Respiratory symptoms and atopy in children in Aberdeen: questionnaire studies of a defined school population repeated over 35 years
http://www.100md.com
《英国医生杂志》
1 Department of Medical Paediatrics, Royal Aberdeen Children's Hospital, Aberdeen AB25 2ZG, 2 Birmingham Heartlands Hospital, Birmingham B9 5SS, 3 Child Health Department, Doncaster Royal Infirmary, Doncaster
Correspondence to: G Russell libra@ifb.co.uk
Introduction
In Aberdeen, the prevalence of symptoms suggestive of asthma now seems to be stable. The proportion of children with symptoms in whom asthma has been diagnosed is high, suggesting that the widespread publicity given to asthma has paid off. Indeed, a higher rate of diagnosis might well be undesirable, leading to asthma drugs being given inappropriately—for instance, to children with chronic cough.5 Nevertheless, the continuing increases between 1994 and 1999 in diagnosed eczema and hay fever suggest that the tendency for children to develop allergies is still increasing, although these increases may also in part reflect changes in diagnostic fashion.
What is already known on this topic
During the past 15 years, the prevalence of childhood asthma and symptoms suggestive of asthma have risen
What this study adds
The rate of rise in the prevalence of childhood asthma has slowed, although a quarter of primary school children have been diagnosed as having asthma at some time in their lives
Most of the recent increase can be attributed to increased diagnosis in children with symptoms; increase in wheeze is barely significant
This article was posted on bmj.com on 24 June 2004: http://bmj.com/cgi/doi/10.1136/bmj.38139.666447.F7
Contributors: AD, SDK, and HW shared responsibility for the planning and day to day running of the 1999 study. TN shared responsibility for the planning of the 1989, 1994, and 1999 studies and for the day to day running of the 1989 study. MO shared responsibility for the design of the 1994 and 1999 studies and for the day to day running of the 1994 study. All authors analysed the data, discussed and interpreted the results, and prepared this report. GR had overall responsibility for funding, design and supervision of the 1989, 1994, and 1999 studies. GR is guarantor.
Funding: Grampian University Hospitals Children's Respiratory Fund, into which GR paid his earnings from drug trials, medico-legal reports, lectures, adoption medical examinations, etc. A generous donation was received in memory of Stuart Kerr.
Competing interests: None declared.
Ethical approval: Grampian Research Ethics Committee.
References
Ninan TK, Russell G. Respiratory symptoms and atopy in Aberdeen schoolchildren: evidence from two surveys 25 years apart. BMJ 1992;304: 873-5.
Omran M, Russell G. Continuing increase in respiratory symptoms and atopy in Aberdeen schoolchildren. BMJ 1996;312: 34.
Hill R, Williams J, Tattersfield A, Britton J. Change in use of asthma as a diagnostic label for wheezing illness in schoolchildren. BMJ 1989;299: 898.
Ronchetti R, Villa MP, Barreto M, Rota R, Pagani J, Martella S, et al. Is the increase in childhood asthma coming to an end? Findings from three surveys of schoolchildren in Rome, Italy. Eur Respir J 2001;17: 881-6.
Chang AB, Phelan PD, Carlin JB, Sawyer SM, Robertson CF. A randomised, placebo controlled trial of inhaled salbutamol and beclomethasone for recurrent cough. Arch Dis Child 1998;79: 6-11.(Anne Devenny, specialist )
Correspondence to: G Russell libra@ifb.co.uk
Introduction
In Aberdeen, the prevalence of symptoms suggestive of asthma now seems to be stable. The proportion of children with symptoms in whom asthma has been diagnosed is high, suggesting that the widespread publicity given to asthma has paid off. Indeed, a higher rate of diagnosis might well be undesirable, leading to asthma drugs being given inappropriately—for instance, to children with chronic cough.5 Nevertheless, the continuing increases between 1994 and 1999 in diagnosed eczema and hay fever suggest that the tendency for children to develop allergies is still increasing, although these increases may also in part reflect changes in diagnostic fashion.
What is already known on this topic
During the past 15 years, the prevalence of childhood asthma and symptoms suggestive of asthma have risen
What this study adds
The rate of rise in the prevalence of childhood asthma has slowed, although a quarter of primary school children have been diagnosed as having asthma at some time in their lives
Most of the recent increase can be attributed to increased diagnosis in children with symptoms; increase in wheeze is barely significant
This article was posted on bmj.com on 24 June 2004: http://bmj.com/cgi/doi/10.1136/bmj.38139.666447.F7
Contributors: AD, SDK, and HW shared responsibility for the planning and day to day running of the 1999 study. TN shared responsibility for the planning of the 1989, 1994, and 1999 studies and for the day to day running of the 1989 study. MO shared responsibility for the design of the 1994 and 1999 studies and for the day to day running of the 1994 study. All authors analysed the data, discussed and interpreted the results, and prepared this report. GR had overall responsibility for funding, design and supervision of the 1989, 1994, and 1999 studies. GR is guarantor.
Funding: Grampian University Hospitals Children's Respiratory Fund, into which GR paid his earnings from drug trials, medico-legal reports, lectures, adoption medical examinations, etc. A generous donation was received in memory of Stuart Kerr.
Competing interests: None declared.
Ethical approval: Grampian Research Ethics Committee.
References
Ninan TK, Russell G. Respiratory symptoms and atopy in Aberdeen schoolchildren: evidence from two surveys 25 years apart. BMJ 1992;304: 873-5.
Omran M, Russell G. Continuing increase in respiratory symptoms and atopy in Aberdeen schoolchildren. BMJ 1996;312: 34.
Hill R, Williams J, Tattersfield A, Britton J. Change in use of asthma as a diagnostic label for wheezing illness in schoolchildren. BMJ 1989;299: 898.
Ronchetti R, Villa MP, Barreto M, Rota R, Pagani J, Martella S, et al. Is the increase in childhood asthma coming to an end? Findings from three surveys of schoolchildren in Rome, Italy. Eur Respir J 2001;17: 881-6.
Chang AB, Phelan PD, Carlin JB, Sawyer SM, Robertson CF. A randomised, placebo controlled trial of inhaled salbutamol and beclomethasone for recurrent cough. Arch Dis Child 1998;79: 6-11.(Anne Devenny, specialist )