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{{Asthma}}
{{Asthma}}
{{CMG}}; [[Philip Marcus, M.D., M.P.H.]] [mailto:pmarcus192@aol.com]
{{CMG}}; [[Philip Marcus, M.D., M.P.H.]] [mailto:pmarcus192@aol.com]
==Epidemiology==
[[Image:asthma prevalence.png|thumb|left|350px|The [[prevalence]] of childhood asthma has increased since 1980, especially in younger children.]]
More than 6% of children in the United States have been diagnosed with asthma, a 75% increase in recent decades. The rate soars to 40% among some populations of urban children.


==Developed Countries==
==Developed Countries==
Line 17: Line 13:
On the remote South Atlantic island Tristan da Cunha, 50% of the population are asthmatics due to heredity transmission of a mutation in the gene CC16.
On the remote South Atlantic island Tristan da Cunha, 50% of the population are asthmatics due to heredity transmission of a mutation in the gene CC16.


==Impact of age and gender==
==Impact of Age and Gender==
Males are affected more often during their childhood and the prevalence declines with age. On the contrary, prevalence rises among females steadily through childhood equaling that among males between ages 14-17 years. During adulthood, females report higher current asthma prevalence compared with men<ref name="pmid21355352">{{cite journal| author=Akinbami LJ, Moorman JE, Liu X| title=Asthma prevalence, health care use, and mortality: United States, 2005-2009. | journal=Natl Health Stat Report | year= 2011 | volume=  | issue= 32 | pages= 1-14 | pmid=21355352 | doi= | pmc= | url= }} </ref>.
Males are affected more often during their childhood and the prevalence declines with age. On the contrary, prevalence rises among females steadily through childhood equaling that among males between ages 14-17 years. During adulthood, females report higher current asthma prevalence compared with men<ref name="pmid21355352">{{cite journal| author=Akinbami LJ, Moorman JE, Liu X| title=Asthma prevalence, health care use, and mortality: United States, 2005-2009. | journal=Natl Health Stat Report | year= 2011 | volume=  | issue= 32 | pages= 1-14 | pmid=21355352 | doi= | pmc= | url= }} </ref>.


==Socioeconomic factors==
[[File:Asthma prevalence.png|300px|left|The [[prevalence]] of childhood asthma has increased since 1980, especially in younger children]]
More than 6% of children in the United States have been diagnosed with asthma, a 75% increase in recent decades. The rate soars to 40% among some populations of urban children<ref name="pmid12165584">{{cite journal| author=Akinbami LJ, Schoendorf KC| title=Trends in childhood asthma: prevalence, health care utilization, and mortality. | journal=Pediatrics | year= 2002 | volume= 110 | issue= 2 Pt 1 | pages= 315-22 | pmid=12165584 | doi= | pmc= | url= }} </ref>.
 
<br clear="left"/>
 
==Socioeconomic Factors==
The incidence of asthma is higher among low-income populations within a society (it is not more common in developed countries than developing countries [http://www.who.int/mediacentre/factsheets/fs307/en/]), which in the western world are disproportionately ethnic minorities, and more likely to live near industrial areas. Additionally, asthma has been strongly associated with the presence of cockroaches in living quarters, which is more likely in such neighborhoods.<ref name=AAAAAI>{{cite web | title=Patient/Public Education: Fast Facts - Asthma Demographics/Statistics | publisher= American Academy of Allergy Asthma & Immunology | url=http://www.aaaai.org/patients/resources/fastfacts/asthma_demographics.stm}}</ref>
The incidence of asthma is higher among low-income populations within a society (it is not more common in developed countries than developing countries [http://www.who.int/mediacentre/factsheets/fs307/en/]), which in the western world are disproportionately ethnic minorities, and more likely to live near industrial areas. Additionally, asthma has been strongly associated with the presence of cockroaches in living quarters, which is more likely in such neighborhoods.<ref name=AAAAAI>{{cite web | title=Patient/Public Education: Fast Facts - Asthma Demographics/Statistics | publisher= American Academy of Allergy Asthma & Immunology | url=http://www.aaaai.org/patients/resources/fastfacts/asthma_demographics.stm}}</ref>


Asthma incidence and quality of treatment varies among different racial groups, though this may be due to correlations with income (and thus affordability of health care) and geography. For example, Black Americans are less likely to receive outpatient treatment for asthma despite having a higher prevalence of the disease. They are much more likely to have emergency room visits or hospitalization for asthma, and are three times as likely to die from an asthma attack compared to whites. The prevalence of "severe persistent" asthma is also greater in low-income communities compared with communities with better access to treatment.<ref name="NIH2004">{{cite journal | author=National HAeart, Lung, and Blood Institute | title=Morbidity & Mortality: 2004 Chart Book On Cardiovascular, Lung, and Blood Diseases | year=May 2004 | publisher=National Institutes of Health}}</ref><ref name="CDC2002">{{cite web | author=National Center for Health Statistics | title=Asthma Prevalence, Health Care Use and Mortality, 2002 | year=07 April 2006 | publisher=Centers for Disease Control and Prevention | url=http://www.cdc.gov/nchs/products/pubs/pubd/hestats/asthma/asthma.htm}}</ref>
==Impact of Ethnicity==
Asthma incidence and quality of treatment varies among different racial groups, though this may be due to correlations with income (and thus affordability of health care) and geography. For example, Black Americans are less likely to receive outpatient treatment for asthma despite having a higher prevalence of the disease. They are much more likely to have emergency room visits or hospitalization for asthma, and are three times as likely to die from an asthma attack compared to whites. The prevalence of "severe persistent" asthma is also greater in low-income communities compared with communities with better access to treatment.<ref name="NIH2004">{{cite journal | author=National HAeart, Lung, and Blood Institute | title=Morbidity & Mortality: 2004 Chart Book On Cardiovascular, Lung, and Blood Diseases | year=May 2004 | publisher=National Institutes of Health}}</ref><ref name="CDC2002">{{cite web | author=National Center for Health Statistics | title=Asthma Prevalence, Health Care Use and Mortality, 2002 | year=07 April 2006 | publisher=Centers for Disease Control and Prevention | url=http://www.cdc.gov/nchs/products/pubs/pubd/hestats/asthma/asthma.htm}}</ref>.
 
{| class="wikitable" border="1"
|+ Prevalence of asthma among different ethnicity in U.S.A<ref name="pmid21355352">{{cite journal| author=Akinbami LJ, Moorman JE, Liu X| title=Asthma prevalence, health care use, and mortality: United States, 2005-2009. | journal=Natl Health Stat Report | year= 2011 | volume=  | issue= 32 | pages= 1-14 | pmid=21355352 | doi= | pmc= | url= }} </ref>
! Ethnicity !! Prevalence
|-
| White || 7.8%
|-
| Black || 11.1%
|-
| American Indian or Alaska Native || 8.8%
|-
| Asian || 5.3%
|-
| Non-Hispanic white || 8.2%
|-
| Non-Hispanic black || 11.1%
|-
| Total Hispanic || 6.3%
|-
| Puerto Rican || 16.6%
|-
| Mexican || 4.9%
|}


==Asthma and athletics==
==Asthma and Athletics==
Asthma appears to be more prevalent in athletes than in the general population. One survey of participants in the 1996 Summer Olympic Games, in Atlanta, Georgia, U.S., showed that 15% had been diagnosed with asthma, and that 10% were on asthma medication. <ref name=olympics>Weiler JM, Layton T, Hunt M. Asthma in United States Olympic athletes who participated in the 1996 Summer Games. ''J Allergy Clin Immunol''. 1998;102(5):722-6. PMID 9819287</ref>
Asthma appears to be more prevalent in athletes than in the general population. One survey of participants in the 1996 Summer Olympic Games, in Atlanta, Georgia, U.S., showed that 15% had been diagnosed with asthma, and that 10% were on asthma medication. <ref name=olympics>Weiler JM, Layton T, Hunt M. Asthma in United States Olympic athletes who participated in the 1996 Summer Games. ''J Allergy Clin Immunol''. 1998;102(5):722-6. PMID 9819287</ref>
These statistics have been questioned on at least two bases. Athletes with mild asthma may be more likely to be diagnosed with the condition than non-athletes, because even subtle symptoms may interfere with their performance and lead to pursuit of a diagnosis. It has also been suggested that some professional athletes who do not suffer from asthma claim to do so in order to obtain special permits to use certain performance-enhancing drugs.
These statistics have been questioned on at least two bases. Athletes with mild asthma may be more likely to be diagnosed with the condition than non-athletes, because even subtle symptoms may interfere with their performance and lead to pursuit of a diagnosis. It has also been suggested that some professional athletes who do not suffer from asthma claim to do so in order to obtain special permits to use certain performance-enhancing drugs.

Revision as of 19:09, 20 September 2011

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Philip Marcus, M.D., M.P.H. [2]

Developed Countries

Current research suggests that the prevalence of childhood asthma has been increasing. According to the Centers for Disease Control and Prevention's National Health Interview Surveys, some 9% of US children below 18 years of age had asthma in 2001, compared with just 3.6% in 1980 (see figure). The World Health Organization (WHO) reports that some 8% of the Swiss population suffers from asthma today, compared with just 2% some 25–30 years ago.[1]. In the U.S., urban residents, Hispanics, and African Americans are affected more than the population as a whole. Globally, asthma is responsible for around 180,000 deaths annually[1].

According to the National Health Statistic Reports, 2009, there is higher prevalence of asthma among people residing in northeast( 9.3%) and midwest (8.8%) regions of USA in comparison to those in south[2].

Developing Countries

Although asthma is more common in affluent countries, it is by no means a problem restricted to the affluent; the WHO estimate that there are between 15 and 20 million asthmatics in India.

On the remote South Atlantic island Tristan da Cunha, 50% of the population are asthmatics due to heredity transmission of a mutation in the gene CC16.

Impact of Age and Gender

Males are affected more often during their childhood and the prevalence declines with age. On the contrary, prevalence rises among females steadily through childhood equaling that among males between ages 14-17 years. During adulthood, females report higher current asthma prevalence compared with men[2].

The prevalence of childhood asthma has increased since 1980, especially in younger children
The prevalence of childhood asthma has increased since 1980, especially in younger children

More than 6% of children in the United States have been diagnosed with asthma, a 75% increase in recent decades. The rate soars to 40% among some populations of urban children[3].


Socioeconomic Factors

The incidence of asthma is higher among low-income populations within a society (it is not more common in developed countries than developing countries [3]), which in the western world are disproportionately ethnic minorities, and more likely to live near industrial areas. Additionally, asthma has been strongly associated with the presence of cockroaches in living quarters, which is more likely in such neighborhoods.[4]

Impact of Ethnicity

Asthma incidence and quality of treatment varies among different racial groups, though this may be due to correlations with income (and thus affordability of health care) and geography. For example, Black Americans are less likely to receive outpatient treatment for asthma despite having a higher prevalence of the disease. They are much more likely to have emergency room visits or hospitalization for asthma, and are three times as likely to die from an asthma attack compared to whites. The prevalence of "severe persistent" asthma is also greater in low-income communities compared with communities with better access to treatment.[5][6].

Prevalence of asthma among different ethnicity in U.S.A[2]
Ethnicity Prevalence
White 7.8%
Black 11.1%
American Indian or Alaska Native 8.8%
Asian 5.3%
Non-Hispanic white 8.2%
Non-Hispanic black 11.1%
Total Hispanic 6.3%
Puerto Rican 16.6%
Mexican 4.9%

Asthma and Athletics

Asthma appears to be more prevalent in athletes than in the general population. One survey of participants in the 1996 Summer Olympic Games, in Atlanta, Georgia, U.S., showed that 15% had been diagnosed with asthma, and that 10% were on asthma medication. [7] These statistics have been questioned on at least two bases. Athletes with mild asthma may be more likely to be diagnosed with the condition than non-athletes, because even subtle symptoms may interfere with their performance and lead to pursuit of a diagnosis. It has also been suggested that some professional athletes who do not suffer from asthma claim to do so in order to obtain special permits to use certain performance-enhancing drugs.

There appears to be a relatively high incidence of asthma in sports such as cycling, mountain biking, and long-distance running, and a relatively lower incidence in weightlifting and diving. It is unclear how much of these disparities are from the effects of training in the sport, and from self-selection of sports that may appear to minimize the triggering of asthma.[7][8]

In addition, there exists a variant of asthma called exercise-induced asthma that shares many features with allergic asthma. It may occur either independently, or concurrent with the latter. Exercise studies may be helpful in diagnosing and assessing this condition.

References

  1. 1.0 1.1 World Health Organization. "Bronchial asthma: scope of the problem".
  2. 2.0 2.1 2.2 Akinbami LJ, Moorman JE, Liu X (2011). "Asthma prevalence, health care use, and mortality: United States, 2005-2009". Natl Health Stat Report (32): 1–14. PMID 21355352.
  3. Akinbami LJ, Schoendorf KC (2002). "Trends in childhood asthma: prevalence, health care utilization, and mortality". Pediatrics. 110 (2 Pt 1): 315–22. PMID 12165584.
  4. "Patient/Public Education: Fast Facts - Asthma Demographics/Statistics". American Academy of Allergy Asthma & Immunology.
  5. National HAeart, Lung, and Blood Institute (May 2004). "Morbidity & Mortality: 2004 Chart Book On Cardiovascular, Lung, and Blood Diseases". National Institutes of Health.
  6. National Center for Health Statistics (07 April 2006). "Asthma Prevalence, Health Care Use and Mortality, 2002". Centers for Disease Control and Prevention. Check date values in: |year= (help)
  7. 7.0 7.1 Weiler JM, Layton T, Hunt M. Asthma in United States Olympic athletes who participated in the 1996 Summer Games. J Allergy Clin Immunol. 1998;102(5):722-6. PMID 9819287
  8. Helenius I, Haahtela T. Allergy and asthma in elite summer sport athletes. J Allergy Clin Immunol. 2000;106(3):444-52 PMID 10984362

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