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1 Dept of Medical Science: Respiratory Medicine and Allergology, Uppsala University, Sweden. 2 Respiratory and Environmental Health Research Unit, IMIM, Barcelona, Spain. 3 Dept of Public Health Sciences, King's College, London, Guy's Campus, London, UK. 4 Division of Epidemiology and Medical Statistics, University of Verona, Verona, Italy. 5 Gesellschaft für Strahlen-und Umweltforschung (GSF) - National Research Centre for Environment and Health, Institute of Epidemiology, Neuherberg, Germany. 6 Institute for Social and Preventive Medicine, University Basel, Dept of Environment & Health, Basel, Switzerland. 7 INSERM U408 - Epidémiologie, Paris, France. 8 Dept of Thoracic Medicine, Haukeland Hospital, Bergen, Norway
CORRESPONDENCE: C. Janson, Dept of Respiratory Medicine, Akademiska sjukhuset, SE-751 85, Uppsala, Sweden. Fax: 46 186112819
Keywords: asthma, atopy, epidemiology, incidence, prevalence, risk factors
Received: January 16, 2001
Accepted May 2, 2001
Abstract
The European Community Respiratory Heath Survey (ECRHS) was the first study to assess the geographical variation in asthma and allergy in adults using the same instruments and definitions. The database of the ECRHS includes information from
The ECRHS has shown that there are large geographical differences in the prevalence of asthma, atopy and bronchial responsiveness, with high prevalence rates in English speaking countries and low prevalence rates in the Mediterranean region and Eastern Europe. Analyses of risk factors have highlighted the importance of occupational exposure for asthma in adulthood. The association between sensitization to individual allergens and bronchial responsiveness was strongest for indoor allergens (mite and cat). Analysis of treatment practices has confirmed that the treatment of asthma varies widely between countries and that asthma is often undertreated.
In conclusion, the European Community Respiratory Health Survey has shown that the prevalence of asthma varies widely. The fact that the geographical pattern is consistent with the distribution of atopy and bronchial responsiveness supports the conclusion that the geographical variations in the prevalence of asthma are true and most likely due to environmental factors.
140,000 individuals from 22 countries. The aim of this review is to summarize the results of the ECRHS to date.
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