EUGLOREH project
THE STATUS OF HEALTH IN THE EUROPEAN UNION:
TOWARDS A HEALTHIER EUROPE

FULL REPORT

PART II - HEALTH CONDITIONS

5. HEALTH IMPACTS OF NON COMMUNICABLE DISEASES AND RELATED TIME-TRENDS

5.9. Asthma and allergic rhinitis

5.9.2. Data sources

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5.9.2. Data sources

 

 

The data presented in this section are:

- Data derived from  papers published in peer reviewed journals;

- The Quality of life and management of human resources programme under the Fifth Framework Programme for Research;

- The GA²LEN - Global Allergy and Asthma European Network funded by the European Commission's 6th Framework Programme for Research;

- PASTURE” (Protection Against Allergy-Study in Rural Environments), under the 5th Framework Program;

- Lung Health in Europe Facts & Figures, from European Lung white book edited by European Respiratory Society and European Lung Foundation;

Eurostat NewCronos Database

- OECD (Organization for Economic Co-operation and Development) Health Working Paper

 

Mortality due to asthma (J45-J46 ICD9)

Groups of diseases which are dealt with in the chapter, with reference to ICD 9:

·          Extrinsic asthma  493.00

(Excluded:

Allergic asthma SAI 493.9

Detergent asthma 507.8

Wood asthma 95.8

Miner’s asthma 500)

·          Extrinsic asthma without mention of status asthmaticus 493.00

·          Extrinsic asthma with status asthmaticus 493.01

·          Intrinsic asthma 493.1

·          Late onset asthma 493.1

·          Intrinsic asthma without mention of status asthmaticus 493.10

·          Intrinsic asthma with status asthmaticus 493.11

·          Chronic obstructive asthma 493.2

(Excluded:

Chronic asthmatic bronchitis 491.2

Obstructive chronic bronchitis 491.2)

·          Chronic obstructive asthma without mention of status asthmaticus 493.2C

·          Chronic obstructive asthma with status asthmaticus 493.21

·          Unspecified asthma without mention of status asthmaticus 493.90

·          Specified asthma with status asthmaticus 493.91

·          Obstructive chronic bronchitis with (acute) exacerbation 491.21

·          Nasal turbinate hypertrophy 478.0

·          Allergic rhinitis due to pollen 477.0

·          Allergic rhinitis due to other allergens 477.8

·          Allergic rhinitis (non seasonal) (seasonal) 477.9

·          Allergic rhinitis, cause unspecified 477.9

 

An interesting survey (Compalati et al, 2007) has analyzed the results of a cross-sectional study by the World Allergy Organization (WAO), including more than 70 regional and national allergology and clinical immunology societies. Through questionnaires sent to 60 WAO member societies, the number of cases and the prevalence of asthma and AR for each country were collected at the end of 2005.

 

In early 1990s two large studies were set up which standardized the methods for data collection on asthma. The first one is the International Study of Asthma and Allergies in Childhood (ISAAC) (Björkstén al, 2007) and the second one was The European Community Respiratory Health Survey (ECRHS) (Burney et al, 2004).

 

ISAAC started in 1991. As many as 463 801 children were enrolled in 155 collaborating centres in 56 countries. In the Phase I of ISAAC, the prevalence of symptoms of asthma, allergic rhino-conjunctivitis and atopic eczema in 6-7 and 13-15 years old were assessed through a self administered questionnaire. Phase II of ISAAC (in a large number of countries) assessed the prevalence of objective markers of atopic diseases and investigated allergic determinants in children aged from 9 to 11 years. ISAAC Phase III is the continuation of this multicountry cross-sectional survey. Between 2002 and 2003, two age-groups of schoolchildren were enrolled: 193 404 children aged 67 years from 66 centres in 37 countries and 304 679 children aged 1314 years from 106 centres in 56 countries, chosen from a random sample of schools. Standardized questionnaires with questions about symptoms referred to asthma, allergic rhino-conjunctivitis and eczema were administered.

 

The European Community Respiratory Health Survey (ECRHS) (Burney et al, 2004) was set up in 1993 and was carried out in two stages including more than 18,000 individuals aged 20 to 44 years from 29 centres in 14 countries (mostly European). In stage I, subjects were given the ECRHS screening questionnaire dealing with symptoms suggestive of asthma, the use of medication for asthma and the presence of hay fever and rhinitic symptoms. In stage II, in a smaller random sample of subjects who had completed the screening questionnaire, skin prick test, PRIST, RAST, spirometry and methacoline challenge were performed. ECRHS II is a nine year follow-up prospective survey of more than 10,000 young adults begun in 1998.

 

In contrast with these two studies, the AIRE study (Asthma Insights & Reality in Europe) (Blanc et al, 2002) has been carried out using telephone interviews for data collection and including patients from all age groups with current asthma. A total of 213,158 people were reported living in the 73,880 households screened for the survey.

 

From the year 2000 onwards few data have been published; a review by von Hertzen and Haahtela has analyzed the most recent literature on time trends in asthma prevalence among children and adults by Medline searches for the period between 1 January 2000 and 15 June 2004 (tables 5.9.5 to 5.9.7). Twenty studies have been considered: 5 of them were among adults, 13 among children and two among both of them.