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Seventy years of asthma in Italy: age, period and cohort effects on incidence and remission of self-reported asthma from 1940 to 2010

Pesce, Giancarlo and Locatelli, Francesca and Cerveri, Isa and Bugiani, Massimiliano and Pirina, Pietro and Johannessen, Ane and Accordini, Simone and Zanolin, Maria Elisabetta and Verlato, Giuseppe and De Marco, Roberto (2015) Seventy years of asthma in Italy: age, period and cohort effects on incidence and remission of self-reported asthma from 1940 to 2010. PLoS One, Vol. 10 (10), e0138570. ISSN 1932-6203. Article.

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DOI: 10.1371/journal.pone.0138570

Abstract

Background: It is well known that asthma prevalence has been increasing all over the world in the last decades. However, few data are available on temporal trends of incidence and remission of asthma.
Objective: To evaluate the rates of asthma incidence and remission in Italy from 1940 to 2010.
Methods: The subjects were randomly sampled from the general Italian population between 1991 and 2010 in the three population-based multicentre studies: ECRHS, ISAYA, and GEIRD. Individual information on the history of asthma (age at onset, age at the last attack, use of drugs for asthma control, co-presence of hay-fever) was collected on 35,495 subjects aged 20–84 and born between 1925–1989. Temporal changes in rates of asthma incidence and remission in relation to age, birth cohort and calendar period (APC) were modelled using Poisson regression and APC models.
Results: The average yearly rate of asthma incidence was 2.6/1000 (3,297 new cases among 1,263,885 person-years). The incidence rates have been linearly increasing, with a percentage increase of +3.9% (95%CI: 3.1–4.5), from 1940 up to the year 1995, when the rates begun to level off. The stabilization of asthma incidence was mainly due to a decrease in the rates of atopic asthma after 1995, while non-atopic asthma has continued to increase. The overall rate of remission was 43.2/1000person-years, and it did not vary significantly across generations, but was associated with atopy, age at asthma onset and duration of the disease.
Conclusions: After 50 years of a continuous upward trend, the rates of asthma incidence underwent a substantial stabilization in the late 90s. Despite remarkable improvements in the treatment of asthma, the rate of remission did not change significantly in the last seventy years. Some caveats are required in interpreting our results, given that our estimates are based on self-reported events that could be affected by the recall bias.

Item Type:Article
ID Code:11763
Status:Published
Refereed:Yes
Uncontrolled Keywords:Asthma, allergic rhinitis, cohort studies, antigen-presenting cells, Italian people, Italy, age groups, questionnaires
Subjects:Area 06 - Scienze mediche > MED/10 Malattie dell'apparato respiratorio
Divisions:001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Medicina Clinica e Sperimentale
Publisher:Public Library of Science
ISSN:1932-6203
Copyright Holders:© 2015 Pesce et al.
Deposited On:14 Jun 2017 13:39

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