Daniel Czarny

Risk factors for asthma among young adults in Melbourne, Australia

Abstract Asthma is more prevalent in Australia than in Europe or North America. As part of the European Community Respiratory Health Survey (ECRHS), we investigated exposure to risk factors for asthma among young adults in Melbourne. During this study, 553 randomly selected and 204 symptomatic participants aged between 20 and 44 years completed a detailed respiratory questionnaire, of whom 675 underwent measurement of bronchial hyperreactivity (BHR) by methacholine challenge and 745 had skin prick tests for atopy. Current asthma, defined as BHR and wheeze in the preceding 12 months, was present in 25.5% of those tested. A family history of asthma was a risk factor for current asthma (maternal asthma odds ratio [OR] 2.4, paternal asthma OR 2.1). Current smokers were 1.7 times more likely to have current asthma. A serious respiratory infection before 5 years of age increased the risk of current asthma 2.3‐fold. Atopy on skin testing was also strongly associated with current asthma (OR 5.9). The greatest risks were associated with positive skin tests to Cladosporium, house dust mite, cat and rye grass pollen. We conclude that female gender, maternal asthma, smoking, hayfever, early respiratory infection, occupational exposure and atopy are important risk factors for asthma in young adults.

The prevalence of asthma and respiratory symptoms among young adults : Is it increasing in Australia ?

The objective of this study was to determine the prevalence of self-reported asthma and respiratory symptoms among young adults and whether there had been any change since a previous survey. A cross-sectional postal community survey was conducted in three parliamentary electorates in the inner South East region of Melbourne, Australia. A total of 4500 individuals aged between 20 and 44 years were randomly selected from the electoral roll. After three mailings and telephone follow-up, an adjusted response rate of 79% was achieved. No intervention was performed. Self-reported asthma and respiratory symptoms were recorded from the European Community Respiratory Health Survey screening questionnaire. Respondents were most likely to report nasal allergies (41%), nocturnal cough (28.6%), and wheeze in the last 12 months (28.1%). Nocturnal cough was more common in females than males. The prevalence of wheeze, nocturnal chest tightness, and use of asthma medications decreased with age. An attack of asthma in the last 12 months was reported by 9.7% of young adults, and this fell to 8.2% after correction for nonresponse bias. The prevalence of current asthma had not increased significantly since a previous postal survey in 1990. However the prevalence of nocturnal chest tightness, nocturnal cough, and use of asthma medications had increased significantly over a 2-year period. Further research is required to investigate why asthma is so prevalent in Australia and why some features are increasing in prevalence.

Geographic tongue: Sensitivity to the environment

The prevalence of geographic tongue was assessed among 102 atopic patients with extrinsic asthma and/or rhinitis and was found to be significantly greater in these patients than in an asymptomatic, nonatopic control population. However, there was no difference between the prevalence of geographic tongue among atopic patients with extrinsic asthma and rhinitis as compared to a group of patients with asthma and rhinitis who were not atopic. These findings suggest that geographic tongue is a sign common to those patients who have a tendency to develop recurrent acute inflammatory disease on surfaces in contact with the external environment (for example, asthma or rhinitis), whether they are atopic or not.

Allergies, Upper Respiratory Tract Infections, and Asthma

The aims of this study were (1) to quantify the prevalence of aeroallergen hypersensitivity in presentations for emergency treatment of asthma and (2) to determine the strength of association between viral upper respiratory tract infections (URTIs) and admission for treatment of asthma. A series of 209 asthmatic patients presenting to the Emergency Department (ED) of the Alfred Hospital over 6 months underwent skin prick testing and venipuncture for serum IgE and rye grass pollen (RGP) RAST. A case-control study of 38 asthmatic inpatients and 90 controls admitted for road trauma or endoscopy underwent nasopharyngeal aspiration for viral culture and immunofluorescence (IF). Eighty-four percent of ED asthmatic patients had one or more positive skin tests to common aeroallergens, 57% had a positive skin test, and 45% had a positive RAST to RGP. Viral cultures or IF studies were positive in 8 asthmatic patients and 2 controls. Asthmatic inpatients were 6 times more likely to have a viral URTI than were controls. It is concluded that aeroallergen hypersensitivity is present in most asthmatic patients presenting to the ED, and that there is a strong association between viral URTIs and admission for asthma.