Asthma Rates in U.S. Rising

People diagnosed with asthma in the United States grew by 4.3 million between 2001 and 2009, with nearly 1 in 12 Americans diagnosed with asthma. In addition to increased diagnoses, asthma costs grew from about $53 billion in 2002 to about $56 billion in 2007, about a 6 percent increase. The explanation for the growth in asthma rates is unknown.

Asthma is a lifelong disease that causes wheezing, breathlessness, chest tightness, and coughing, though people with asthma can control symptoms and prevent asthma attacks by avoiding things that can set off an asthma attacks, and correctly using prescribed medicine, like inhaled corticosteroids. The report highlights the benefits of essential asthma education and services that reduce the impact of these triggers, but most often these benefits are not covered by health insurers.

“Despite the fact that outdoor air quality has improved, we’ve reduced two common asthma triggers—secondhand smoke and smoking in general—asthma is increasing,” said Paul Garbe, D.V.M., M.P.H, chief of CDC’s Air Pollution and Respiratory Health Branch. “While we don’t know the cause of the increase, our top priority is getting people to manage their symptoms better.”

Asthma triggers are usually environmental and can be found at school, work, home, outdoors, and elsewhere and can include tobacco smoke, mold, outdoor air pollution, and infections linked to influenza, cold-like symptoms, and other viruses.

Asthma diagnoses increased among all demographic groups between 2001 and 2009, though a higher percentage of children reported having asthma than adults (9.6 percent compared to 7.7 percent in 2009), Diagnoses were especially high among boys (11.3 percent). The greatest rise in asthma rates was among black children (almost a 50 percent increase) from 2001 through 2009. Seventeen percent of non-Hispanic black children had asthma in 2009, the highest rate among racial/ethnic groups.

Annual asthma costs in the United States were $3,300 per person with asthma from 2002 to 2007 in medical expenses. About 2 in 5 uninsured and 1 in 9 insured people with asthma could not afford their prescription medication.

“Asthma is a serious, lifelong disease that unfortunately kills thousands of people each year and adds billions to our nation’s health care costs,” said CDC Director Thomas R. Frieden, M.D., M.P.H. “We have to do a better job educating people about managing their symptoms and how to correctly use medicines to control asthma so they can live longer more productive lives while saving health care costs.”

This report coincides with World Asthma Day, an annual event sponsored by the Global Initiative for Asthma. This year’s theme is “You Can Control Your Asthma.” Reducing asthma attacks and the human and economic costs of asthma are key priorities for the U.S. Department of Health and Human Services and the focus of a collaborative effort involving many parts of HHS. In support of this effort CDC recommends:

  • Improving indoor air quality for people with asthma through measures such as smoke-free air laws and policies, healthy schools and workplaces.
  • Teach patients how to avoid asthma triggers such as tobacco smoke, mold, pet dander, and outdoor air pollution.
  • Encouraging clinicians to prescribe inhaled corticosteroids for all patients with persistent asthma and to use a written asthma action plan to teach patients how manage their symptoms.
  • Promoting measures that prevent asthma attacks such as increasing access to corticosteroids and other prescribed medicines.
  • Encourage home environmental assessments and educational sessions conducted by clinicians, health educators, and other health professionals both within and outside of the clinical setting.

The figures were reported in Vital Signs, released today by the Centers for Disease Control and Prevention.

Source: CDC

H1N1 Vaccine Boosts Immune Response in Asthmatics

A single dose of H1N1 vaccine is safe and induces a strong immune response predictive of protection, according to a clinical trial of inactivated H1N1 flu vaccine in people with asthma.

The findings also suggest that individuals over the age of 60 who have severe asthma may require a larger dose of vaccine.

“Asthma was the most common underlying health condition among those hospitalized in the United States with 2009 H1N1 influenza infection during the 2009-2010 influenza season,” says NIAID Director Anthony S. Fauci, M.D. “The results of this clinical trial show that the 2009 H1N1 influenza vaccine was safe and led to adequate production of antibodies thought to be protective against the virus. This is important because the H1N1 vaccine is one component of the seasonal influenza vaccine currently being distributed for the 2010-2011 influenza season.” [Read more…]

Adult Illness and Death Risk Increased by Respiratory Disease During Childhood

Respiratory disease in childhood increases the risk of illness and premature death in adulthood, according to a study published in the journal, Thorax.

Between 1948 and 1968 10,000 male graduates of Glasgow University supplied researchers with details of childhood illnesses, including bronchitis, asthma and pneumonia, plus their weight, height and blood pressure.

When survivors of the original study were traced between 1998 and 2002, 4044 men out of 8410 replied. Victims of bronchitis, pneumonia asthma in early childhood were 57% more likely to die of respiratory disease than those who had not suffered from these illnesses as children. And they were more than twice as likely to die of chronic obstructive pulmonary disease, emphysema and bronchitis.

Men who had had bronchitis were also 38% more likely to die of cardiovascular disease. Respiratory illness during childhood was also associated with a higher risk of assorted respiratory problems in adulthood, ranging from the relatively minor to the severe.

Source: Thorax,/em> 2008; doi 10.1136/thx.2007.086744

Pharma-Funded Studies Conclude Less Risk from Inhaled Corticosteroids Than Studies Funded by Other Organizations

Concerns have been raised about the use of inhaled corticosteroids for long-term treatment of children or for milder cases of asthma and other respiratory problems. While many studies have been conducted on the adverse effects of inhaled corticosteroids, researchers have found that studies funded by pharmaceutical companies are less likely to find significant differences in adverse effects between individuals assigned to inhaled corticosteroid groups and those who were not when compared to results of studies funded by other groups.

Specifically, 34.5% of pharma-funded studies and 65.1% of studies funded by other groups, including non-profit organizations and government agencies, found a significant difference in adverse effects between the two groups of patients.

The study by Antonio Nieto, M.D., Ph.D., of the Children’s Hospital La Fe, Valencia, Spain and colleagues assessed the safety reporting of inhaled corticosteroids in 504 studies of the drugs published between 1993 and 2002. Of those, 275 were funded by pharmaceutical companies and 229 were funded by other sources.

The authors conclude that "having information on source of funding will help readers of these studies have a better informed and balanced judgment on the authors’ interpretations," and that "disclosure of conflicts of interest should be strengthened for a more balanced opinion on the safety of drugs."

Source: Archives of Internal Medicine, October 22, 2007