THE PAST AND THE PRESENT OF MORTALITY FROM ASTHMA - TOWARDS A SHIFT IN THE SECULAR TREND

In recent years disconcerting observations have been published concern ing changes in mortality from asthma in France and other countries. Th ese conclusions are difficult to assess due to uncertainty regarding t he underlying asthma mortality trends. We have attempted to address th is question by constituting a statistical series of asthma deaths from 1925 to 1989. The 1925 to 1989 mortality trend is clearly decreasing. This decrease follows the same rhythm as the general mortality declin e, since the proportion of asthma in total deaths remained between 3 t o 4 parts per thousand. Three periods are emphasized : from 1925 to 19 65 where the decreasing trend is interrupted by an important crisis in mortality, from 1965 to 1980 where the decrease is regular, and the l ast period since 1980 with an important crisis in 1985 and 1986; crisi s applying to all genders and ages. The latest trend is uncertain. Car eful epidemiologic surveillance will decide between a change in the se cular trend or a transitory crisis and thus determine the cause(s). An effect due to the reinclusion by ICD 9 of a fluctuating component in asthma mortality cannot be excluded