measures to reduce exposure to PAH may possibly lead to reduced incidence and severity of bronchial asthma.
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