Trends in prevalence of symptoms of asthma, hay fever, and eczema in 12-14 year olds in the British Isles, 1995-2002: questionnaire survey
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《英国医生杂志》
1 Department of Community Health Sciences, St George's Hospital Medical School, London SW17 0RE, 2 Highlands and Islands Health Research Institute, University of Aberdeen, Inverness IV2 3ED, 3 Department of Epidemiology, Statistics and Public Health, University of Wales College of Medicine, Cardiff CF14 4XN, 4 Board of Health, St Martins, Guernsey GY4 6UU, 5 Princess Elizabeth Hospital, St Martins, 6 Department of Health and Social Security, Douglas, Isle of Man IM1 3QA, 7 Harvey Education Centre, St Helier, Jersey JE1 3QZ
Correspondence to: H R Anderson r.anderson@sghms.ac.uk
Introduction
In 1995, as part of the international study of asthma and allergies in childhood (ISAAC), we surveyed symptoms of atopic disease in England, Scotland, Wales, and the offshore islands of Guernsey, Isle of Man, and Jersey.4 5 A self completed questionnaire which adhered to the core ISAAC protocol was administered to secondary school children aged 12-14 in school years 8 and 9 (S2 and S3 in Scotland). In 2002 the survey was repeated in Scotland, Wales, and the islands in the same school years, using the same questionnaire and procedures in the same period of the year and, mostly, in the same schools. In England, only the schools in the South East Region were surveyed a second time. The table shows the changes in prevalence over the seven years from 1995 to 2002.
Trends in symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema in 12-14 year olds, British Isles, 1995-2002
Overall, the prevalence of any wheezing or whistling in the chest in the past 12 months fell from 34% to 28% (19% relative reduction). Even larger proportional falls were observed for frequent attacks (35%) and speech limiting attacks (24%). Large reductions were also observed for symptoms of allergic rhinoconjunctivitis (16%) and atopic eczema (30%). The proportion of children reporting "ever" having had "asthma" or "eczema" increased (26% and 15%), as did the lifetime prevalence of "hay fever" (8%). Trends in the four regions were similar.
The fall in prevalence is consistent with other sources. From 1995 to 2000, hospital admissions for asthma fell by 20.4% in 10-14 year olds in England, Scotland, and Wales combined (see table). From 1995 to 2002, in 10-14 year olds in a sample of 75 English and Welsh practices, visits to a general practitioner for episodes of asthma decreased by 47% (from 38.3 to 20.4 per 1000). Recently released data from the health survey for England shows that from 1997 to 2001, the 12 month prevalence of wheezing in 10-14 year olds, based on parental reporting, fell by 18% (from 17.4% to 14.2%).
Comment
ISAAC Steering Committee. Worldwide variations in the prevalence of asthma symptoms: the International Study of Asthma and Allergies in Childhood (ISAAC). Eur Respir J 1998;12: 315-35.
Anderson HR, Gupta R. Trends in asthma. In: Partridge MR, Miles A, eds. The effective management of asthma. London: Aesculapius, 2002.
Ng Man KG, Proctor A, Billings C, Duggan R, Das C, Whyte MK, et al. Increasing prevalence of asthma diagnosis and symptoms in children is confined to mild symptoms. Thorax 2001;56: 312-4.
Kaur B, Anderson HR, Austin J, Burr ML, Harkins L, Strachan DP, et al. Prevalence of asthma symptoms, diagnosis, and treatment in 12-14 year old children across Great Britain (international study of asthma and allergies in childhood, ISAAC UK). BMJ 1998;316: 118-24.
Jeffs D, Grainger R, Powell P. Is childhood allergy more common amongst an island population? J R Soc Health 2000;120: 236-41.(H Ross Anderson, professo)
Correspondence to: H R Anderson r.anderson@sghms.ac.uk
Introduction
In 1995, as part of the international study of asthma and allergies in childhood (ISAAC), we surveyed symptoms of atopic disease in England, Scotland, Wales, and the offshore islands of Guernsey, Isle of Man, and Jersey.4 5 A self completed questionnaire which adhered to the core ISAAC protocol was administered to secondary school children aged 12-14 in school years 8 and 9 (S2 and S3 in Scotland). In 2002 the survey was repeated in Scotland, Wales, and the islands in the same school years, using the same questionnaire and procedures in the same period of the year and, mostly, in the same schools. In England, only the schools in the South East Region were surveyed a second time. The table shows the changes in prevalence over the seven years from 1995 to 2002.
Trends in symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema in 12-14 year olds, British Isles, 1995-2002
Overall, the prevalence of any wheezing or whistling in the chest in the past 12 months fell from 34% to 28% (19% relative reduction). Even larger proportional falls were observed for frequent attacks (35%) and speech limiting attacks (24%). Large reductions were also observed for symptoms of allergic rhinoconjunctivitis (16%) and atopic eczema (30%). The proportion of children reporting "ever" having had "asthma" or "eczema" increased (26% and 15%), as did the lifetime prevalence of "hay fever" (8%). Trends in the four regions were similar.
The fall in prevalence is consistent with other sources. From 1995 to 2000, hospital admissions for asthma fell by 20.4% in 10-14 year olds in England, Scotland, and Wales combined (see table). From 1995 to 2002, in 10-14 year olds in a sample of 75 English and Welsh practices, visits to a general practitioner for episodes of asthma decreased by 47% (from 38.3 to 20.4 per 1000). Recently released data from the health survey for England shows that from 1997 to 2001, the 12 month prevalence of wheezing in 10-14 year olds, based on parental reporting, fell by 18% (from 17.4% to 14.2%).
Comment
ISAAC Steering Committee. Worldwide variations in the prevalence of asthma symptoms: the International Study of Asthma and Allergies in Childhood (ISAAC). Eur Respir J 1998;12: 315-35.
Anderson HR, Gupta R. Trends in asthma. In: Partridge MR, Miles A, eds. The effective management of asthma. London: Aesculapius, 2002.
Ng Man KG, Proctor A, Billings C, Duggan R, Das C, Whyte MK, et al. Increasing prevalence of asthma diagnosis and symptoms in children is confined to mild symptoms. Thorax 2001;56: 312-4.
Kaur B, Anderson HR, Austin J, Burr ML, Harkins L, Strachan DP, et al. Prevalence of asthma symptoms, diagnosis, and treatment in 12-14 year old children across Great Britain (international study of asthma and allergies in childhood, ISAAC UK). BMJ 1998;316: 118-24.
Jeffs D, Grainger R, Powell P. Is childhood allergy more common amongst an island population? J R Soc Health 2000;120: 236-41.(H Ross Anderson, professo)