Stable and high incidence of asthma among adults in northern Sweden
during the last decades.
Abstract
Background: The prevalence of asthma has increased both among children
and adults during the latter half of the 20th century. The prevalence
among adults is affected by the incidence of asthma in childhood but
also in adulthood. Time trends in asthma incidence are poorly studied.
The aim was to study the incidence of asthma among adults from 1996-2006
and 2006-2016, and compare the risk factor patterns. Methods: Within the
Obstructive Lung Disease in Northern Sweden (OLIN) studies, two randomly
selected population-based samples in ages 20-69 years participated in
postal questionnaire surveys about asthma in 1996 (n=7104, 85%) and
2006 (n=6165, 77%), respectively. A 10-year follow-up of the two
cohorts with the same validated questionnaire was performed, and n=5709
and n=4552, respectively, responded. Different definitions of population
at risk were used in the calculations of asthma incidence. The protocol
followed a study performed 1986 to 1996 in the same area. Results: The
crude incidence rate of physician-diagnosed asthma was 4.4/1000/year
(men 3.8, women 5.5) from 1996-2006, and 4.8/1000/year (men 3.7, women
6.2) from 2006-2016. When correcting for possible under-diagnosis at
study entry, the incidence rate was 2.4/1000/year from 1996-2006 and
2.6/1000/year from 2006-2016. The incidence rates were similar across
age groups. Allergic rhino-conjunctivitis was the main risk factor for
incident asthma in both observation periods (risk ratios 2.4-2.6).
Conclusions: The incidence of asthma among adults has been stable over
the last two decades, and on similar level since the 1980s. The high
incidence contributes to the increase in asthma prevalence.