Abstract
To establish the prevalence of asthma and wheeze in 12 year old children in a region with low background pollution levels, a population of children resident in the Highland Region of Scotland was studied by questionnaire supported by objective data. A respiratory questionnaire was distributed to the parents of 1919 children aged from 12-13 years and attending secondary schools in the educational divisions of Lochaber, Ross and Cromarty, and Inverness including Skye in Highland Region to ascertain history of wheeze and parental awareness of a diagnosis of asthma. Peak expiratory flow (PEF) measurements were carried out before and after a standardised exercise test. Ozone levels were noted. Questionnaires were completed by 1825 parents (95% of those invited) and 1702 (93%) of those returning questionnaires took part in the exercise test. The overall prevalence of reported asthma was 14% and wheeze 25%. Defined as a fall in PEF of more than 15% with exercise, the overall prevalence of exercise induced bronchospasm was 9%. In Skye the prevalence of reported asthma was 17%, wheeze 28%, and exercise induced bronchospasm 30%. There were no significant differences between areas for reported asthma or wheeze. There was, however, a highly significant difference between areas for exercise induced bronchospasm, most of which was accounted for by the very high incidence in Skye, which is one of the most rural of the areas studied. The results of this study do not support the hypothesis that asthma is commoner in urban than rural areas, whether we compare the Highlands with the rest of the UK or areas within the Highlands, or whether we examine reported symptoms or exercise induced bronchospasm. The results do not support an association between atmospheric pollution and the prevalence of asthma.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Abramson M., Voigt T. Ambient air pollution and respiratory disease. Med J Aust. 1991 Apr 15;154(8):543–553. doi: 10.5694/j.1326-5377.1991.tb119453.x. [DOI] [PubMed] [Google Scholar]
- Anderson H. R. Is the prevalence of asthma changing? Arch Dis Child. 1989 Jan;64(1):172–175. doi: 10.1136/adc.64.1.172. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Andrae S., Axelson O., Björkstén B., Fredriksson M., Kjellman N. I. Symptoms of bronchial hyperreactivity and asthma in relation to environmental factors. Arch Dis Child. 1988 May;63(5):473–478. doi: 10.1136/adc.63.5.473. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Barry D. M., Burr M. L., Limb E. S. Prevalence of asthma among 12 year old children in New Zealand and South Wales: a comparative survey. Thorax. 1991 Jun;46(6):405–409. doi: 10.1136/thx.46.6.405. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burr M. L., Butland B. K., King S., Vaughan-Williams E. Changes in asthma prevalence: two surveys 15 years apart. Arch Dis Child. 1989 Oct;64(10):1452–1456. doi: 10.1136/adc.64.10.1452. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burr M. L., Eldridge B. A., Borysiewicz L. K. Peak expiratory flow rates before and after exercise in schoolchildren. Arch Dis Child. 1974 Dec;49(12):923–926. doi: 10.1136/adc.49.12.923. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cotes J. E., Dabbs J. M., Hall A. M., Axford A. T., Laurence K. M. Lung volumes, ventilatory capacity, and transfer factor in healthy British boy and girl twins. Thorax. 1973 Nov;28(6):709–715. doi: 10.1136/thx.28.6.709. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hahn A., Anderson S. D., Morton A. R., Black J. L., Fitch K. D. A reinterpretation of the effect of temperature and water content of the inspired air in exercise-induced asthma. Am Rev Respir Dis. 1984 Oct;130(4):575–579. doi: 10.1164/arrd.1984.130.4.575. [DOI] [PubMed] [Google Scholar]
- Keeley D. J., Neill P., Gallivan S. Comparison of the prevalence of reversible airways obstruction in rural and urban Zimbabwean children. Thorax. 1991 Aug;46(8):549–553. doi: 10.1136/thx.46.8.549. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Klabuschnigg A., Götz M., Horak F., Jäger S., Machalek A., Popow C., Haschke F., Skoda-Türk R. Influence of aerobiology and weather on symptoms in children with asthma. Respiration. 1981;42(1):52–60. doi: 10.1159/000194403. [DOI] [PubMed] [Google Scholar]
- Miller M. R., Dickinson S. A., Hitchings D. J. The accuracy of portable peak flow meters. Thorax. 1992 Nov;47(11):904–909. doi: 10.1136/thx.47.11.904. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ninan T. K., Russell G. Is exercise testing useful in a community based asthma survey? Thorax. 1993 Dec;48(12):1218–1221. doi: 10.1136/thx.48.12.1218. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ninan T. K., Russell G. Respiratory symptoms and atopy in Aberdeen schoolchildren: evidence from two surveys 25 years apart. BMJ. 1992 Apr 4;304(6831):873–875. doi: 10.1136/bmj.304.6831.873. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Oldham P. D., Cole T. J. Estimation of the FEV. Thorax. 1983 Sep;38(9):662–667. doi: 10.1136/thx.38.9.662. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Palmer J. D., Anderson R. J., Downer M. C. Guidelines for prevalence studies of dental caries. Community Dent Health. 1984 Mar;1(1):55–66. [PubMed] [Google Scholar]
- Peat J. K., Salome C. M., Toelle B. G., Bauman A., Woolcock A. J. Reliability of a respiratory history questionnaire and effect of mode of administration on classification of asthma in children. Chest. 1992 Jul;102(1):153–157. doi: 10.1378/chest.102.1.153. [DOI] [PubMed] [Google Scholar]
- Phelan P. D. Hyperresponsiveness as a determinant of the outcome in childhood asthma. Am Rev Respir Dis. 1991 Jun;143(6):1463–1467. doi: 10.1164/ajrccm/143.6.1463. [DOI] [PubMed] [Google Scholar]
- Robertson C. F., Rubinfeld A. R., Bowes G. Pediatric asthma deaths in Victoria: the mild are at risk. Pediatr Pulmonol. 1992 Jun;13(2):95–100. doi: 10.1002/ppul.1950130207. [DOI] [PubMed] [Google Scholar]
- Rossi O. V., Kinnula V. L., Tienari J., Huhti E. Association of severe asthma attacks with weather, pollen, and air pollutants. Thorax. 1993 Mar;48(3):244–248. doi: 10.1136/thx.48.3.244. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schmitzberger R., Rhomberg K., Büchele H., Puchegger R., Schmitzberger-Natzmer D., Kemmler G., Panosch B. Effects of air pollution on the respiratory tract of children. Pediatr Pulmonol. 1993 Feb;15(2):68–74. doi: 10.1002/ppul.1950150203. [DOI] [PubMed] [Google Scholar]
- Speight A. N., Lee D. A., Hey E. N. Underdiagnosis and undertreatment of asthma in childhood. Br Med J (Clin Res Ed) 1983 Apr 16;286(6373):1253–1256. doi: 10.1136/bmj.286.6373.1253. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Strachan D. P., Golding J., Anderson H. R. Regional variations in wheezing illness in British children: effect of migration during early childhood. J Epidemiol Community Health. 1990 Sep;44(3):231–236. doi: 10.1136/jech.44.3.231. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Terblanche E., Stewart R. I. The prevalence of exercise-induced bronchoconstriction in Cape Town schoolchildren. S Afr Med J. 1990 Dec 15;78(12):744–747. [PubMed] [Google Scholar]
- Tsanakas J. N., Bannister O. M., Boon A. W., Milner R. D. The 'Sport-tester': a device for monitoring the free running test. Arch Dis Child. 1986 Sep;61(9):912–914. doi: 10.1136/adc.61.9.912. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Van Niekerk C. H., Weinberg E. G., Shore S. C., Heese H. V., Van Schalkwyk J. Prevalence of asthma: a comparative study of urban and rural Xhosa children. Clin Allergy. 1979 Jul;9(4):319–314. doi: 10.1111/j.1365-2222.1979.tb02489.x. [DOI] [PubMed] [Google Scholar]
- Wright B. M. A miniature Wright peak-flow meter. Br Med J. 1978 Dec 9;2(6152):1627–1628. doi: 10.1136/bmj.2.6152.1627. [DOI] [PMC free article] [PubMed] [Google Scholar]
- von Mutius E., Fritzsch C., Weiland S. K., Röll G., Magnussen H. Prevalence of asthma and allergic disorders among children in united Germany: a descriptive comparison. BMJ. 1992 Dec 5;305(6866):1395–1399. doi: 10.1136/bmj.305.6866.1395. [DOI] [PMC free article] [PubMed] [Google Scholar]