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Asthma Prevalence -
| 5/14/03 re:
Asthma incidence in the USA |
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What is latest incidence of reported Asthma in the United States by age? (Adult and Adolescent/Pediatrics)
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I assume that you are requesting information about the prevalence of asthma in the USA (the term "incidence" is used by epidemiologists to more precisely describe the new occurrence of a diseases or disease manifestation in a particular time period).
I believe that the most extensive survey of asthma prevalence in the US population is contained in the National Health and Nutrition Examination Survey (NHANES), a project of the federal government. The most recent published data of that project is the NHANES III project covering the years 1988-1994 (see enclosed abstracts). Although slightly different results have been reported in different articles with regards to the prevalence of asthma in children/adolescents in the NHANES III project, the overall prevalence is in the range of 6.0-6.8% (see enclosed abstracts).
Estimating the prevalence of asthma in adults is more difficult because of the difficulty in distinguishing asthma from smoking-related obstructive airways disease (COPD). The NHANES study describes Obstructive Lung Disease (OLD) which can include both asthma and COPD. In one analysis by a CDC group of data from over 20,000 subjects in the NHANES project, they calculated a 5.8% prevalence of OLD in never- smoking adults, which may be a fairly close estimate of asthma prevalence in adults (see enclosed abstract)
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The main outcome measure was doctor-diagnosed asthma, as reported by the parent. RESULTS: Six percent of children had doctor-diagnosed asthma. The prevalence of asthma was higher among boys (6.7%) than girls (5.1%) and was higher among black children (8.9%) than white children (5.2%:
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Arch Pediatr Adolesc Med 2002 Mar;156(3):269-75
Comment in: Arch Pediatr Adolesc Med. 2002 Jul;156(7):729-30; discussion 730.
Identification of population subgroups of children and adolescents with high asthma prevalence: findings from the Third National Health and Nutrition Examination Survey.
Rodriguez MA, Winkleby MA, Ahn D, Sundquist J, Kraemer HC.
Department of Family Medicine, UCLA School of Medicine, 924 Westwood
Blvd, Suite 725, Los Angeles, CA 90024, USA.
OBJECTIVES: To provide national estimates of asthma prevalence in
African-American, Mexican American and white (non-Latino) children and adolescents using several common definitions; to evaluate familial, socio-demographic, and environmental risk factors that are independently associated with current asthma in children; and to identify subgroups at particular risk for current asthma using 2 complementary data analytic approaches. DESIGN: Cross-sectional study, using the Third National Health and Nutrition Examination Survey, 1988-1994. SETTING: Eighty-nine mobile examination centers in the United States. PARTICIPANTS: Twelve thousand three hundred eighty-eight African American, Mexican American, and white (non-Latino) children and adolescents, aged 2 months through 16 years, selected from a systematic random, population-based, nationally representative sample. MAIN OUTCOME MEASURE: Current asthma, defined by caregivers who reported that their child currently had doctor-diagnosed asthma. RESULTS: The overall prevalence of current asthma was 6.7% (95% confidence interval [CI], 5.6-7.8). Odds ratios for
current asthma from the multiple regression analysis were 4.00 (95% CI, 2.90-5.52) for children with a parental history of asthma or hay fever, 1.94 (95% CI, 1.09-3.46) for children with body mass index (calculated as weight in kilograms divided by the square of height in meters) greater than or equal to the 85th percentile, and 1.64 (95% CI, 1.20-2.26) for children of African American ethnicity. African American and Mexican American children showed a consistent prevalence of current asthma across age while white children showed an increase in prevalence with age. The 2 highest-risk subgroups identified by the signal detection analysis were composed of children with a parental history of asthma or hay fever who were 10 years or older with a body mass index greater than or equal to the 85th percentile (31.0% current asthma), and children with a parental history who were 10 years or younger and of African American ethnicity (15.6% current asthma). CONCLUSIONS: The findings from this analysis show a strong independent association between obesity and current asthma in children and adolescents, and confirm previous reports of a parental history of asthma or hay fever and African American ethnicity as additional important risk factors.
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Arch Intern Med 2000 Jun 12;160(11):1683-9
Obstructive lung disease and low lung function in adults in the United States:
data from the National Health and Nutrition Examination Survey, 1988-1994.
Mannino DM, Gagnon RC, Petty TL, Lydick E.
Division of Environmental Hazards and Health Effects, National Center for
Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
30341-3724, USA.
BACKGROUND: Obstructive lung disease (OLD) is an important cause of morbidity and mortality in the US adult population. Potentially treatable mild cases of OLD often go undetected. This analysis determines the national estimates of reported OLD and low lung function in the US adult population. METHODS: We examined data from the Third National Health and Nutrition Examination Survey (NHANES III), a multistage probability representative sample of the US population. A total of 20,050 US adults participated in NHANES III from 1988 to 1994. Our main outcome measures were low lung function (a condition determined to be present if the forced expiratory volume in 1 second-forced vital capacity ratio was less than 0.7 and the forced expiratory volume in 1 second was less than 80% of the predicted value), a physician diagnosis of OLD (chronic bronchitis, asthma, or emphysema), and respiratory symptoms. RESULTS: Overall a mean (SE) of 6.8% (0.3%) of the population had low lung function, and 8.5% (0.3%) of the population reported OLD. Obstructive lung disease (age-adjusted to study population) was currently reported among 12.5% (0.7%) of current smokers, 9.4% (0.6%) of former smokers, 3.1% (1.1%) of pipe or cigar smokers, and 5.8% (0.4%) of never smokers. Surprisingly, 63.3% (0.2%) of the subjects with documented low lung function had no prior or current reported diagnosis of any OLD. CONCLUSIONS: This study demonstrates that OLD is present in a substantive number of US adults. In addition, many US adults have low lung function but no reported OLD diagnosis, which may indicate the presence of undiagnosed lung disease.
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| 12/6/99 re: Methods to assess asthma prevalence |
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I am interested in prevalance of asthma and I am planing epidemiological study in the city I live. Could you send me a sample of ISAAC protocol by e-mail. |
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As you know, there have been extensive studies of asthma prevalence in
some European countries and in the USA. I am not an epidemiologist.
Therefore, to obtain details of surveying prevalence, I suggest that you
contact Dr, P. Burney, one of the leaders in the European Community
Respiratory Health Survey (see their recent report in the European
Respiratory Journal 1999 (October);14:885-91). Dr. Burney's address is:
Department of Public Health Sciences
United Medical and Dental Schools of Guy's, Kings and St. Thomas
London, UK
Another individual very experienced in setting up prevalence surveys for
asthmatics is Dr. P J Gergen, Center for Primary Care, Agency for Health
Care Policy and Research, Rockville, MD 20852, USA
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