TRENDS IN THE PREVALENCE OF ASTHMA IN SCOTTISH AND ENGLISH PRIMARY-SCHOOL CHILDREN 1982-92

Background - Some doubts exist as to whether the increase in the preva lence of asthma is real or an artefact. The 10 year trend of asthma up to 1993 in England and Scotland was therefore assessed. Methods - Inf ormation on asthma and bronchitis attacks, occasional wheeze, and pers istent wheeze in the last 12 months, was obtained using a self adminis tered questionnaire completed by the parents. Exactly the same questio ns were asked in 14 study areas in Scotland and 22 study areas in Engl and in 1982 or 1983 and in 1992 or 1993 in 5-11 year old children. Res ults - The numbers of children with data for all respiratory illness w ere 5556 (85 . 2%) and 5801 (87 . 1%) in England acid 3748 (90 . 4%) a nd 3738 (90 . 4%) in Scotland in 1982 and 1992, respectively. There wa s a significant increase in asthma attacks (approximately three times more in 1992 than in 1982) and occasional wheeze (30-60% more in 1992 than in 1982) in both sexes in England and Scotland. Persistent wheeze also increased in both countries, but the increase was significant on ly in England (30-40% more in 1992 than in 1982). Conclusions - The st udy coincides with others that suggest that the increased prevalence o f asthma may be due, in part, to changes in diagnostic behaviour. Howe ver, the continuing increase of persistent wheeze in the total sample suggests that part of the increase is real. There was no difference in the increase of persistent wheeze between Scotland and England, but t he trend was only significant in England.