Decrease in asthma mortality rate in Israel from 1991-1995: Is it related to increased use of inhaled corticosteroids?☆,☆☆
Section snippets
METHODS
The annual AMR was derived from the Department of National Health Statistic’s publications for the years 1971-1995.
Deaths from asthma were diagnosed in accordance with the International Classification of Diseases coding. It should be noted that the coding was changed in 1979. To avoid overestimation of changes in death rates from asthma after 1979, before that date we included cases reported under bronchial asthma, chronic bronchitis, and emphysema.3 After 1979, all 3 entities were reported
RESULTS
The absolute number of deaths under the codes of obstructive lung diseases for each 5-year period is shown in Table I.
Empty Cell Age groups 5-34 y 35-64 y 1971-1975 33 434 1976-1980 17 205 1981-1985 41 218 1986-1990 44 226 1991-1995 26 245
The mean AMR in the 5- to 34-year-old population decreased to 0.202 ± 0.046 during 1991-1995 compared with 0.388 ± 0.066 and 0.398 ± 0.091 during 1981-1985 and 1986-1990, respectively. This figure is significantly lower
DISCUSSION
We observed a decrease in AMR in Israel during 1991-1995 compared with the preceding decade. This decrease was significant only in the 5- to 34-year-old group, and it paralleled an increase in sales of ICSs.
The AMR in Israel was low compared with that of Western countries. There are no data regarding the validity of asthma death certificates in Israel; however, studies from England and Northern Ireland revealed that asthma death certificates are more accurate in the younger age group.17, 18 To
Acknowledgements
We thank S. Shir (Glaxo-Wellcome Israel), Amir El-Chasid (Teva, distributer of Astra in Israel), and L. Choppe (Trading Pharma representative of Schering-Plough in Israel) for supplying the data about drug sales in Israel; R. C. Strunk, MD, for critical review and helpful comments; Yael Villa, PhD, for the statistical analysis; and Anji Agajany for secretarial assistance.
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Reprint requests: Yitzhak Katz, MD, Pulmonary and Allergy Institute, Assaf Harofeh Medical Center, Zerifin 70300, Israel.
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0091-6749/2000 $12.00 + 0 1/1/103419