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Fewer colds, less asthma? A hypothesis to explain the fall in childhood asthma in the UK

D S Urquhart1, A-K Anderson, S A McKenzie

  • 1Department of Paediatric Respiratory Medicine, Level 2, Fielden House, Royal London Hospital, Whitechapel, London E11BB, UK.

Journal of Epidemiology and Community Health
|September 16, 2008
PubMed

Insights

UK asthma prevalence decreased significantly from 1993-2000, with notable drops in hospital admissions and primary care visits for children. This decline in asthma may be linked to reduced respiratory infections, possibly due to smaller household sizes limiting virus transmission.

Area of Science:

  • Epidemiology
  • Public Health
  • Respiratory Medicine

Background:

  • Asthma prevalence in the UK experienced a significant decline between 1993 and 2000.
  • Concurrently, there were observed reductions in hospital admissions and primary care consultations for asthma, particularly in children.
  • This period also saw a decrease in acute respiratory infections and common cold consultations across all age groups.

Purpose of the Study:

  • To investigate the potential correlation between the declining prevalence of asthma and the observed reduction in respiratory infections.
  • To explore the hypothesis that smaller household sizes may contribute to decreased virus transmission, impacting asthma exacerbations.
  • To highlight the need for future asthma research to account for the influence of changing respiratory virus burden.

Main Methods:

  • Analysis of UK asthma prevalence data from 1993-2000.
  • Examination of hospital admission and primary care consultation data for asthma and respiratory infections.
  • Review of data on respiratory syncytial virus (RSV) notifications.
  • Consideration of demographic data on UK birth rates and living conditions.

Main Results:

  • Asthma hospital admissions in children under 5 fell by 52%.
  • Primary care presentations for asthma in children under 14 decreased by over 40%.
  • Consultations for acute respiratory infections dropped by 36%, and for the common cold by 46% (1994-2000).
  • Respiratory syncytial virus isolates decreased by 56% (1993-2003).

Conclusions:

  • The observed fall in UK asthma prevalence is hypothesized to be linked to a reduction in respiratory infections.
  • Decreased virus transmission, potentially due to smaller household sizes, may be a contributing factor to lower asthma exacerbations.
  • Future research on asthma prevalence should incorporate the impact of evolving respiratory virus burdens within populations.

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