Chest
Volume 85, Issue 5, May 1984, Pages 623-630
Journal home page for Chest

clinical investigations
A Prospective Study of Asthma in a Rural Community

https://doi.org/10.1378/chest.85.5.623Get rights and content

Changes in symptoms and pulmonary function among asthmatic subjects in the general population remain poorly characterized. We studied 1,303 white residents aged seven years and older in Lebanon, Conn, a rural community largely unaffected by air pollution or major occupational exposures. These residents were examined in 1972 and again in 1978. There were 73 asthmatic subjects seen in 1972 who were followed. In addition, we identified 278 persons in 1972 who complained of wheezing who were also seen in 1978. Of the original asthmatic subjects, 50 (68 percent) were in remission; and from the original nonasthmatic population, 19 (1.4 percent) new asthmatic subjects were identified. Similarly, the condition of 215 (77 percent) of those who initially complained of wheeze had improved, whereas 56 (4.6 percent) of those initially studied either developed new wheeze or saw their wheezing worsen. When the groups of persons complaining of wheeze and the asthmatic subjects were analyzed for the presence of chronic bronchitis, we found a significant correlation between wheeze and chronic bronchitis in individuals aged 18 years and older (p<0.001) for both men and women, and a significant correlation (p<0.001) between asthma and chronic bronchitis in women aged 18 years and older. Loss of pulmonary function over time measured in terms of the forced expiratory volume in one second and the forced expiratory flow at 50 percent of total lung capacity was consistently greater for asthmatic adults than for nonasthmatic adults. Furthermore, when individuals were studied by the severity and duration of their asthmatic symptoms, a trend of worse pulmonary function was seen in those individuals with chronic asthma. We conclude that remission rates among asthmatic subjects and persons with wheeze are high in individuals aged seven years and older, that chronic bronchitis is frequently associated with wheezing and a history of asthma in adults, and that significant abnormalities in pulmonary function as well as accelerated loss of pulmonary function are associated with asthma.

Section snippets

METHODS

The population under study consisted of the 1,303 white residents of Lebanon, Conn, who took part in an initial cross-sectional survey in 1972 and responded to a follow-up survey in 1978.

The representativeness of the follow-up population has previously been studied.20, 21 Although some few differences have been delineated between responders and nonresponders, these have not shown any consistent trends. The methods used in the original cross-sectional survey have been previously described,22 and

RESULTS

The prevalences of asthma, wheezing and chronic bronchitis by age in the cross-sectional population among those followed are shown for male and female subjects in Figure 1. The overall prevalence for asthma at the cross-sectional study was 7 percent in male subjects and 5 percent in female subjects. For wheezing, these prevalences were 22 percent for male subjects and 20 percent for female subjects. Percent prevalences for both male and female subjects increased with age up to 35 years and

DISCUSSION

Our analysis of rural community residents followed over a six-year period showed striking improvements in wheezing and asthmatic status in a large proportion of the population aged seven years and older. A significant positive association was seen between chronic bronchitis and asthma in women and a similar trend was seen in men. Finally, trends of worsening residual pulmonary function at the cross-sectional examination were seen in both male and female asthmatic subjects across asthmatic

REFERENCES (34)

  • JM Smith et al.

    Epidemiology of asthma and allergic rhinitis: 1. in a rural area

    Am Rev Respir Dis

    (1965)
  • JM Smith et al.

    Epidemiology of asthma and allergic rhinitis

    Am Rev Respir Dis

    (1965)
  • MEC Horn et al.

    Role of viral infection and host factors in acute episodes of asthma and chronic bronchitis

    Chest

    (1973)
  • AJ Martin et al.

    Lung function in young adults who had asthma in childhood

    Am Rev Respir Dis

    (1980)
  • AJ Martin et al.

    The natural history of childhood asthma to adult life

    Br Med J

    (1980)
  • KN McNichol et al.

    Spectrum of asthma in children: 1. clinical and physiological components

    Br Med J

    (1973)
  • KN McNichol et al.

    Spectrum of asthma in children: 2. allergic components

    Br Med J

    (1973)
  • Cited by (86)

    • Epidemiology of Asthma and Allergic Airway Diseases. Retired Cement Factory Worker Who Was a Smoker

      2014, Middleton's Allergy: Principles and Practice: Eighth Edition
    • Respiratory findings in a nursing home population

      2007, Archives of Gerontology and Geriatrics
      Citation Excerpt :

      A second possibility is that the nursing home itself may create an environment which favors the development of airway obstruction. Many large community based studies estimate the prevalence of asthma in the general population between 5 and 10% (Schachter et al., 1984; Burrows et al., 1991). A high prevalence of asthma similar to that seen in our nursing home cohort was recently reported (Snyder and Eisner, 2004) among the urban homeless.

    View all citing articles on Scopus

    Presented in part at the Annual Scientific Assembly, American College of Chest Physicians, San Francisco, October 1981.

    Manuscript received June 17; revision accepted November 8.

    View full text