Journal of Allergy and Clinical Immunology
Prevalence and etiology of asthma☆,☆☆,★
Section snippets
IMPORTANCE OF GLOBAL COMPARISONS
The value of international comparisons is well established in other fields of epidemiology. For example, many of the recent discoveries of the causes of cancer (including dietary factors and colon cancer, hepatitis B and liver cancer, aflatoxins and liver cancer, human papilloma virus and cervical cancer) have their origins, directly or indirectly, in the systematic international comparisons of cancer incidence conducted in the 1950s and 1960s.2 These revealed that there were major
WHAT DO WE ALREADY KNOW FROM INTERNATIONAL COMPARISONS?
From the initial publications of the ECRHS program, the abstracts reporting the preliminary ISAAC analyses, and other asthma prevalence studies, it is possible to draw some tentative conclusions as to the patterns of asthma prevalence worldwide.
WHAT DOES THIS TELL US ABOUT THE MAJOR CAUSES OF ASTHMA WORLDWIDE?
These features of the international patterns of asthma prevalence raise major issues regarding current knowledge of the causes of asthma worldwide. In particular, it is evident that the current recognized risk factors for the development of asthma probably cannot fully account for either the worldwide increase in prevalence or the international variations in asthma prevalence that have been observed.
For example, the global pattern of asthma prevalence is consistent with the considerable body of
SUMMARY
Asthma epidemiology is entering a phase of major significance that is likely to lead to greatly increased understanding of the causes of asthma. A key contributor to this increased understanding is the evidence from international comparisons of asthma prevalence, particularly those from the ECRHS study of asthma prevalence in adults and the ISAAC study of asthma prevalence in children. Although the findings of these two major international studies had not been fully published at the time of
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2020, Clinical BiomechanicsSocioeconomic Status and Bronchiolitis Severity Among Hospitalized Infants
2020, Academic PediatricsCitation Excerpt :Although mechanistic research is limited, there are several explanations for how higher income status might increase the risk of bronchiolitis severity during infancy. The hygiene hypothesis, first postulated by Strachan in 1989,14 suggests that reduced microbial exposure in early life may help explain the increased prevalence of asthma and allergic diseases over the past several decades.15–17 The underlying assumption here is that the proper immune system development relies on the presence of infections in early life, which has led some to interpret the hygiene hypothesis as proposing that excessive cleanliness can lead to decreased immune system activation.
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The Wellington Asthma Research Group is supported by a Programme Grant from the Health Research Council of New Zealand and by a major grant from the Guardian Trust (Trustee of the David and Cassie Anderson Memorial Trust). C.K.W. Lai is supported by Research Grant Council Earmarked grant 96/97 No. CUHK 232/96M.
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Reprint requests: Richard Beasley, DM, Department of Medicine, Wellington School of Medicine, PO Box 7343, Wellington South, New Zealand. E-mail: [email protected]
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