Respiratory symptoms/diseases prevalence is still increasing: a 25-yr population study

Chronic respiratory diseases and allergic diseases have doubled in the last 25 years and living in a urban area is a risk factors for these diseases.
Few epidemiological surveys on general population samples estimated changes in prevalence of respiratory symptoms/diseases over a long time interval. A study performed by the Pulmonary Environmental Epidemiology Unit, Institute of Clinical Physiology, CNR, Pisa, along with the Institute of Biomedicine and Molecular Immunology, CNR, Palermo, the University Hospital of Pisa and the University of Verona, allowed quantifying the temporal changes in the prevalence rates of asthma, allergic rhinitis and Chronic Obstructive Pulmonary Disease (COPD) after 25 years from baseline. The results of the study have been published in Respiratory Medicine [1].
A large sample of subjects living in Pisa and Cascina (Tuscany) participated in three epidemiological surveys performed in 1985-88 (n=3865, mean age 44 yrs), 1991-93 (n=2841, mean age 48 yrs), 2009-11 (n=1620, mean age 56 yrs), filling in a questionnaire about health status and risk factors. Statistical analyses included a total of over 4800 subjects, of which about 2500 performed at least two of the three surveys.
The results of the statistical analyses showed that the prevalence more than doubled from the first to the third survey: asthma attacks (from 3.4 to 7.2%), allergic rhinitis (from 16.2 to 37.4%), phlegm (from 8.7 to 19.5%) and COPD (from 2.1 to 6.8%). These data confirmed the increasing trend evidenced by other international and national epidemiological studies.
Moreover, the research highlighted that smoking habits and work exposure are still very important risk factors for respiratory diseases. The "urban factor" is another important risk factors for both allergic and chronic obstructive diseases; in particular, the results of the multivariate statistical analyses showed that subjects living in the urban area, with respect those living in a suburban area, had a significantly higher risk of 19% for allergic rhinitis, of 14% for cough, of 30% for phlegm and of 54% for COPD.
This study confirms that respiratory diseases are still increasing in general population sample. Such an increment prompts the need of planning longitudinal epidemiological surveys in order to monitor the population health status and to increase knowledge about factors (allergens, air pollutants...) potentially associated to the current temporal trend.

[1] Maio S, Baldacci S, Carrozzi L, Pistelli F, Angino A, Simoni M, Sarno G, Cerrai S, Martini F, Fresta M, Silvi P, Di Pede F, Guerriero M, Viegi G. Respiratory symptoms/diseases prevalence is still increasing: a 25-yr population study. Respir Med 2016;110:58-65.

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