Asthma, Rhinitis, Other Respiratory Diseases: Rapid Publication
Is the prevalence of adult asthma and allergic rhinitis still increasing? Results of an Italian study,☆☆

https://doi.org/10.1067/mai.2003.1484Get rights and content

Abstract

Background: The prevalence of asthma and allergic rhinitis has increased worldwide during the 1970s and 1980s. Objective: This study was aimed at evaluating whether the increasing trend in prevalence persisted during the 1990s in the young adult Italian population. Methods: In 1998 to 2000 a screening questionnaire was sent by mail to a general population sample aged 20 to 44 years; nonresponders were contacted again first by mail and then by phone, achieving a final response rate of 78.1% (6876 of 8800). Prevalence estimates, adjusted to correct for nonresponse bias, were compared with those recorded in Italy in 1991 to 1993 during the European Community Respiratory Health Survey, when response rate had been slightly higher (87.6%). Temporal variations in symptom prevalence were analyzed by a logistic regression model, controlling for sex, age, site of residence (urban vs suburban areas), season of response, response rate, and type of contact (mail vs phone). Results: The prevalence of asthma attacks did not vary significantly from 1991 to 1993 (3.6%) to 1998 to 2000 (3.2%) (P = .188). The prevalence of asthma-like symptoms (wheezing, chest tightness, shortness of breath) tended to decrease in the age classes of 32.5 to 45 years, while increasing in the youngest age class (20 to 26 years). A clear-cut increase from 15.4% to 18.3% was observed for the prevalence of allergic rhinitis (P < .001), whereas the proportion of people under antiasthmatic treatment increased in suburban areas but not in urban areas (interaction time–site of residence, P < .001). Conclusion: Asthma prevalence has not increased during the last decade in Italy. The persistence of an increasing trend in allergic rhinitis prevalence deserves attention. (J Allergy Clin Immunol 2003;111:1232-8.)

Section snippets

Study protocol

The survey was performed in 3 centers of northern Italy, Turin, Pavia, and Verona, located in the plain of the Po river and characterized by a temperate climate. Turin is a large urban area (909,717 residents in 1998) with large manufacturing industries, Pavia is a smaller town (74,290 inhabitants) in the middle of a farming area, and Verona is a middle-size town (254,712 residents) involved in tourism and services.

In the previous survey (ECRHS, 1991 to 1993), probability samples of the general

Results

As shown in Fig 1,

. Crude prevalence (in percentage) of self-reported respiratory symptoms in northern Italy in 1991-1993 (dark columns) and in 1998-2000 (light columns) . Bars are values; lines are 95% confidence intervals.

the crude prevalence of asthma attacks and asthma-like symptoms remained rather stable from the first to the second survey; more precisely, the prevalence of asthma attacks, chest tightness, and shortness of breath slightly decreased, whereas the prevalence of wheezing

Discussion

The main results of the present survey are as follows: (1) In the overall young adult population, the prevalence of asthma attacks and asthma-like symptoms has not increased during the 1990s in Italy. (2) However, when considering age classes separately, a generational effect emerged because asthma-like symptom prevalence tended to decrease in older subjects (32.5 to 45 years) and to increase in younger subjects (20 to 26.2 years). (3) The prevalence of self-reported allergic rhinitis has

References (36)

  • JK Peat et al.

    Prevalence of asthma in adults in Busselton, Western Australia

    BMJ

    (1992)
  • AJ Woolcock et al.

    Evidence for the increase in asthma worldwide

  • MD Lang

    The asthma odyssey

    Ann Allergy

    (2001)
  • MP Alpers

    Relationship between mite densities and the prevalence of asthma: comparative studies in two populations in the Eastern Highlands of Papua New Guinea

    Clin Allergy

    (1988)
  • E Von Mutius et al.

    Prevalence of asthma and atopy in two areas of West and East Germany

    Am J Respir Crit Care Med

    (1994)
  • SH Downs et al.

    Continued increase in the prevalence of asthma and atopy

    Arch Dis Child

    (2001)
  • R Ronchetti et al.

    Is the increase in childhood asthma coming to an end? findings from three surveys of schoolchildren in Rome, Italy

    Eur Respir J

    (2001)
  • AF Kalyoncu et al.

    Prevalence of asthma and allergic diseases in primary school children in Ankara, Turkey: two cross-sectional studies, five years apart

    Pediatr Allergy Immunol

    (1999)
  • Cited by (138)

    • Butylphthalide ameliorates airway inflammation and mucus hypersecretion via NF-κB in a murine asthma model

      2019, International Immunopharmacology
      Citation Excerpt :

      Bronchial asthma (asthma) is one of the most common airway inflammatory diseases worldwide [1]. Recently, the morbidity and mortality of asthma are on the rise due to the aggravation of environmental pollution and the increase of allergic population [2]. Airway inflammation is the pathological basis of asthma.

    • Abietic acid attenuates allergic airway inflammation in a mouse allergic asthma model

      2016, International Immunopharmacology
      Citation Excerpt :

      These cytokines induce release of IgE and the infiltration of inflammatory cells into the lungs which lead to the development of allergic asthma [4]. During the last decade, the incidence, morbidity, and mortality of allergic asthma in the world are increasing [5]. Therefore, the development of novel and efficient therapeutic drugs for the treatment of allergic asthma is urgently needed.

    View all citing articles on Scopus

    Supported by Italian Ministry of Education, University and Research (MIUR), University of Verona; GlaxoSmithKline Italia; National Health Service, AUSL Pavia; National Health Service, ASL 4 Turin; IRCCS San Matteo; Pavia Province; Veneto Region.

    ☆☆

    Reprint requests: Giuseppe Verlato, PhD, Sezione di Epidemiologia e Statistica Medica, Istituti Biologici 2, Strada Le Grazie 8, 37134 Verona, Italy.

    View full text