Incidence and prevalence of adult asthma is associated with low socio‐economic status

Background: Low socio‐economic status is often related to health problems; however, previous studies on asthma, usually cross‐sectional, yield inconsistent results. In this study, longitudinal and cross‐sectional data on the association between socio‐economic status and asthma as well as respiratory symptoms among adults are presented. Methods: A postal questionnaire was sent on two occasions, 1996 and 2006, to a randomly selected sample of subjects aged 20–69 years in 1996. In total, 4479 subjects participated in both surveys. The questionnaire included questions on asthma, respiratory symptoms and possible determinants. Logistic regression analysis, adjusted for potential confounders, was used to study the association between asthma, respiratory symptoms and socio‐economic status. Results: Manual workers in service had the highest prevalence and cumulative incidence for all investigated symptoms and asthma. Despite a large decrease in smokers, the increase in incident bronchitic symptoms was higher than the increase of incident asthma and incident asthmatic symptoms. Low socio‐economic status, rhinitis and a family history of asthma were risk factors for having and developing asthma and respiratory symptoms. Conclusion: Low socio‐economic status is significantly associated with an increased risk for prevalent and incident asthma and respiratory symptoms in this longitudinal population‐based survey. The increase in risk was most pronounced in manual workers. Several studies have recently shown an association between low socio‐economic status and respiratory symptoms and we conclude that asthma can not be considered as a disease that mainly affects the middle and upper socio‐economic classes. Please cite this paper as: Ekerljung L, Sundblad B‐M, Rönmark E, Larsson K and Lundbäck B. Incidence and prevalence of adult asthma is associated with low socio‐economic status. The Clinical Respiratory Journal 2010; 4: 147–156.     

Endometrial ablation with NovaSure GEA,a pilot study

OBJECTIVE: A prospective, single-arm, multicenter, controlled, observational pilot study to assess the safety and efficacy of the NovaSure Global Endometrial Ablation (NovaSure GEA) system in women with severe menorrhagia secondary to dysfunctional uterine bleeding (DUB). SETTING: University tertiary referring center and central hospital. PATIENTS: Forty-six premenopausal women aged 41.3 years with menorrhagia secondary to DUB unresponsive to medical therapy, who had completed childbearing, with non-distorted uterine cavities were included in the study. METHODS: Bleeding score was recorded before, 6 and 12 months after treatment. All patients received the treatment under intravenous sedation with para-cervical block and were treated with Nova Sure endometrial ablation for mean 94 s at the day surgery unit. RESULTS: No serious intraoperative complications were observed. Treatment time averaged 94 s. Forty-six patients have completed 6-months of follow-up and 45 patients completed the 12-months follow-up. 50% of the patients were amenorrheic at 6 months follow-up and 58% had complete cessation of uterine bleeding (amenorrhea) at 12 months follow-up. CONCLUSIONS: Preliminary results indicates that the NovaSure GEA System is an effective treatment for DUB, achieving 58% amenorrhea after 12 months.     

Incidence rates and risk factors for asthma among school children: a 2-year follow-up report from the obstructive lung disease in Northern Sweden (OLIN) studies

Studies of incidence of asthma are still limited. A longitudinal study of asthma in school children was started in 1996 in Northern Sweden. The incidence of asthma and the associated risk factors have been studied over a 2 years period. The study started with a parental questionnaire, the ISAAC questionnaire with additional questions, and a skin-prick test. The cohort, 3,525 children, 7 and 8 years old at start, was followed after 1 and 2 years by using the same questions, Each year responded 97%. The cumulative incidence of physician-diagnosed asthma was 1.7%, 0.9/1,000/year the first year, and 0.8/1,000/year the second year. The cumulative incidence of wheezing was 6.3%, and of frequent or daily users of asthma medicines 2.1%. Significant risk factors for incident asthma were a positive skin test, OR 5.64 (3.10-10.25); rhinitis,OR 3.53 (1.80-6.90); eczema, OR 2.19 (1.26-3.82); a family history of asthma, OR 2.83 (1.75-4.56); low birth weight, OR 3.38 (1.61-754); respiratory infections, OR 2.12 (1.24-3.63); male gender, OR 1.71 (1.06-2.81); and a smoking mother OR 2.00 (1.07-3.73). In summary the incidence of asthma during 2 years after age 7 was high, almost 1/100/year. Allergy was the most important risk factor, but other factors were influential.     

Four-year incidence of allergic sensitization among schoolchildren in a community where allergy to cat and dog dominates sensitization: report from the Obstructive Lung Disease in Northern Sweden Study Group

BACKGROUND: Exposure to high levels of cat allergen might prevent sensitization. OBJECTIVE: We sought to measure the incidence of allergic sensitization among schoolchildren living in a dust mite- and cockroach-free environment and the associated risk factors. METHODS: In 1996, a longitudinal cohort was established in northern Sweden, including 2454 children aged 7 to 8 years. Children were skin tested, and the testing was repeated 4 years later. Questionnaires were completed yearly. Participation was 88% both in 1996 and 2000. RESULTS: The prevalence of positive skin test results increased from 20.6% at age 7 and 8 years to 30.4% at age 11 and 12 years, a cumulative incidence of 13.8%, and was significantly higher among boys. The incidence was highest for cat (6.0%), timothy grass (5.9%), dog (4.9%), and birch (3.6%). A family history of allergy was the major risk factor for both a positive skin test response at age 7 and 8 years (odds ratio [OR], 1.69; 95% CI, 1.36-2.10) and for development of a positive skin test response over the next 4 years (OR, 1.67; 95% CI, 1.23-2.28). A significant inverse association between cat and dog ownership and the prevalence of type 1 allergy was found, particularly for those children who had lived with a cat both before age 7 and 8 years and during the next 4 years (OR, 0.44; 95% CI, 0.31-0.61). A similar pattern, although not significant, was found for incident cases. CONCLUSION: The high incidence of type 1 allergy at this age was similar to reports from communities with mite and cockroach allergen. Despite cat and dog being the most common allergens of sensitization, keeping these animals at home was not associated with an increased risk for sensitization.