Conflict Of Interest Statement
AC has received personal fees for consultancy from Regeneron/Sanofi, Philips and Boehringer Ingelheim consultancy and speaker fees from Novartis and speaker fees from Thermo Fisher Scientific. JP has received a travel grant from Boehringer Ingelheim. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest
How Do Rates Of Emergency Admission To Hospital For Asthma Vary Across The Uk 200812
Asthma accounts for 60,000 hospital admissions and 200,000 bed days a year. Compared with conditions such as pneumonia and COPD, these figures are low. But like mortality rates, they are too high for such a manageable condition.
Its also worth noting that many people with asthma attend accident and emergency units without needing admission, but still adding to the burden on health services.
England: There were higher rates of emergency admission in the North East, North West, Yorkshire and the Humber and the West Midlands than in the UK generally. There were lower admission rates in the East of England, the South East and South West.
Notably more males were admitted in the North East, North West, West Midlands, and London.
Scotland: The admission rate among women was higher than in the UK generally.
Wales: Admission rates were comparable to those for the UK generally.
Northern Ireland: There were lower admission rates for males and females compared with the UK generally.
Asthma hospital admission ratios, males and females, in each UK region, 200812
Relative risk of hospital admissions for asthma, by local authority district , 2010
You can find out how these figures were calculated.
Asthma Facts And Figures
Asthma causes swelling of the airways. This results in narrowing of the airways that carry air from the nose and mouth to the lungs. Allergens or irritating things entering the lungs trigger asthma symptoms. Symptoms include trouble breathing, wheezing, coughing and tightness in the chest. Asthma can be deadly.
- There is no cure for asthma, but it can be managed with proper prevention of asthma attacks and treatment.
- More Americans than ever before have asthma. It is one of this countrys most common and costly diseases.
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How Many People In The Uk Have Asthma
We found that 8 million people over 12% of the population have been diagnosed with asthma. This means more people have had an asthma diagnosis than have been diagnosed with all other lung diseases combined.
This does not mean that there are 8 million people living with the condition, however. Many children diagnosed with asthma grow out of it. Asthma UK states that around 5.4 million people receive treatment for the disease. Research has also suggested asthma maybe considerably over-diagnosed.
Further research is needed to understand if this is a more accurate indication of the number of people living with asthma in the UK. Or whether this is an underestimate due to the number of people who no longer take treatment for asthma in adulthood, despite still having symptoms.
Our data also confirm that the number of people who have had a diagnosis of asthma is plateauing. There has only been a small increase of under 3% in recent years. However, asthma is still the most common lung condition by a considerable margin.
Estimated numbers of people ever diagnosed with asthma 200412
Impact Of Poor Asthma Management: Er Visits Hospitalizations And Deaths
- Asthma accounts for 4,261 deaths, approximately half a million hospitalizations, about 1.9 million emergency room visits and 12.7 million physician visits annually in the U.S. alone.
- Everyday in America 40,000 people miss school or work due to asthma, 30,000 people have an asthma attack, and 1,000 people are admitted to the hospital.
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The Impact Of Asthma On Daily Life
Asthma is often under-diagnosed and under-treated, particularly in low- and middle-income countries.
People with under-treated asthma can suffer sleep disturbance, tiredness during the day, and poor concentration. Asthma sufferers and their families may miss school and work, with financial impact on the family and wider community. If symptoms are severe, people with asthma may need to receive emergency health care and they may be admitted to hospital for treatment and monitoring. In the most severe cases, asthma can lead to death.
How Many People Die From Asthma
- On average, ten Americans die from asthma each day. In 2019, 3,524 people died from asthma. Many of these deaths are avoidable with proper treatment and care.7
- Adults are five times more likely to die from asthma than children.7
- Women are more likely to die from asthma than men, and boys are more likely than girls.7
- Black Americans are nearly three times more likely to die from asthma than white Americans.7
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Who Strategy For Prevention And Control Of Asthma
Asthma is included in the WHO Global Action Plan for the Prevention and Control of NCDs and the United Nations 2030 Agenda for Sustainable Development.
WHO is taking action to extend diagnosis of and treatment for asthma in a number of ways.
The WHO Package of Essential Noncommunicable Disease Interventions was developed to help improve NCD management in primary health care in low-resource settings. PEN includes protocols for the assessment, diagnosis, and management of chronic respiratory diseases , and modules on healthy lifestyle counselling, including tobacco cessation, and self-care.
Reducing tobacco smoke exposure is important for both primary prevention of asthma and disease management. The Framework Convention on Tobacco Control is enabling progress in this area as are WHO initiatives such as MPOWER and mTobacco Cessation.
Other Health Impacts Of Childhood And Adult Asthma
Another major impact of asthma is through its associated additional morbidities, including a predisposition to serious infections such as bacterial pneumonia from a higher nasopharyngeal carriage of Streptococcus pneumoniae . Although not well-understood, asthma-related chronic airway inflammation with damaged airway mucosa and immunomodulating treatments such as inhaled corticosteroids have been implicated, and lower antibody levels in response to the Pneumococcal vaccine have also been observed . In addition to a 2.4-fold increased risk for invasive pneumococcal disease , susceptibility to respiratory and non-respiratory infections in never smokers with asthma has been compared with the relative risk of diabetes . This susceptibility to infection supports the hypothesis of weaker TH1 immune responses associated with TH2-related disease. However, recommendations for Pneumococcal immunization are inconsistent suggesting more evidence is needed to gain consensus of its benefits .
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Asthma In Massachusetts Is Costly
- The total charges for hospitalization due to asthma in Massachusetts increased 82.5% from $57 million in 2002 to $104 million in 2013.
- In 2013, public insurance was the expected payer for 66.61% of hospitalizations due to asthma.
Figure 2. Total Charges for Hospitalizations Due to Asthma, Massachusetts Residents, 2002-2013
Disparities Exist in Hospitalizations, Emergency Department Visits, and Outpatient Observation Stays by age, gender and race/ethnicity.
- Adults ages 65 years and older had the 2nd highest rate of hospitalization due to asthma, but had the lowest rates of emergency department visits and outpatient observation stays due to asthma.
- From 2002 through 2013, Black, non-Hispanics and Hispanics consistently had significantly higher age-adjusted rates of hospitalization due to asthma than White, non-Hispanics. Children ages 0-4 years had the highest rates of emergency department visits, outpatient observation stays, and hospitalization due to asthma
Figure 3 Age-Specific Rates of Emergency Department Visits Due to Asthma, Massachusetts Residents, 2009-2013
For more information about Massachusetts asthma statistics, please contact .
Severe Asthma In Adults And Children
Severe asthma represents a small subgroup of individuals who have a disproportionately high health burden. The European Respiratory Society /American Thoracic Society Task Force defines severe asthma as asthma which requires treatment with high dose of inhaled corticosteroids plus a second controller to prevent it from becoming uncontrolled, or which remains uncontrolled despite this therapy . This definition applies to both children and adults with asthma, and it is highly likely that the condition we refer to as severe asthma is the extreme end of the spectrum for several different asthma endotypes.
In the absence of linking data with national pharmaceutical schemes, capturing detailed information on medication use is challenging in epidemiological studies, although such information is critical when defining severe asthma. For example, in children the maximum treatment used to define severe asthma includes high doses of ICS or oral corticosteroids, often in combination with add-on therapy with long-acting -2 agonists and/or leukotriene-receptor antagonists . The limitation of the use of maximum treatment is that there may be different reasons for poor asthma control among patients on maximum treatment, such as the wrong diagnosis , non-adherence with medication , or therapy-resistant disease .
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How Does Asthma Develop
Possible risk factors for the development of asthma include:
- Family history of allergies, asthma and eczema9
- High exposure to airborne allergens in the first years of life9
- Exposure to tobacco smoke9
- Frequent respiratory infections early in life9
- Low birth weight and respiratory distress syndrome at birth9
- Being overweight or obese10
Environmental Exposures Associated With Asthma In Children And Adults
Childhood asthma and adult onset asthma are known to share many of the same causes and triggers. While there is stronger evidence on the role of environmental factors as triggers than causes, there is increasing evidence for interactions among and between environmental and other intrinsic factors, such as genetics and atopy, to potentially cause asthma. The vast majority of childhood onset asthma manifests as an allergic phenotype, while there is a predominance of the non-allergic phenotype in adult onset asthma. However, both allergic and non-allergic asthma can exhibit individual responses to both allergic and non-allergic airborne triggers such as animal hair and dander, pollen, and mold spores, food allergens, tobacco smoke, or other pollutant exposures . Other than this table that provides key references to the main environmental exposures associated with asthma across the lifespan, the typical non-allergic, food and animal triggers of asthma are not described further in this chapter. Subsequent text has focused on the relationships between outdoor, indoor and workplace air pollutants and allergens and asthma, followed by a section on lifestyle factors such as obesity, diet, and breastfeeding.
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Parental And Personal Smoking
In utero maternal smoking and parental smoking in early life has been shown to be temporally associated with increased asthma in young children . Recent evidence from multi-generational studies suggest that grandmaternal smoking while the mother is in utero and paternal smoking during his adolescence can independently increase the risk of subsequent offspring childhood asthma. These findings suggest that tobacco smoking may cause heritable modifications of the epigenome, which increase the risk of asthma in future generations .
Smoking also seems to interact with sex. Female smokers had a higher prevalence of asthma than female non-smokers, but this difference was less frequent for males, suggesting that females may be more susceptible. Many studies have found that personal smoking predisposes an individual to increased risk of incident or new-onset asthma, although smoking-onset in adolescence, or adulthood typically occurs after early-onset asthma . As non-atopic asthma becomes increasingly common compared with atopic asthma in adults, this is most likely because this phenotype frequently coincides with a substantial history of cigarette smoking and its potential to predispose to chronic airflow limitation . Smokers with asthma form a distinct group that are more likely to have suboptimal asthma control and develop asthma-COPD overlap syndrome in later life, characterized by incompletely reversed airflow obstruction following an inhaled bronchodilator .
The Prevalence Of Asthma Is High In Massachusetts
- In 2015, approximately 1 in 9 people in Massachusetts 10.2% of adults and 12.9% children currently had asthma2.
- The prevalence of lifetime and current asthma among adults was higher in Massachusetts than the nation.
- In Massachusetts, prevalence of current asthma was higher among
- Adult females compared to adult males
- Male children compared to female children
- Adults and children in households with lower incomes
- Adults and children in households with lower educational attainment of the adult
- Adults who smoke
- Adults and children who have a disability
1 Moorman JE, Akinbami LJ, Bailey CM, et al. National Surveillance of Asthma: United States, 20012010. National Center for Health Statistics. Vital Health Stat 3. 2012
2 A Profile of Health Among Massachusetts Adults, 2015
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Whats The Risk In Taking Ibuprofen If You Have Asthma
If you have asthma, but arent aspirin-sensitive, you should be able to take ibuprofen as directed.
If you do have aspirin-sensitive asthma, ibuprofen can trigger symptoms of asthma or allergy. Symptoms of severe allergic reaction usually develop within a few hours after taking the drug. Some of them are:
- nasal congestion, runny nose
If youre ibuprofen-sensitive, its important to scrutinize medicine labels carefully. Avoid products that contain ibuprofen, aspirin, or any other NSAID.
Most people with asthma can safely take acetaminophen to treat fever or pain.
Certain asthma medications block leukotrienes. These include zafirlukast , montelukast , and zileuton . Ask your doctor if these medicines affect your ability to take ibuprofen. Your doctor can also guide you on the safest pain relievers, potential side effects, and what to do if you have an allergic reaction.
For frequent or chronic pain, your doctor may be able to provide alternate solutions based on the cause.
If youve had a bad reaction in the past and accidentally take ibuprofen, contact your doctor right away. Seek emergency medical care or call 911 if you have symptoms of severe allergic reaction such as:
- facial swelling
How Common Is Asthma
- Approximately 25 million Americans have asthma. This equals to about 1 in 13 Americans, including 8 percent of adults and 7 percent of children.1
- About 20 million U.S. adults age 18 and over have asthma. 1
- Asthma is more common in adult women than adult men.1
- It is the leading chronic disease in children. 2 Currently, there are about 5.1 million children under the age of 18 with asthma. 1
- Asthma is more common in boys than girls.1
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Global Alliance Against Chronic Respiratory Diseases
The Global Alliance against Chronic Respiratory Diseases contributes to WHOs work to prevent and control chronic respiratory diseases. GARD is a voluntary alliance of national and international organizations and agencies from many countries committed to the vision of a world where all people breathe freely.
Do Men Or Women Have Higher Rates Of Asthma
- Women are more likely to have asthma than men. 9.8 percent of women have asthma, compared to 6.1 percent of men.1
- Women are more likely to die from asthma than men.7
- Boys are more likely to have asthma than girls. 8.4 percent of boys have asthma, compared to 5.5 percent of girls.1
References
Centers for Disease Control and Prevention. . 2019 National Health Interview Survey data. U.S. Department of Health & Human Services. Retrieved from:
Ferrante, G., & La Grutta, S. . The Burden of Pediatric Asthma. Frontiers in Pediatrics, 6.
Zahran, H., Bailey, C., Damon, S., Garbe, P. and Breysse, P. . Vital signs: Asthma in children United States, 20012016. .
National Center for Health Statistics. . National Ambulatory Medical Care Survey . U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Retrieved from:
Agency for Healthcare Research and Quality. . Healthcare Cost and Utilization Project . U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Retrieved from:
Asthma Research
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Exposure To Tobacco Smoke Among Those Diagnosed With Asthma
The negative health effects of tobacco smoke are well established.Footnote 3 For those with asthma, exposure to tobacco smoke, either directly or indirectly, can provoke or exacerbate an asthmatic condition . Smoking cessation or elimination of second hand smoke exposure among those who have asthma can lead to better controlled asthma. The SLCDC found that among those who have asthma:
- 14.7% reported that they were current smokers .
- 26.2% reported that they were former smokers.
- 22.6% indicated members of their household smoke.
- Of those who indicated that a household member smokes, 37.5% indicated a doctor or other health professional suggested that other members of their household quit or cut down smoking to help control their asthma.
Preparing For A Doctors Appointment
Patients with asthma or suspected asthma will likely be referred to an allergist or a pulmonologist. These tips may help you be more prepared for your appointment:
- Keep a log of symptoms you are having, even if they are seemingly unrelated.
- Bring a list of any prescription or over-the-counter medications you are taking. Dont forget to list vitamins and supplements, too.
- Jot down a list of questions, such as:
- What tests or procedures will be performed?
- How will my asthma be monitored?
- How should I use my medications? How should they be stored?
- What triggers might cause my asthma to flare? Is there anything I can/should do to reduce my risk of having an asthma attack?
- Will I have an asthma action plan?
- How often do I need follow-up care?
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What Are The Costs Of Asthma To Society
More than $80 billion is spent in the United States each year on medical expenses related to asthma. The annual per person medical costs for asthma were $3,266.7
The number of doctors office visits due to asthma dropped between 2001 and 2016, from 409.7 visits per 10,000 population to 307.8 per 10,000 population. Rates of asthma-related emergency room visits did not change between 2001 and 2016. Rates of hospitalizations for asthma also declined by half during the same period.2
The number of children who missed one or more days of school decreased from 61.5 percent in 2003 to 49 percent in 2013. Missed school days did not change for age, gender, race, ethnicity or poverty level.6