Asthma prevalence in 1973, 1988 and 2003

Michael L Burr ^1*, Dennis Wat ², Claire Evans ¹, Frank D J Dunstan ¹ and Iolo J M Doull ²

¹ Department of Epidemiology, Statistics and Public Health, Cardiff University, United Kingdom
² Respiratory / Cystic Fibrosis Unit, Children's Hospital for Wales, Cardiff, United Kingdom

^* To whom correspondence should be addressed. E-mail: burrml{at}cf.ac.uk.

Accepted 14 December 2005

Abstract

Aim: To see whether the prevalence of asthma has changed since a survey was conducted in 1988, using the same methods that showed an increase during the previous 15 years.

Methods: A survey of 12-year-old children was conducted in schools in South Wales where surveys had taken place in 1973 and 1988. The survey comprised a parentally-completed questionnaire and an exercise challenge test, performed when no bronchodilator had been recently used.

Results: In 1973, 1988 and 2003 questionnaires were obtained for 817, 965 and 1148 children respectively; the exercise test was performed by 812, 960 and 1019 children. The prevalence of reported wheeze in the last year rose during each 15-year period (9.8%, 15.2%, 19.5%), with an even steeper rise in reported asthma ever (5.5%, 12.0%, 27.3%). There was a continued increase in wheeze attributed to running, in terms of all children (5.8%, 10.5%, 16.0%) and also as the proportion of those with a history of wheeze (34.1%, 47.0%, 57.3%). The use of inhaled corticosteroids (not available in 1973) increased fourfold between 1988 and 2003. The prevalence of exercise-induced bronchospasm rose 1973-1988 but had declined by 2003.

Conclusions: The rise in the prevalence of asthmatic symptoms has continued since 1988. This appears to conflict with a reported recent decline, unless asthma prevalence peaked in the 1990s. The decline in exercise-induced brochospasm is probably attributable to better control of the disease, more children now using inhaled corticosteroids as preventive treatment.

Keywords: asthma, children, epidemiology, wheeze

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