ABSTRACT
OBJECTIVE: To determine the incidence of adult-onset asthma, along with lung function and immunologic characteristics, causes, and clinical course of the disease. PATIENTS AND METHODS: After identifying incident cases of asthma among adult residents of the district of North Barcelona, Spain, we proceeded to characterize the disease using a questionnaire, lung function tests, and skin allergy tests. Patients with an occupation associated with asthma, wheezing at work, and/or sensitization to workplace allergens were considered as having occupational asthma. The risk factors for developing chronic asthma were determined by multivariate analysis. RESULTS: In the 2-year study period, 218 incident cases of adult-onset asthma were identified (in a population of 68 067 adults, corresponding to an annual incidence of 160 per 100 000 per year). In total, 152 patients agreed to participate in the study (response rate, 70%); 140 reported wheezing and/or asthma in the last year (92%). The skin tests showed atopy in 57 cases (41%). Occupational asthma was diagnosed in 19 cases (14%). Domestic mammals were identified as causal agents in 8 patients (6%), drugs in 7 (5%), and environmental allergens in 44 (31%). Household cleaning was the occupation most frequently associated with the disease (26%). Of the 102 patients examined again after 2 years, 70 had chronic asthma (69%). Atopy (odds ratio [OR], 3.39; 95% confidence interval [CI], 1.15-9.99) and risk occupation when the disease was diagnosed (OR, 5.54; 95% CI, 1.05-29.11) were the factors associated with development of chronic disease. CONCLUSIONS: Occupation was related to adult-onset asthma in a little over 10% of the cases and was the main determinant of the development of chronic symptoms.
Subject(s)
Asthma/diagnosis , Asthma/epidemiology , Adult , Age of Onset , Female , Humans , Incidence , Male , Spain/epidemiology , Urban PopulationABSTRACT
OBJETIVO: Determinar la incidencia del asma del adulto, junto con las características funcionales e inmunológicas de la enfermedad, sus causas y su evolución. PACIENTES Y MÉTODOS: Tras la identificación de los habitantes de Barcelona Norte con un primer diagnóstico de asma del adulto, se procedió a la caracterización de la enfermedad por cuestionario, función respiratoria y pruebas cutáneas de alergia. Los pacientes con una ocupación causante de asma, sibilancias durante el trabajo y/o sensibilización a un alérgeno laboral se consideraron afectados de asma relacionada con la ocupación. Los factores de riesgo de cronificación del asma se determinaron por medio de análisis multivariante. RESULTADOS: En 2 años se identificaron 218 primeros diagnósticos de asma del adulto (población: 68.067 adultos; incidencia anual: 160/100.000). Aceptaron participar en el estudio 152 pacientes (índice de respuesta: 70%), de los que se caracterizó a 140 que referían sibilancias y/o asma bronquial en el último año (92%). Las pruebas cutáneas mostraron atopia en 57 casos (41%). Se diagnosticó asma relacionada con la ocupación en 19 casos (14%), por mamíferos domésticos en 8 (6%), por fármacos en 7 (5%) y por alérgenos ambientales en 44 (31%), siendo la limpieza doméstica la ocupación más frecuentemente asociada a la enfermedad (26%). De los 102 pacientes examinados de nuevo a los 2 años, 70 presentaban asma crónica (69%); la atopia (odds ratio [OR] = 3,39; intervalo de confianza [IC] del 95%, 1,15-9,99) y una ocupación de riesgo cuando se diagnosticó la enfermedad (OR = 5,54; IC del 95%, 1,05-29,11) fueron los factores de cronificación del asma. CONCLUSIONES: La ocupación del paciente está relacionada con el asma del adulto en algo más de una décima parte de los casos y es un determinante principal de la cronicidad de sus síntomas
OBJECTIVE: To determine the incidence of adult-onset asthma, along with lung function and immunologic characteristics, causes, and clinical course of the disease. PATIENTS AND METHODS: After identifying incident cases of asthma among adult residents of the district of North Barcelona, Spain, we proceeded to characterize the disease using a questionnaire, lung function tests, and skin allergy tests. Patients with an occupation associated with asthma, wheezing at work, and/or sensitization to workplace allergens were considered as having occupational asthma. The risk factors for developing chronic asthma were determined by multivariate analysis. RESULTS: In the 2-year study period, 218 incident cases of adult-onset asthma were identified (in a population of 68 067 adults, corresponding to an annual incidence of 160 per 100 000 per year). In total, 152 patients agreed to participate in the study (response rate, 70%); 140 reported wheezing and/or asthma in the last year (92%). The skin tests showed atopy in 57 cases (41%). Occupational asthma was diagnosed in 19 cases (14%). Domestic mammals were identified as causal agents in 8 patients (6%), drugs in 7 (5%), and environmental allergens in 44 (31%). Household cleaning was the occupation most frequently associated with the disease (26%). Of the 102 patients examined again after 2 years, 70 had chronic asthma (69%). Atopy (odds ratio [OR], 3.39; 95% confidence interval [CI], 1.15-9.99) and risk occupation when the disease was diagnosed (OR, 5.54; 95% CI, 1.05-29.11) were the factors associated with development of chronic disease. CONCLUSIONS: Occupation was related to adult-onset asthma in a little over 10% of the cases and was the main determinant of the development of chronic symptoms
