The prevalence of occupational asthma has usually been estimated from registers of cases rather than population surveys. We examined the causes and derived estimates of the risk of asthma attributable to occupational exposures in a randomly selected population of five areas of Spain. The study is part of the EC Respiratory Health Survey and comprises 2,646 subjects age 20 to 44 yr. Bronchial reactivity was determined in 1,797 subjects and atopy in 2,164. Twenty-one occupational sets were defined using information on current occupation, or in subjects reporting change of occupation due to respiratory problems, their occupation at that time. The highest risk of asthma was observed for laboratory technicians, spray painters, bakers, plastics and rubber workers, welders, and cleaners. The risk of asthma attributed to occupational exposures after adjusting for age, sex, residence, and smoking status was 5.0% when asthma was defined as "bronchial reactivity and a report of wheezing or whistling in the chest during the last 12 mo," and 6.7% when asthma was defined as "bronchial reactivity and a report of asthma-related symptoms or medication." Estimates of the attributable risk for adult onset asthma were higher. Occupational exposures constitute a substantial cause of asthma in the young adult Spanish population.

While there is evidence for variations in prevalence rates of childhood wheeze and asthma between countries, longitudinal, individual-level data are needed to understand these differences. The aim of this study was to examine variations in prevalence rates of childhood asthma, wheeze and wheeze with asthma in Europe.We analysed datasets from 10 MeDALL (Mechanisms of the Development of ALLergy) cohorts in eight countries, representing 26 663 children, to calculate prevalence rates of wheeze and asthma by child age and wheeze with asthma at age 4 years. Harmonised variables included outcomes parent-reported wheeze and parent-reported doctor-diagnosed asthma, and covariates maternal education, parental smoking, pets, parental asthma, doctor-diagnosed allergic rhinitis, doctor-diagnosed eczema and wheeze severity.At age 4 years, asthma prevalence varied from 1.72% in Germany to 13.48% in England and the prevalence of wheeze varied from 9.82% in Greece to 55.37% in Spain. Adjusted estimates of the proportion of 4-year-old children with wheeze diagnosed with asthma remained highest in England (38.14%, 95% CI 31.38–44.90%) and lowest in Spain (15.94%, 95% CI 6.16–25.71%).The large differences in prevalence rates of asthma, wheeze and wheeze with asthma at age 4 years between European cohorts may indicate that childhood asthma is more readily diagnosed in some countries while going unrecognised elsewhere.

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