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ICD Code: 493. Asthma



ICD Code: 493. Article Review
Title: Science and Technology Committee; "Allergy." http://www.publications.parliament.uk/pa/ld200607/ldselect/ldsctech/166/166i.pdf; Accessed 7/14/08; p1
      PREVALENCE AND INCIDENCE (UK): According to QRESEARCH, an estimated 5.7 million people in England are affected by asthma, and 1 person in 192 in the population was newly diagnosed during 2005. In 2006, the ISAAC Phase III study reported that the incidence of asthma symptoms had risen in 6- to 7-year-olds in the UK, from 18.4% to 20.9% over a period of approximately 5 years. The prevalence of asthma symptoms in 13- to 14-year-olds was higher, at 24.7%, but the incidence within this age group had actually decreased from 31%.
      A consultant respiratory pediatrician from the Royal Brompton Hospital suggested that the prevalence of asthma had probably reached a plateau or was possibly even falling. There has been a steady decline in child hospital admissions since 1990, and asthma-related deaths in childhood remain uncommon. The newly recorded incidence of asthma within primary care also decreased from 6.9 per 1000 person-years in 2001 to 5.22 per 1000 in 2005, possibly due to a greater awareness of the disease and the availability of more effective treatments. However the allergy burden is unclear: there are a lot of other conditions that are probably not allergic that make people wheeze.
      It is estimated that around 5.7 million people in England suffer from asthma, and asthma and allergy are so closely interlinked that the majority of asthma cases are caused by an allergic mechanism. Asthma UK reported that 90% of people with asthma say their symptoms are triggered by dust and 79% say their symptoms are triggered by pollen. Other non-allergenic triggers such as tobacco smoke or air pollution can also exacerbate asthma symptoms, so for some patients it is almost impossible to avoid situations which may aggravate their condition. Although some asthma patients may present with an isolated cough, others suffer from wheezy breathlessness which can make even the simplest of everyday tasks impossible, and in some cases, an "asthma attack" can lead to death. Furthermore, people with asthma often also suffer from other allergic disorders such as rhinitis, eczema or food allergies, which produce additional burdensome symptoms, and further restrictions in daily life.
      DISEASE BURDEN: The burden of asthma in the population should not be underestimated. Written evidence from Asthma UK included an account from one asthma sufferer, who reported that: "My quality of life is non-existent. I know this may sound extreme to a lot of people but I would be prepared to lose an arm and a leg if it meant my asthma would go away. I face daily restrictions in every aspect of my life … I find it really difficult to do day-to-day activities on my own; I don’t have enough breath to push a trolley around the supermarket … I’m not allowed on an aeroplane and it’s impossible for me to get travel insurance. Winter is also a problem for me; I can’t go outside because the cold air can set off my asthma."
      Although allergy is a major trigger of asthma attacks, most asthma hospital admissions and deaths are caused by infection or unknown causes, rather than allergy. The Department of Health reported that there were 924 asthma deaths in England in 2004, with most of these occurring in "older people and may not be directly attributed to uncontrolled allergy." The costs of asthma to the national are phenomenal, with Asthma UK estimating that "over 12.7 million working days are lost each year as a result of asthma, and that the total annual cost of asthma to the economy is 2.3 billion" pounds Sterling. Despite much research, the exact causes of asthma are still unknown, so it is unlikely that this burden will be reduced any time in the near future.

Search Criteria: Text - Science and Technology Committee; "Allergy." http://www.publications.parliament.uk/pa/ld200607/ldselect/ldsctech/166/166i.pdf; Accessed 7/14/08; p1