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Clinical Commentary |

International Trends in Asthma Mortality Rates in the 5- to 34-Year Age Group: A Call for Closer Surveillance

Meme Wijesinghe, BSc, MBBS; Mark Weatherall, MApplStats; Kyle Perrin, MBChB; Julian Crane, MBBS; Richard Beasley, DSc
Author and Funding Information

*From the Medical Research Institute of New Zealand (Drs. Wijesinghe, Perrin, and Beasley), Wellington, New Zealand; and the Department of Medicine (Drs. Weatherall and Crane), University of Otago Wellington, Wellington, New Zealand.

Correspondence to: Richard Beasley, DSc, Medical Research Institute of New Zealand, PO Box 10055, Wellington 6143, New Zealand; e-mail: Richard.Beasley@mrinz.ac.nz


Dr. Beasley has been a member of the GlaxoSmithKline and Novartis International Advisory Boards and has received research funding from GlaxoSmithKline, Novartis, and MedSafe (New Zealand government). No conflict of interest exists for the other authors.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2009;135(4):1045-1049. doi:10.1378/chest.08-2082
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Background:  International time trends in asthma mortality have played an important sentinel role in the identification of two epidemics of asthma mortality in some countries in the 1960s and the 1970s and 1980s. Since then, little attention has been paid to the ongoing international time trends.

Methods:  Country-specific data on asthma mortality rates since 1960 in the 5- to 34-year-old age group were collated. To be included in the analysis, countries were required to have data available prior to 1980. A scatter plot smoothing technique was used to model the change in asthma mortality rates with time.

Results:  Asthma mortality rates from 20 countries were included in the analysis. An increase in asthma mortality rates was found in the 1960s, with a mean increase of 53% from 0.55 per 100,000 in 1960 and 1961 to a peak of 0.84 in 1966 and 1967. This trend was followed by a progressive decline to a nadir of 0.45 per 100,000 in 1974 and 1975. A gradual increase was then found in asthma mortality rates to a peak of 0.62 per 100,000 in 1985 and 1986, with a mean increase of 38% during this period. Since the late 1980s, there has been a widespread and progressive reduction in mortality rates to a level of 0.23 per 100,000 in 2004 and 2005, with a mean reduction of 63% during this period.

Conclusions:  The widespread increase in asthma mortality in the 1980s and the subsequent, even greater reduction has largely gone unrecognized. We propose that awareness of such trends and their causes is important and that they are investigated contemporaneously.

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