Prevalence of asthma in Finnish young men.

Haahtela, Tari; Lindholm, Harri; Björkstén, Fred; Koskenvuo, Karoliina; Laitinen, Lauri A.

doi:10.1136/bmj.301.6746.266

Cited by 252 publications

(123 citation statements)

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“…The rise in black pediatric asthma hospitalizations started around 1970 and has occurred in a population with a decreasing percentage of 0-to 18-year-olds and a stable racial makeup during the period studied. This study shows an increase in the number of children requiring admission for asthma since 1970, which parallels the increase reported among black children age 0 to 14 years in Washington, DC, 9 in children nationwide age 0 to 17 years based on National Center for Health Statistics results, 7 in Finnish 19-year-olds, 3 and in children age 0 to 14 years in community-based studies in the United States. 11,17 The increase in asthma hospitalization reported here occurred despite many advances in emergency department treatment of asthma during the same period, most notably the introduction of controlledrelease theophylline in the early 1970s, nebulized albuterol in the late 1970s, and intravenous methylprednisolone in the 1980s.…”

Section: Discussionsupporting

confidence: 58%

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Asthma Hospitalization Trends in Charleston, South Carolina, 1956 to 1997: Twenty-fold Increase Among Black Children During a 30-Year Period

et al. 2001

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ABSTRACT. Objective. The increase in asthma prevalence has been documented worldwide, affecting many races living in many different climates. Multiple studies have demonstrated that the most striking prevalence and morbidity of asthma in the United States has been in black children, but little research has determined the scale of the increase, or specifically when the disease became severe in this group. This study sought to determine exactly when the rise in asthma hospitalizations among black patients began and what the pattern of asthma hospitalizations has been in different races and age groups over a 40-year period in 1 urban area.Methods. A retrospective chart review of discharges from the Medical University of South Carolina was conducted from 1956 to 1997. Charts with the primary discharge diagnosis of asthma were examined for discharge date, race, and age group (0-to 4-year-olds, 5-to 18-yearolds, 19-to 50-year-olds, >51-year-olds). The diagnostic codes used were based on the International Classification of Diseases (ICD)-6, 1956 -1957; ICD-7, 1958 -1967; ICD-8, 1968 -1978; and ICD-9, 1979 -1997. Over the period studied, this hospital was the primary inpatient provider for children in this area, and the only provider for uninsured children. Between 1960 and 1990, the racial makeup of the area remained stable, as did the percentage of blacks living at the poverty level. The raw number of asthma discharges, rate per 10 000 discharges of the same race, and rate per 100 000 population in Charleston County were tabulated for each age group and racial category.Results. Over the time period examined, there has been a progressive increase in asthma hospitalizations in black individuals of all age groups and in whites under 18 years. The most striking increase has been in black children 0 to 18 years old (Figure). The increase either as raw values or as a rate per 100 000 began around 1970, and was linear. This increase in black children discharged with asthma as a rate per 100 000 population was 20-fold: the rate increased from 18 in 1970 to 370 in 1997. Asthma discharges as a rate per 10 000 black children discharged increased by 24-fold from 1960 to 1997. Total discharges from the hospital increased from 49 000 to 128 000 per year over this period. Blacks made up only 28% of discharges in 1957, but that proportion increased to 56% in 1960 and remained relatively stable over the following 35 years. The increase seen in white children 0 to 18 years of age as a rate per 100 000 population was 5-fold and began around 1980. Both increases seem to be consistent over the time period studied, and continued to 1997.Conclusions. Among a predominantly poor black population living in a southern US city, there has been a steady increase in childhood asthma hospitalizations over the past 30 years. A significant although less dramatic rise has occurred in white children. Over this time period, although there have been many changes in lifestyle that could have contributed to this rise, there have been no major changes in hou...

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Section: Discussionsupporting

confidence: 58%

“…[1][2][3][4][5] In addition to the increase in prevalence, there has been an increase in asthma mortality and hospitalization. 2,6 -8 In the United States, the most striking increases in asthma have occurred in black communities and among children.…”

mentioning

confidence: 99%

Asthma Hospitalization Trends in Charleston, South Carolina, 1956 to 1997: Twenty-fold Increase Among Black Children During a 30-Year Period

et al. 2001

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“…They also showed that old-fashioned and less urban living conditions conferred protection against atopic diseases (30,31). The differences in prevalence of atopic diseases between Eastern and Western Europe have been found to be largely limited to populations born after the late 1950s, at a time when the lifestyle between the two parts of the continent began to drift apart (12,14,17,32,33).…”

Section: Lifestyle and Standard Of Livingmentioning

confidence: 99%

Asthma and atopy – the price of affluence?

Hertzen

Haahtela²

2004

Allergy

121

110

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Irrespective of improved knowledge of many aspects of atopic diseases, the unfavorable trends in their prevalence particularly among children could not have been reversed. A growing body of evidence suggests that something may lack from our societal affluence that has the capacity to provide protection against the development of atopic diseases. Much attention during the last years has been devoted to the hygiene hypothesis. This review outlines the impact of environment and lifestyle, particularly from the perspective of the East–West gradient, on the development of atopic diseases, with a special emphasis on the hygiene hypothesis in its broadest sense.

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“…The prevalence of asthma and allergic disease has increased in many countries (5,14), and there has been speculation as to the possible causes (4,46,47), including a possible role of immunization in promoting allergic sensitization (12,55). Asthma is a chronic disease of the respiratory tract and is tightly associated with airway hyperresponsiveness, increased mucus production, and infiltration of the bronchial mucosa by CD4 ϩ T cells (59).…”

mentioning

confidence: 99%

Acellular Pertussis Vaccine Protects against Exacerbation of Allergic Asthma Due toBordetella pertussisin a Murine Model

Ennis

Cassidy

Mahon

2005

Clin Vaccine Immunol

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The prevalence of asthma and allergic disease has increased in many countries, and there has been speculation that immunization promotes allergic sensitization. Bordetella pertussis infection exacerbates allergic asthmatic responses. We investigated whether acellular pertussis vaccine (Pa) enhanced or prevented B. pertussis-induced exacerbation of allergic asthma. Groups of mice were immunized with Pa, infected with B. pertussis, and/or sensitized to ovalbumin. Immunological, pathological, and physiological changes were measured to assess the impact of immunization on immune deviation and airway function. We demonstrate that immunization did not enhance ovalbumin-specific serum immunoglobulin E production. Histopathological examination revealed that immunization reduced the severity of airway pathology associated with sensitization in the context of infection and decreased bronchial hyperreactivity upon methacholine exposure of infected and sensitized mice. These data demonstrate unequivocally the benefit of Pa immunization to health and justify selection of Pa in mass vaccination protocols. In the absence of infection, the Pa used in this study enhanced the interleukin-10 (IL-10) and IL-13 responses and influenced airway hyperresponsiveness to sensitizing antigen; however, these data do not suggest that Pa contributes to childhood asthma overall. On the contrary, wild-type virulent B. pertussis is still circulating in most countries, and our data suggest that the major influence of Pa is to protect against the powerful exacerbation of asthma-like pathology induced by B. pertussis.

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Prevalence of asthma in Finnish young men.

Abstract: Objective-To assess whether monthly treatment with intravenous methylprednisolone enhances or accelerates the effect of disease modifying drugs in patients with rheumatoid arthritis. Design-A 12 month double blind, placebo controlled, multicentre trial in which patients with active

Cited by 252 publications

References 5 publications

Asthma Hospitalization Trends in Charleston, South Carolina, 1956 to 1997: Twenty-fold Increase Among Black Children During a 30-Year Period

Asthma Hospitalization Trends in Charleston, South Carolina, 1956 to 1997: Twenty-fold Increase Among Black Children During a 30-Year Period

Asthma and atopy – the price of affluence?

Acellular Pertussis Vaccine Protects against Exacerbation of Allergic Asthma Due toBordetella pertussisin a Murine Model

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