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Time trends in asthma prevalence may have levelled off
Few diseases have a relation to age which is as fascinating and complex as for asthma. It is a chronic but not necessarily lifelong condition. The incidence of asthma and wheezing illness peaks in very early childhood, but new incident cases occur throughout life.1–4 In many affected subjects, particularly children, it disappears after some time.2–4 However, in a substantial proportion of cases which have apparently lost the disease it will come back, often after many years.3,4 Another intriguing feature is that the sex ratio changes with age. Most studies show that boys are affected more often by wheezing illnesses than girls, but this sex ratio usually reverses during or shortly after puberty, partly due to a higher incidence in females.5–9
Most studies investigating the relationship between age and asthma have been performed in infants and children and, in fact, different age related phenotypes in childhood have been described which seem to have distinct causes and consequences.2,10 Information on the relation to age in adults is scarce and has often been based on routine data or cross sectional studies.1,6
In this issue of Thorax Chinn and colleagues report the findings of phase II of the European Community Respiratory Health Survey (ECRHS) which involved following more than 11 000 randomly selected adults (participants in ECRHS phase I stage 2 at which time they were aged 20–44 years) for a period of 5–11 …
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