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ICD Code: 493. Asthma

ICD Code: 493. Article Review
Title: Huovinen E et al; "Incidence and Prevalence of Asthma Among Adult Finnish Men and Women of the Finnish Twin Cohort From 1975 to 1990, and Their Relation to Hay Fever and Chronic Bronchitis." Chest; V.115; No.4; 4/99; p928
      STUDY DESIGN: Incidence studies on asthma are rare compared with prevalence studies. This prospective cohort study from Finland examined the incidence of asthma, hay fever, and chronic bronchitis among adults during a 15-year follow-up period, as well as the prevalence of asthma and hay fever. The study population was based on the Finnish Twin Cohort, which consists primarily of adult twin pairs with both members born before 1958 and alive in 1967. The European standard population was used to calculate age-standardized prevalence rates for men and women. The study used a questionnaire-based classification of physician-diagnosed asthma, allowing consistency of follow-up information provided by the identical questions in each questionnaire. Finns tend to know quite well what diseases they have when their knowledge is compared with medical records.
      PREVALENCE TRENDS: The age-standardized prevalence of asthma in 1975 was 2.0% among men and 2.2% among women, and there were no significant differences between singletons and twins. The 1981 rates were quite similar (2.1% and 2.3% for men and women). In 1990, there was some increase for both sexes, with rates of 2.9% for men and 3.5% for women.
      INCIDENCE: The incidence of asthma was similar among men (2.3%) and women (2.6%) throughout the whole follow-up period of 1976 to 1990. Cumulative incidence provides an estimate of the probability, or risk, that an individual will develop a disease during a specified period of time. The probability of developing asthma during the 15-year period was about 2% for both men and women, but risk was dependent on age, even though all subjects were adults. On average, 1.6 new asthma diagnoses were made annually per 1000 adults.
      COMORBIDITY AND RISK: Overall, 28% of asthmatic men and 15% of asthmatic women had only asthma, with no history of hay fever or chronic bronchitis, and 29% and 38% had asthma with both diagnoses. Both hay fever and chronic bronchitis significantly increased the risk of asthma. Men reporting hay fever in 1975 had over 4 times the incidence of asthma during 1976 to 1990 than men without hay fever in 1975. Among women the effect of hay fever was even greater (6-fold increased risk). Chronic bronchitis increased the risk of asthma more among men (5.8-fold), but the increase was also significant among women (4.3-fold). Asthma incidence rates were also elevated among subjects with hay fever or chronic bronchitis during the first 6 years (1976 to 1981) and last 9 years (1982 to 1990).

Search Criteria: Text - Chest; V.115; No.4; 4/99; p928