VARIATIONS IN THE PREVALENCE OF RESPIRATORY SYMPTOMS, SELF-REPORTED ASTHMA ATTACKS, AND USE OF ASTHMA MEDICATION IN THE EUROPEAN-COMMUNITY RESPIRATORY HEALTH SURVEY (ECRHS)

Asthma is a common chronic disorder which may be increasing in prevale nce. However, little is known of its distribution and determinants. Th e European Community Respiratory Health Survey (ECRHS) is a multicentr e survey of the prevalence, determinants and management of asthma This paper presents a descriptive account of the variation in self-reporte d attacks of asthma and asthma symptoms across Europe, and in part ful fils the first aim of the study. A screening questionnaire, including seven questions relating to the 12 month prevalence of symptoms of ast hma, was distributed to representative samples of 20-44 year old men a nd women in 48 centres, predominantly in Western Europe. The median re sponse rate to the questionnaire was 75% but, after removing from the denominator those who were the wrong age, were known to have moved out of the area, or had died, it was 78% (range 54-100). The prevalence o f all symptoms varied widely. Although these were generally lower in n orthern, central and southern Europe and higher in the British Isles, New Zealand, Australia and the United States, there were wide variatio ns even within some countries. Centres with a high prevalence of self- reported attacks of asthma also reported high prevalences of nasal all ergies and of waking at night with breathlessness. The use of asthma m edication was more common where wheeze and asthma attacks were more fr equent. In most centres in The Netherlands, Sweden, New Zealand and th e United Kingdom over 80% of those with a diagnosis of asthma were cur rently using asthma medication. In Italy, France and Spain the rate wa s generally less than 70%. These data are the best evidence to date th at geographical differences in asthma prevalence exist, are substantia l and are not an artefact of the use of noncomparable methods.