Changes in the prevalence of asthma and respiratory symptoms in western Sweden between 2008 and 2016

Borna, Eivind Christian; Nwaru, Bright I.; Bjerg, Anders; Mincheva, Roxana; Rådinger, Madeleine; Lundbäck, Bo; Ekerljung, Linda

doi:10.1111/all.13840

Cited by 52 publications

(63 citation statements)

References 57 publications

(72 reference statements)

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“…The prevalence of asthmatic wheeze decreased also significantly in Helsinki (7.7% in 2006 vs 5.3% in 2016) but was stable in Sweden (7.4% in 2006 vs 7.2% in 2016) [16]. The asthma prevalence increased among young men in our study, and the same worrying trend is seen also in Sweden [39]. In a Norwegian study overweight increased the odds of asthma in adolescents [8].…”

Section: Discussionsupporting

confidence: 65%

The increase of asthma prevalence has levelled off and symptoms decreased in adults during 20 years from 1996 to 2016 in Helsinki, Finland

Hisinger‐Mölkänen

Pallasaho

Haahtela

et al. 2019

Respiratory Medicine

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Background: Mortality and hospitalization due to asthma have decreased in many European countries, but asthma symptoms still cause a lot of morbidity and costs. Objectives: We evaluated prevalence trends of asthma, asthma symptoms and allergic rhinoconjunctivitis in adults aged 20-69 years during a 20-year period from 1996 to 2016 in the city of Helsinki, the capital of Finland. Methods: Three cross-sectional postal surveys were conducted in random population samples 10 years apart. In 1996, 2006 and 2016, a total of 6062 (response rate 75.9%), 2449 (61.9%) and 4026 subjects (50.3%) took part, respectively. Results: In all responders, the prevalence of physician-diagnosed asthma was 6.6% in 1996, 10% in 2006 and 10.9% in 2016. The prevalence increased from 1996 to 2006, but stabilized from 2006 to 2016, both in men and women and in smokers and non-smokers. The prevalence of current asthma (8.5% in 2006 and 8.8% in 2016) and of asthma with rhinoconjunctivitis (7.6% in 2006 and 7.5% in 2016) remained also at the same level. Allergic rhinoconjunctivitis decreased significantly from 2006 (42.7%) to 2016 (39.0%, p = 0.004). Those with physician diagnosed asthma reported significantly less symptoms in 2016 compared to 2006 and 1996, although there was no change in smoking habits or medication use. Young asthmatics (20-29 years) without rhinoconjunctivitis reported least symptoms. Conclusion: Previously observed increase of physician-diagnosed asthma prevalence in adults seems to be levelling off in Helsinki, and patients have fewer symptoms than 20 years ago. In addition, allergic rhinoconjunctivitis is less frequent than 10 years earlier.

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Section: Discussionsupporting

confidence: 65%

The increase of asthma prevalence has levelled off and symptoms decreased in adults during 20 years from 1996 to 2016 in Helsinki, Finland

Hisinger‐Mölkänen

Pallasaho

Haahtela

et al. 2019

Respiratory Medicine

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“…Even the diagnoses chosen by clinicians, obtained from the national registers, may risk misclassification bias. However, the prevalence of respiratory disease in our study (20.4%) matches well the combined estimated mean prevalence of asthma (10%) and COPD (9%) in Sweden [45].…”

Section: Limitations and Strengthssupporting

confidence: 87%

Early life exposures and risk of adult respiratory disease during 50 years of follow-up

2020

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Adult health is influenced by factors during fetal life affecting organ development and birth weight. We aimed to study such factors in relation to adult respiratory disease (ARD) risk. The Helsingborg Birth Cohort, Sweden, contributed baseline data collected by medical staff through clinical examination and questionnaires on maternal and birth characteristics 1964-1967. Register linkages were performed with completions of data on ARD by ICD 8-10 classifications (1969-2016), and/or ARDrelated drug usage (2005-2016) enabling a 50-year follow-up time. Cox proportional hazard regression analyses were made to adjust for potential confounders, adjusted hazard ratio (aHR). A total of 3675 mothers and their offspring were included. Female offspring showed higher frequency of ARD than males, aHR 1.5 (95% CI 1.3-1.8). Maternal use of sedatives during second trimester, aHR 2.2 (95% CI 1.4-3.4), and maternal smoking during most of pregnancy, aHR 1.2 (95% CI 1.0-1.4), were associated with offspring ARD. Stratified by sex, large-for-gestational-age, aHR 1.4 (95% CI 1.0-1.9), was significantly associated with ARD in female offspring along with maternal sedative use during second trimester and maternal smoking during most of pregnancy. Maternal sedative use during second trimester or all trimesters were the only significant risk factors for male offspring. In conclusion, maternal sedative use in second trimester was independently associated with subsequent respiratory disease in adult offspring irrespective of sex.

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“…The elucidation of the genetic variants associated with NSAIDs hypersensitivity could help us prevent and evaluate potential risks through genetic testing, guiding precision medicine. 29,[173][174][175] However, despite recent advances, including high-throughput sequencing technologies development, individual predisposing factors remain unknown. 176 In addition to the difficulties to shed light on the genetics of complex diseases, another important drawback in NSAIDs hypersensitivity is the heterogeneity of phenotypes, and potential differences in their definition.…”

Section: On the Genetics Of Nsaids Hypersensitivitymentioning

confidence: 99%

Progress in understanding hypersensitivity reactions to nonsteroidal anti‐inflammatory drugs

Doña

Pérez‐Sánchez

Eguiluz‐Gracia

et al. 2019

Allergy

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Nonsteroidal anti‐inflammatory drugs (NSAIDs), the medications most commonly used for treating pain and inflammation, are the main triggers of drug hypersensitivity reactions. The latest classification of NSAIDs hypersensitivity by the European Academy of Allergy and Clinical Immunology (EAACI) differentiates between cross‐hypersensitivity reactions (CRs), associated with COX‐1 inhibition, and selective reactions, associated with immunological mechanisms. Three phenotypes fill into the first group: NSAIDs‐exacerbated respiratory disease, NSAIDs‐exacerbated cutaneous disease and NSAIDs‐induced urticaria/angioedema. Two phenotypes fill into the second one: single‐NSAID‐induced urticaria/angioedema/anaphylaxis and single‐NSAID‐induced delayed reactions. Diagnosis of NSAIDs hypersensitivity is hampered by different factors, including the lack of validated in vitro biomarkers and the uselessness of skin tests. The advances achieved over recent years recommend a re‐evaluation of the EAACI classification, as it does not consider other phenotypes such as blended reactions (coexistence of cutaneous and respiratory symptoms) or food‐dependent NSAID‐induced anaphylaxis. In addition, it does not regard the natural evolution of phenotypes and their potential interconversion, the development of tolerance over time or the role of atopy. Here, we address these topics. A state of the art on the underlying mechanisms and on the approaches for biomarkers discovery is also provided, including genetic studies and available information on transcriptomics and metabolomics.

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Changes in the prevalence of asthma and respiratory symptoms in western Sweden between 2008 and 2016

Cited by 52 publications

References 57 publications

The increase of asthma prevalence has levelled off and symptoms decreased in adults during 20 years from 1996 to 2016 in Helsinki, Finland

The increase of asthma prevalence has levelled off and symptoms decreased in adults during 20 years from 1996 to 2016 in Helsinki, Finland

Early life exposures and risk of adult respiratory disease during 50 years of follow-up

Progress in understanding hypersensitivity reactions to nonsteroidal anti‐inflammatory drugs

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