In this Issue December 2003

Compliments of the season from the National Asthma Council.

Vigilance is the Key

Has Childhood Asthma Peaked?

Touring and IPCRG

Asthma and Mental Health

Awareness and Action on COPD

Int'l Pediatric Respiratory, Allergy and Immunology Congress

Conference Diary 2003/4
 

Vigilance is the Key

The release of the latest asthma death figures from the Australian Bureau of Statistics show a welcome fall from 422 in 2001 to 397 in 2002.

Having some time off for those of us who are able to take a break, provides a good opportunity to reflect on the news that fewer Australians died from asthma in 2002 than in each of the past 20 years.

The majority of asthma deaths occurred in people over 65 years (279 deaths), with few children and younger people having died from asthma.

There were nine deaths for 2002 among children 14 years and younger.

The number of asthma deaths in the  5 – 34 years age group fell from 43 in 2001 to just 33 in 2002.
 

The National Asthma Council recognises that decreasing asthma deaths is a tribute to the collaborative efforts of the community, doctors and pharmacists in managing asthma.

Reference

Asthma Deaths Table

Asthma mortality 1960 - 2002 (5 to 34 year olds)

Asthma mortality 1960 - 2002 (all ages)
 

Has Childhood Asthma Peaked?

With Australia experiencing a record low number of deaths from asthma, Dr Colin Robertson from the Royal Children's Hospital in Melbourne has just published an interesting paper looking at the prevalence of childhood asthma. Over a nine-year period, Dr Robertson used the standardised method developed by the International Study of Asthma and Allergy in Childhood (ISAAC) to review the prevalence of asthma and other atopic disorders in schoolchildren.

The study involved surveying 6-7 year old children from a range of primary schools from 1993 to 2002. The results were a 26% reduction in the prevalence of reported wheeze from 27.2% in 1993 to 20.0% in 2002. The rate of hospital admissions for children 5-9 years over this period also fell from 10 per 1000 to 3.9 per 1000.

For the latter half of the 20th century in Australia, and worldwide, the prevalence of asthma has been rising with the cause remaining mostly unknown. What is perhaps surprising about the latest survey is that the prevalence of asthma has actually fallen, even while the prevalence of eczema and allergic rhinitis has increased. This seeming paradox, as allergic rhinitis and eczema are asthma risk factors, has also been seen in studies from Singapore and Leipzig.

The decrease in asthma prevalence has reduced the burden for the community, but there is lesser reduction of burden for the individual children. Although the study shows a decreased prevalence for asthma, there seems to be room for improvement in asthma management. The reduction in the number of children taking asthma medication is  proportional only to the decreased prevalence.

Of the children with troublesome asthma 55% did not take regular preventative therapy, indicating virtually no change from 1993 to 2002. On a more positive note, the number of children with frequent symptoms who now have written Asthma Action Plan has risen to 50%.

The full paper may be found at the Medical Journal of Australia website
Asthma prevalence in Melbourne schoolchildren: have we reached the peak?
(http://www.mja.com.au/public/rop/robertson/rob10446_fm.html)

Touring and IPCRG

While you are preparing for the holidays you may like to review the tourism options available for IPCRG 2nd World Conference on Respiratory Disease in Primary Care 'The Way Forward'.

During the conference there are exciting options for partners and an excellent range of pre- and post-conference tours available including attractions around Melbourne and Victoria as well as Australia-wide.

For all the details go to
IPCRG Melbourne 2004
(http://www.ipcrg-melbourne.org/default.htm)

Asthma and Mental Health

Reports linking asthma and a range of mental disorders recently appeared following the publication of a research study involving a 4,000 strong representative sample of the general population aged 18 to 65 years.

The study conducted  by Dr R D Goodwin, of Columbia University, New York, and colleagues in Germany and the US, found adults with asthma to be twice as likely to suffer mental illness as the general community.

For people with severe asthma they found nearly double the rate of anxiety disorders and five times the likelihood of having panic attacks. However the reasons for this are not clear.

Several notes of caution have been raised about interpretation of the research including

• the potential for confusion between asthma and COPD (chronic obstructive pulmonary disease) resulting from smoking with people aged to 65 years included; and

• asthma medications can also mimic the symptoms of anxiety, such as breathlessness and tightness in the chest.

Further research is required to clarify the association between asthma and mental disorders and determine any common genetic or biological development pathways.

Reference

Mental Disorders and Asthma in the Community
Renee D. Goodwin, PhD, MPH; Frank Jacobi, PhD; Wolfgang Thefeld, MD
Arch Gen Psychiatry. 2003;60:1125-1130  

Awareness and Action on COPD

There are more than 600 million people worldwide with COPD (Chronic Obstructive Pulmonary Disease), and by 2020 it will have become the third leading cause of death in the world. COPD is one of the few major diseases that is still increasing in terms of the number of people diagnosed and still remains highly under-recognised. One of the main causes of COPD is smoking and with smoking rates high among young people with asthma, it is not difficult to understand an overlap between the two conditions.

The European Federation of Allergy and Airways Diseases Patients’ Associations (EFA) launched an educational internet resource last month to coincide with World COPD Day The information on the website is aimed at patients, patient associations and health professionals.

EFA is an alliance of 41 organisations in 23 different countries across Europe that works to improve the quality of life of patients with allergy, asthma and COPD in Europe.

EFANet  (http://www.efanet.org/copd)

International Pediatric Respiratory, Allergy and Immunology Congress

Hong Kong is set to host the International Pediatric Respiratory, Allergy and Immunology Congress (IPRAIC) from 10-13 July 2004.

The program has been designed as an update meeting for general paediatricians and general practitioners with an interest in childhood respiratory illnesses and allergic diseases.

The congress will be held at the Hong Kong Convention and Exhibition Centre and covers four main areas including:

• Asthma and Allergies,
• Respiratory Infection & Immunology,
• Paediatric Respirology and
• Intensive Care Medicine.

The Scientific Committee has put together a comprehensive program with world renowned speakers confirmed and invites submission of papers for the Oral and Poster Sessions.

The deadline for abstract submission and early bird registration is 31 January 2004.

The final program details and registration forms are available from

IPRAIC  (www.ipraic.org).

Conference Diary 2003/4

Submit brief conference/meeting details to the National Asthma Council for possible posting in our Conference Diary by email to nac@NationalAsthma.org.au.