PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of bmjThe BMJ
 
BMJ. 1990 May 19; 300(6735): 1306–1310.
PMCID: PMC1663026

Has the prevalence of asthma increased in children? Evidence from the national study of health and growth 1973-86.

Abstract

OBJECTIVES--To estimate changes in the prevalence of reported symptoms of respiratory disease and reported diagnoses of asthma and bronchitis in primary school children in England between 1973 and 1986. DESIGN--Mixed longitudinal survey. SETTING--Representative sample of English primary schools in 22 areas. PARTICIPANTS--15,000 Boys and 14,156 girls each studied at least once between 1973 and 1986. DATA COLLECTED--Whether, according to the parent or guardian, the child had wheezed, wheezed on most days or nights, or had attacks of bronchitis or asthma in the past year. RESULTS--Within age groups trends in successive annual cohorts showed an increasing prevalence of asthma for each annual birth cohort (boys, 6.9%, p less than 0.001; girls, 12.8%, p less than 0.001) and of wheeze on most days or nights (boys, 4.3% per cohort, p less than 0.001; girls, 6.1% per cohort, p less than 0.001) and a falling prevalence of bronchitis (boys, -4.7% per cohort, p less than 0.001; girls, -5.8% per cohort, p less than 0.001). There was a smaller increase in the prevalence of wheeze whether or not it occurred on most days or nights, and this increase was significant only among the girls (boys, 1.0% per cohort, p greater than 0.05; girls, 1.7% per cohort, p less than 0.05). Although the rate of increase of "asthma" was greater than the rate of decrease in "bronchitis," the baseline prevalence of asthma was much lower than that of bronchitis, and the total proportion of children with either diagnosis declined slightly over the whole period. The main change was an increase in the proportion of children whose parents stated that they had persistent wheeze and yet did not have a report of either "asthma" or "bronchitis." CONCLUSIONS--These results suggest that there has been a true increase in morbidity that is not simply due to changes in diagnostic fashion. The increase is large enough to explain much if not all of the increase in admission to hospital and mortality, and it underlines the importance of an understanding of the aetiology of asthma in tackling the causes of the recent increase.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.0M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Charlton JR, Velez R. Some international comparisons of mortality amenable to medical intervention. Br Med J (Clin Res Ed) 1986 Feb 1;292(6516):295–301. [PMC free article] [PubMed]
  • Anderson HR, Bailey P, West S. Trends in the hospital care of acute childhood asthma 1970-8: a regional study. Br Med J. 1980 Nov 1;281(6249):1191–1194. [PMC free article] [PubMed]
  • Fleming DM, Crombie DL. Prevalence of asthma and hay fever in England and Wales. Br Med J (Clin Res Ed) 1987 Jan 31;294(6567):279–283. [PMC free article] [PubMed]
  • Hill R, Williams J, Tattersfield A, Britton J. Change in use of asthma as a diagnostic label for wheezing illness in schoolchildren. BMJ. 1989 Oct 7;299(6704):898–898. [PMC free article] [PubMed]
  • Anderson HR. Is the prevalence of asthma changing? Arch Dis Child. 1989 Jan;64(1):172–175. [PMC free article] [PubMed]
  • Hill RA, Standen PJ, Tattersfield AE. Asthma, wheezing, and school absence in primary schools. Arch Dis Child. 1989 Feb;64(2):246–251. [PMC free article] [PubMed]
  • Jackson RT, Beaglehole R, Rea HH, Sutherland DC. Mortality from asthma: a new epidemic in New Zealand. Br Med J (Clin Res Ed) 1982 Sep 18;285(6344):771–774. [PMC free article] [PubMed]
  • Bousquet J, Hatton F, Godard P, Michel FB. Asthma mortality in France. J Allergy Clin Immunol. 1987 Sep;80(3 Pt 2):389–394. [PubMed]
  • Evans R., 3rd Recent observations reflecting increases in mortality from asthma. J Allergy Clin Immunol. 1987 Sep;80(3 Pt 2):377–379. [PubMed]
  • Mitchell EA, Cutler DR. Paediatric admissions to Auckland Hospital for asthma from 1970-1980. N Z Med J. 1984 Feb 8;97(749):67–70. [PubMed]
  • Halfon N, Newacheck PW. Trends in the hospitalization for acute childhood asthma, 1970-84. Am J Public Health. 1986 Nov;76(11):1308–1311. [PubMed]
  • Chinn S, Rona RJ. The secular trend in the height of primary school children in England and Scotland from 1972-1980. Ann Hum Biol. 1984 Jan-Feb;11(1):1–16. [PubMed]
  • Rona RJ, Altman DG. National study of health and growth: standards of attained height, weight and triceps skinfold in English children 5 to 11 years old. Ann Hum Biol. 1977 Nov;4(6):501–523. [PubMed]
  • Giles GG, Lickiss N, Gibson HB, Shaw K. Respiratory symptoms in Tasmanian adolescents: a follow up of the 1961 birth cohort. Aust N Z J Med. 1984 Oct;14(5):631–637. [PubMed]
  • Taylor B, Wadsworth J, Wadsworth M, Peckham C. Changes in the reported prevalence of childhood eczema since the 1939-45 war. Lancet. 1984 Dec 1;2(8414):1255–1257. [PubMed]
  • Magnusson CG. Maternal smoking influences cord serum IgE and IgD levels and increases the risk for subsequent infant allergy. J Allergy Clin Immunol. 1986 Nov;78(5 Pt 1):898–904. [PubMed]
  • Ware JH, Dockery DW, Spiro A, 3rd, Speizer FE, Ferris BG., Jr Passive smoking, gas cooking, and respiratory health of children living in six cities. Am Rev Respir Dis. 1984 Mar;129(3):366–374. [PubMed]

Articles from The BMJ are provided here courtesy of BMJ Publishing Group