Dáil Éireann díospóireacht -
Tuesday, 25 Jun 1996

Vol. 467 No. 4

Written Answers. - Asthma Prevalence.

Peter Barry

Ceist:

109 Mr. Barry asked the Minister for Health the number of sufferers of asthma recorded in each of the years 1975, 1985 and 1995; the areas of the country that showed the biggest increase; and the statistics, if any, available to indicate the areas where there are more likely to be sufferers, such as urban-rural, inland-seaboard, suburbscity centre, houses-apartment and so on. [13499/96]

Minister for Health (Mr. Noonan,

Limerick East): Precise medical diagnosis of asthma can often be problematic, and the term is frequently used to cover a range of respiratory conditions including bronchitis. In addition, asthma is not a notifiable disease, and most cases are treated by general practitioners rather than in hospitals. For these reasons, national figures on the prevalence of asthma in the community are not available.

The results of a three-year study of asthma funded by the health research board as part of an EU Concerted Action Programme are currently being finalised prior to publication. Provisional results indicate the increase in asthma prevalence rates in the Dublin area between 1991 and 1995. It was not possible to ascertain trends in rural prevalence rates since the study of rural areas was confined to 1993. After controlling for age structure, smoking and other factors, no significant difference was found between urban and rural prevalence rates.

The health research board is also involved in an international collaborative research project on asthma called ISAAC — International Study on Asthma and Allergies in Children. The Irish component of the study is based on a representative survey of 3,000 school children aged 13 to 14 years, and the results are due for publication later this year. Based on preliminary figures, the results suggest an increasing prevalence and a current rate of 15.2 per cent but show no significant difference between urban and rural areas.

Further research, carried out under the auspices of the Department of Respiratory Medicine in James Connolly Memorial Hospital, obtained an estimate of 5 per cent prevalence of Irish adults who had physician diagnosed asthma and 2.2 per cent receiving active treatment for PDA. No significant intercounty differences were observed. The results, based on a postal questionnaire, were published in the Journal of the Irish College of Physicians and Surgeons in October 1994. The relatively low response rate obtained for this survey, 43 per cent, makes it difficult to interpret these results with a high degree of confidence.

In a recent study of asthma in 4-19 year old school children published in the January-February 1996 issue of the Irish Medical Journal, a prevalence rate of 11.9 per cent is reported. This compares with a rate of 4.4 per cent from a similar study conducted in 1983-1984. The prevalence of asthma was not found to be significantly different between urban and rural children.

National results from the Hospital In-Patient Enquiry, HIPE, can be used to compute asthma hospitalisation rates by age group and urban-rural area of residence. These figures for the years 1993, 1994 and 1995 are set out in the following table. Prior to 1992, HIPE coverage is not sufficiently complete or consistent for analysis of hospitalisation rates. In the interpretation of HIPE data, it should be noted that information is not available from private hospitals and, in addition, that a person attending hospital several times in a given year is counted separately in the statistics for each visit. The figures reported as follows give discharge rates per 100,000 population where asthma has been recorded as the principal diagnosis. From this analysis, the concentration of asthma prevalence in the youngest agegroup is apparent and there is some evidence of an increased rate of hospitalisation for urban areas. No overall trend in rates over the three years is evident.

Asthma Hospitalisation Rates per 100,000 Population, 1993 to 1995

Age Groups	1993	1994	1995
Urban	Rural	Total	Urban	Rural	Total	Urban	Rural	Total
0-14	581.3	461.8	501.9	472.8	429.7	444.2	537.0	441.6	473.7
15-44	148.6	115.3	128.5	124.6	110.1	115.9	121.9	128.3	125.7
45-64	184.6	170.1	175.5	172.5	162.4	166.2	168.2	150.1	156.8
65+	184.2	162.8	169.5	158.2	166.8	164.1	162.1	192.1	182.7
Total	264.1	227.8	241.1	221.4	215.7	217.8	235.4	227.7	230.5

Source: Hospital In-Patient Enquiry