Asthma diagnosis and treatmentInfluence of early life exposures on incidence and remission of asthma throughout life☆
Section snippets
Study design
The data presented in this study were collected within the framework of the ECRHS between 1991 and 1993. ECRHS is an international, cross-sectional, 2-stage study on the prevalence, determinants, and management of asthma and has been fully described previously.10 The study involved several centers in different countries; centers were defined by pre-existing administrative boundaries and had a population of at least 150,000 inhabitants. In each center, a random sample of at least 1500 men and
Results
A total of 1558 of 18,156 valid responders (8.6%) reported lifelong asthma. The main characteristics and distribution of studied determinants are given in Table I.
The crude lifelong incidence of asthma was 2.61/1000/y in males and 2.72/1000/y in females (P = .45; Table II); incidence decreased in males as age increased, whereas it remained stable in females. The rate of remission was higher in male patients than in female patients (34% vs 27%; P = .004); in both sexes, the percentage of remittent
Discussion
In recent years, there has been a great epidemiologic effort devoted to the study of environmental factors early in life and their importance to subsequent asthma and allergy. However, until now, only 1 recently published article investigated prospectively the natural history of asthma in a random sample of subjects from age 9 years to age 26 years, suggesting that outcomes in adult asthma may be determined primarily in early childhood.14
The novelty of our approach is that it considers the
Acknowledgements
We thank the ECRHS Co-ordinating Centre (London), the Project Management Group, and the Study Group for their assistance (for a list of principal participants in ECRHS, see the Journal's Online Repository at www.mosby.com/jaci).
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Supplementary data associated with this article can be found at doi:10.1016/j.jaci.2004.01.780.