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Higher occurrence of asthma-related symptoms in an urban than a suburban area in adults, but not in children

¹ Depts of Epidemiology and Community Medicine, ² Respiratory Medicine and³ Pediatrics of the University of Antwerp (UIA) and ⁴ Provincial Institute of Hygiene, Antwerp, Belgium

CORRESPONDENCE: P.A. Vermeire, Dept. Respiratory Medicine, University of Antwerp (UIA), Universiteitsplein 1, B-2610, Antwerp, Belgium. Fax: 32 38202590

Keywords: adults, asthma, children, elderly, epidemiology, urban-suburban

Received: January 27, 2000
Accepted September 26, 2000

This study was supported by Grant #7.0058.94, "Levenslijn", Fund for Scientific Research in Flanders. Full support was given by the Provincial Institute of Hygiene.

In young adults, a higher occurrence of asthma-related symptoms was found in an urban than an adjacent suburban area in a survey performed in 1991. The authors now wondered whether such differences could be established in other age groups.

The present study (in 1996) included 14,299 subjects, aged 5–75 yrs, of a random sample of the general population in the same two adjacent areas: the centre of Antwerp (Belgium) and its south suburban border. The standardized European Community Respiratory Health Survey (ECRHS) and International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires were used to assess the occurrence of asthma-related symptoms.

Higher rates were confirmed in urban compared to suburban Antwerp in adults (20–75 yrs), but no such area differences were found in children (5–8 and 12–15 yrs). Adjustment for a number of recorded risk factors did not seem to affect the area differences in asthma-related symptoms. Comparing the survey results of 1991 and 1996 in 20–44 yr old adults, the findings suggest a slight increase in reported respiratory symptoms in both areas.

A higher occurrence of asthma symptoms was observed in the urban than suburban area in adults, but not in children. This might be explained by a progressive effect of long-term exposure to the "urban environment". However, longitudinal studies are necessary to further clarify the factors accounting for these age-related area differences.