The worldwide variation in asthma prevalence prompted us to carry out a study to assess the variability of asthma-related symptoms in young adults on the islands of Gran Canaria and Tenerife. We used the questionnaire used in the European Community Respiratory Health Survey with the addition of two questions on smoking and ancestors from the Canary Islands. In each island, this questionnaire was distributed to a random sample of 5000 subjects aged 20-44 years. Of the 10,000 subjects, 9,506 (95.06%) were considered eligible. We obtained 7,132 (75.03%) responses. The prevalence of the different symptoms was wheezing 25.3%, nocturnal thoracic tightness 18.0%, awakened by an attack of shortness of breath 13.1%, attack of nocturnal coughing 33.3%, attack of asthma 4.3%, current asthma treatment 6.2%, and nasal allergies 18.0%. Women and smokers showed a significantly higher prevalence of asthma symptoms. No significant difference in symptoms was found between subjects whose ancestors were of Canarian origin and those with ancestors born outside the Canaries. As has been observed on other islands (Great Britain and New Zealand), asthma is common in individuals from 20 to 44 years of age in the Canaries. We hypothesize that climatic conditions play an important role in the prevalence of asthma symptoms.
To estimate the levels of underreporting of medical visits and to compare the reporting of chronic restrictive diseases, 203 individuals who had been visited in a Primary Health Center were interviewed in the period of two weeks following the medical visit. Underreporting of a medical visit was identified in 31 (15.3%) of the users. The level of underreporting was not related with age, sex, education or socioeconomic status. Reporting of chronic restrictive illness was compared with the information recorded in the user's medical record. The highest global agreement (91.6%) was observed for hypertensive disease (kappa index = 0.71), while the lowest agreement was found for chronic back pain (global agreement = 77.8% and kappa index = 0.14). Since underreporting of medical visits was moderate, the results suggest that this question can be used for the analysis of social differences in the access to health services. Nevertheless, estimation of the prevalence of chronic limiting conditions in a health interview survey should be done with great caution.
Current levels of air pollutants had an epidemiologically measurable impact on mortality and emergency-room visits in Barcelona. These results were consistent with the findings of similar studies in other european and american cities and with previous studies of emergency-room admissions in Barcelona. These studies suggest the possible toxicity of air pollution.
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