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Eur Respir J 2003; 21:827-833
Copyright ©ERS Journals Ltd 2003

Prevalence and risk factors of asthma and wheezing among US adults: an analysis of the NHANES III data

A.A. Arif1, G.L. Delclos2, E.S. Lee2, S.R. Tortolero2 and L.W. Whitehead2

1 The Texas Tech University Health Sciences Center, 2 The University of Texas­Houston School of Public Health, TX, USA

CORRESPONDENCE: A. Arif, The Texas Tech University Health Sciences Center, Department of Health Services Research and Management, 3601 4th Street MS 8161, Lubbock, TX­79430, USA. Fax: 1 8067431292. E-mail: ahmed.arif@ttmc.ttuhsc.edu

Keywords: asthma, epidemiology, National Health and Nutrition Examination Survey III

Received: June 24, 2002
Accepted December 5, 2002

The prevalence of asthma has been on the increase in the USA and worldwide. To understand the worsening epidemiological trends of asthma, this study analysed the data from the third National Health and Nutrition Examination Survey (NHANES III) to determine the prevalence and risk factors for asthma and wheezing among US adults.

This analysis used data from 18,825 US adults aged ≥20 yrs who had participated in the NHANES III project. After excluding subjects with physician­diagnosed emphysema, a total of 18,393 subjects were included in the final analysis.

The prevalence of current asthma (asthma) was 4.5% and the prevalence of wheezing in the previous 12 months (wheezing) was 16.4%. Mexican­Americans exhibited the lowest prevalence of asthma when compared with other race/ethnic groups. Multiple logistic regression analysis showed that Mexican­Americans were less likely to report asthma when compared to non­Hispanic whites. Low education level, female sex, current and past smoking status, pet ownership, lifetime diagnosis of physician­diagnosed hay fever and obesity were all significantly associated with asthma and/or wheezing. No significant effect of indoor air pollutants, as derived from the use of household heating/cooking appliances, on asthma and wheezing was observed in this study.

In conclusion, this study observed racial/ethnic differences in the prevalence of asthma and wheezing and identified several important risk factors that may contribute to development and/or exacerbation of asthma and wheezing. Contrary to earlier reports, the proxy measures of indoor air pollution used in this study were not found to be associated with increased risk of asthma and wheezing.




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