To compare the prevalence and severity of asthma and of allergic sensitisation in children in different regions. We hypothesised that regions with different standardised hospital admission rates would have different prevalences of childhood asthma and that diverse climates would result in a range of sensitisations to different allergens.

Design and setting

We studied large random population samples of children in seven regions in ew South Wales (SW) in 1991-1993. Hospitalisation rates were obtained from NSW Department of Health data.

Participants

6394 children aged 8-11 years.

Outcome measures

History of respiratory symptoms by selfadministered questionnaire; airway hyperresponsiveness by histamine inhalation test; and sensitisation to allergens by skin-prick tests.

Results

Children in all regions had a high prevalence of recent wheeze (22%- 27%), of diagnosed asthma (240/0-38%) and of use of asthma medications (220/0-30%), but no region was consistently higher or lower for all measurements. The prevalence of current asthma in children living in three coastal regions (where sensitisation to house-dust mites was high) and in the far west (where sensitisation to alternaria was high) was 12%-13%, which was significantly higher than the prevalence of7o/o-lO% in children living in three inland regions (wher e sensitisation to these allergens was lower) (P < 0.01).

Conclusions

We found significant variations in the prevalence and severity of childhood asthma in NSW. The prevalence ofhospitalisations, diagnosed asthma, recent symptoms and medication use may relate to different regional diagnostic patterns, whereas current asthma prevalence may relate to different levels of allergic sensitisation.

References

1Peat JK, van den Berg RH, Green WF, et al. Changing prevalence of asthma in Australian children. BMJ 1994; 308: 1591–1596.
10.1136/bmj.308.6944.1591
CAS PubMed Web of Science® Google Scholar
2Robertson CF, Heycock E, Bishop J, et al. Prevalence of asthma in Melbourne schoolchildren: changes over 26 years. BMJ 1991; 302: 1116–1118.
10.1136/bmj.302.6785.1116
CAS PubMed Web of Science® Google Scholar
3Gray EJ, Peat JK, Mellis CM, et al. Asthma severity and morbidity in a population sample of Sydney schoolchildren. Part I: Prevalence and effect of air pollutants in coastal regions. Aust N Z J Med 1994; 24: 168–175.
10.1111/j.1445-5994.1994.tb00553.x
CAS PubMed Web of Science® Google Scholar
4Pearce N, Weiland S, Keil U, et al. Self reported prevalence of asthma symptoms in children in Australia, England, Germany and New Zealand: an international comparison using the ISAAC protocol. Eur Respir J 1993; 6: 1455–1461.
CAS PubMed Web of Science® Google Scholar
5Rose G. Sick individuals and sick populations. Int J Epidemiol 1985; 14: 32–38.
10.1093/ije/14.1.32
CAS PubMed Web of Science® Google Scholar
6Yan K, Salome C, Woolcock AJ. Rapid method for measurement of bronchial responsiveness. Thorax 1983; 38: 760–765.
10.1136/thx.38.10.760
CAS PubMed Web of Science® Google Scholar
7 Scientific and Medical [computer program]. 3rd edition. Doylestown, Penn: S&M Instrument Co, Inc, 1990.
Google Scholar
8Pepys J. Skin testing. Br J Hosp Med 1975; 14: 412–417.
Google Scholar
9Toelle BG, Peat JK, Salome CM, et al. Toward a definition of asthma for epidemiology. Am Rev Respir Dis 1992; 146: 633–637.
10.1164/ajrccm/146.3.633
PubMed Web of Science® Google Scholar
10Peat JK, Toelle BG, Salome CM, Woolcock AJ. Predictive nature of bronchial responsiveness and respiratory symptoms in a one year cohort study of Sydney school children. Eur Respir J 1993; 6: 662–669.
PubMed Web of Science® Google Scholar
11Bauman A, Lyle D, Taylor L, Thomson P. The use of medical records in epidemiology: a case study using asthma hospitalisations in New South Wales, 1979-86. Aust Med Rec J 1990; 20: 101–105.
10.1177/183335839002000304
Google Scholar
12 World Health Organization. International classification of diseases. Manual of the international statistical classification of diseases, injuries and causes of death. 9th revision. Vol 1. Geneva: WHO, 1977.
Google Scholar
13 SAS [computer program], version 6.03. Cary, NC: SAS Institute Inc, 1988.
Google Scholar
14Bauman A, Mitchell CA, Henry RL, et al. Asthma morbidity in Australia: an epidemiological study. Med J Aust 1992; 156: 827–831.
10.5694/j.1326-5377.1992.tb136992.x
CAS PubMed Web of Science® Google Scholar
15Sterk PJ, Fabbri LM, Quanjer PH, et al. Airway responsiveness. Standardised challenge testing with pharmacological, physical and sensitising stimuli in adults. Eur Respir J 1993; 6: 53–83.
10.1183/09041950.053s1693
PubMed Web of Science® Google Scholar
16Burr ML, Limb ES, Andrae S, et al. Childhood asthma in four countries: a comparative survey. Int J Epidemiol 1994; 23: 341–347.
10.1093/ije/23.2.341
CAS PubMed Web of Science® Google Scholar
17Robertson CF, Bishop J, Sennhauser FH, Mallol J. International comparison of asthma prevalence in children: Australia, Switzerland, Chile. Pediatr Pulmonol 1993; 16: 219–226.
10.1002/ppul.1950160403
PubMed Web of Science® Google Scholar
18Leung R, Jenkins M. Asthma, allergy and atopy in southern Chinese school students. Clin Exp Allergy 1994; 24: 353–358.
10.1111/j.1365-2222.1994.tb00246.x
CAS PubMed Web of Science® Google Scholar
19Nishima S. A study on the prevalence of bronchial asthma in school children in western districts of Japan: comparison between the studies in 1982 and 1992 with the same methods and same districts. Arerugi 1993; 42: 192–204.
PubMed Google Scholar
20Peat JK, Tovey E, Mellis CM, et al. Importance of house dust mite and Alternaria allergens in childhood asthma: an epidemiological study in two climatic regions of Australia. Clin Exp Allergy 1993; 23: 812–820.
10.1111/j.1365-2222.1993.tb00258.x
CAS PubMed Web of Science® Google Scholar
21Sears MR, Herbison GP, Holdaway MD, et al. The relative risks of sensitivity to grass pollen, house dust mite and cat dander in the development of childhood asthma. Clin Exp Allergy 1989; 19: 419–424.
10.1111/j.1365-2222.1989.tb02408.x
CAS PubMed Web of Science® Google Scholar
22Sporik R, Chapman MD, Platts-Mills TAE. House dust mite exposure as a cause of asthma. Clin Exp Allergy 1992; 22: 897–906.
10.1111/j.1365-2222.1992.tb02062.x
CAS PubMed Web of Science® Google Scholar
23Peat JK, Tovey E, Gray EJ, et al. Asthma severity and morbidity in a population sample of Sydney schoolchildren. Part II: Importance of house dust mite allergens. Aust N Z J Med 1994; 24: 270–276.
10.1111/j.1445-5994.1994.tb02171.x
PubMed Web of Science® Google Scholar
24Pollart SM, Chapman MD, Fiocco GP, et al. Epidemiology of acute asthma: IgE antibodies to common inhalant allergens as a risk factor for emergency room visits. J Allergy Clin Immunol 1989; 83: 875–882.
10.1016/0091-6749(89)90100-0
CAS PubMed Web of Science® Google Scholar
25Lau S, Falkenhorst G, Weber A, et al. High mite-allergen exposure increases the risk of sensitization in atopic children and young adults. J Allergy Clin Immunol 1989; 84: 718–725.
10.1016/0091-6749(89)90300-X
CAS PubMed Web of Science® Google Scholar
26Robertson CF, Bishop J, Dalton M, et al. Prevalence of asthma in regional Victorian schoolchildren. Med J Aust 1992; 156: 831–833.
10.5694/j.1326-5377.1992.tb136993.x
CAS PubMed Web of Science® Google Scholar
27von Mutius E, Martinez FD, Fritzch C, et al. Prevalence of asthma and atopy in two areas of West and East Germany. Am J Respir Crit Care Med 1994; 149: 358–364.
10.1164/ajrccm.149.2.8306030
PubMed Web of Science® Google Scholar
28Burney P. A diet rich in sodium may potentiate asthma. Epidemiological evidence for a new hypothesis. Chest 1987; 91 Suppl: 143S–148S.
10.1378/chest.91.6.143S
CAS PubMed Web of Science® Google Scholar
29Hurry VM, Peat JK, Woolcock AJ. Prevalence of respiratory symptoms, bronchial hyperresponsiveness and atopy in schoolchildren living in the Villawood area of Sydney. Aust N Z J Med 1988; 18: 745–752.
10.1111/j.1445-5994.1988.tb00173.x
CAS PubMed Web of Science® Google Scholar
30Seaton A, Godden DJ, Brown K. Increase in asthma: a more toxic environment or a more susceptible population? Thorax 1994; 49: 171–174.
10.1136/thx.49.2.171
CAS PubMed Web of Science® Google Scholar

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Volume163, Issue1

July 1995

Pages 22-26

Prevalence and severity of childhood asthma and allergic sensitisation in seven climatic regions of New South Wales

Abstract

Objective

Design and setting

Participants

Outcome measures

Results

Conclusions

References

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Prevalence and severity of childhood asthma and allergic sensitisation in seven climatic regions of New South Wales

Abstract

Objective

Design and setting

Participants

Outcome measures

Results

Conclusions

References

Citing Literature

References

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