Increasing prevalence of asthma but not of chronic bronchitis in Finland? Report from the FinEsS-Helsinki study

Abstract

To assess the prevalence of asthma, chronic bronchitis and respiratory symptoms, and to calculate risk factors for them, we performed a postal survey in Helsinki, the capital of Finland. During the spring of 1996, questionnaires were mailed to a random sample of 8000 individuals aged 20-69. The total response rate was 76%, with 6062 complete answers. The prevalence of having ever had asthma was 7.2%, physician-diagnosed asthma was 6.6% and physician-diagnosed chronic bronchitis was 3.7%. Asthma was significantly more common among women than men, but no gender differences existed in prevalence of chronic bronchitis. The most common respiratory symptom was sputum production when coughing, reported by 27%. During the previous 12 months, wheezing had occurred in 20% and attacks of shortness of breath in 13% of subjects. Generally, the prevalence of different respiratory symptoms were significantly higher among smokers. The most important risk factor for asthma was a family history of asthma (Odds ratio:OR 3.3). Multivariate analysis revealed that being a member of the socioeconomic group, manual workers, was associated with a significantly increased risk for chronic productive cough (OR 1.7), and for wheezing during the previous 12 months (OR 1.7). Manual workers of both genders had the highest prevalence of asthma, chronic productive cough and wheezing during the previous 12 months. The prevalence of asthma in Helsinki was higher than previously found in Finland, and was at a similar level to that of other Nordic countries. In contrast, prevalence of chronic bronchitis was lower than previously shown in Finland.

Occupational exposure to dust, gases and fumes, a family history of asthma and impaired respiratory health

“…As expected, we found a family history of asthma to be a strong determinant of respiratory health, especially for asthma, and this finding agrees with the results of other studies (13,15,19,22,24). As people with a family history of asthma have a higher risk of impaired respiratory health a priori, the risk in absolute terms is higher among the susceptible persons.…”

“It's your whole way of life really”: negotiating work, health and gender

“…Focus group interviews 7 gathered accounts of men's and Group, 1999Group, -2000 Twice as many women report asthma symptoms as men farmers in New Zealand. These types of gender differences resonate with other studies-see for example: Dodge et al, 1986;Kimbell-Dunn et al, 1999;Osborne et al, 1998;Pallasaho et al, 1999;and Prescott et al, 1997. 5 The two groups included 506 randomly selected vegetable growers from the Vegetable and Potato Grower's Federation of New Zealand and 659 licensed horse trainers from the Harness Racing New Zealand directory (also randomly selected).…”

Chronic Bronchitis and Chronic Obstructive Pulmonary Disease

“…Table 1 provides an overview of the prevalence of cough and sputum production in population-based studies. CB is seen in 3.4 to 22.0% of adults (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). This wide range of prevalence estimates may be due to varying definitions of CB (i.e., chronic phlegm versus chronic cough and phlegm) as well as the possible inclusion of subjects with bronchiectasis, a syndrome also characterized by chronic cough and daily viscid sputum production that is associated with pathologic airway dilation and recurrent infection.…”