Vol. 490 No. 4
6 Dr. Upton asked the Minister for Health and Children if he will report on the incidence of asthma, recent trends in this regard, comparison with EU rates, and his views on the underlying causes of these levels among Irish people. [10270/98]
In the past, precise medical diagnosis of asthma was problematic as the term was frequently used to cover a range of respiratory conditions, including bronchitis. In addition, asthma is not a notifiable disease as it is not an infectious disease within the meaning of the Health Act, 1947. For these reasons comparative epidemiological data on asthma have not been available to date. However, studies have commenced on Irish prevalence using internationally agreed protocols which will allow for further comparisons of Irish figures with other countries worldwide.
A study by the European Community Respiratory Health Survey was published in the European Respiratory Journal 1996 on the variations in the prevalence of respiratory symptoms, self-reported asthma attacks and use of asthma medication in 48 centres, predominantly in western Europe. This study showed that the prevalence of all symptoms varied widely. Although generally lower in northern, central and southern Europe and higher in the UK, Ireland, New Zealand, Australia and the United States, there were wide variations even within some countries. A 1995 study, employing the ISAAC protocol — the international study on asthma and allergies in children — found a prevalence of asthma of 15.2 per cent in children aged between 13 and 14 years in this country.
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 among Irish adults who had physician diagnosed asthma — PDA — and 2.2 per cent receiving active treatment for PDA. However, the relatively low response rate of 43 per cent obtained for this survey makes it difficult to interpret these results with a high degree of confidence. A prevalence rate of 11.9 per cent is reported in a study of asthma in the four to 19 year old age group, published in the January-February 1996 issue of the Irish Medical Journal.
There is evidence to suggest that the prevalence of asthma is increasing internationally. Some of this increase reflects a change in diagnostic practice while some represents a real increase in the condition. The reasons for the increase are unclear, as asthma is caused by an interplay of genetic and environmental factors. The environmental factors include motor vehicle pollution, the house dust mite, dietary changes and cigarette smoke.
Worldwide research into the causes of asthma is ongoing.
Yet again the Department of Health and Children does not have adequate information or data on serious issues. Is the Minister aware of a recent study published in The Lancet which found that children in Ireland and Great Britain are more likely to suffer from asthma than children in almost any other part of the world? He quoted the 15 per cent prevalence figure found by an international study carried out in 1995. Many doctors have recently expressed concern about the increasing high incidence of asthma and teachers claim it is commonplace for children to have inhalers in school on a regular basis.
I am disappointed the Minister does not have data on this matter. The anecdotal evidence and research data to which I referred point to a high incidence, but I want to know if this is the case. We must examine the reasons for the high incidence. The Minister trotted off the usual textbook reasons for the causes of asthma. My question asked for his views on the high prevalence of asthma among Irish people. Does he intend to undertake research on the underlying causes? Asthma is a very debilitating and disabling condition. It is also extremely costly for families and for the State. What is the Minister doing about this?
With respect, I am answering the Deputy's question.
Not very well.
I am sorry if the Deputy finds the results disappointing, but she asked me to report the incidence of asthma. I gave four examples. The recent trends are incorporated in my reply. I have made comparisons with rates in the US, Australia and New Zealand as well as the UK. As to the underlying causes, I do not claim to have medical expertise in this area. The Minister of State, Deputy Moffatt, told me that all cases of wheezing do not necessarily mean a diagnosis of asthma.
Is the Minister saying there is not a problem?
If the Deputy wanted a detailed, on-the-spot front line approach, perhaps Deputy Moffatt, as a medical practitioner, should have taken the question.
The Minister had a few days' notice.
I am not trotting off textbook data, I am explaining, on a scientific rather than anecdotal basis, the position regarding the prevalence of asthma among a number of age groups found in scientific studies which involved international comparisons. That answered the Deputy's question. The Deputy wants to know what I intend to do about this issue I do not intend to do anything more, but that does not mean I do not regard it as a serious issue. I am not aware of the work being done in this area, but the results may be published shortly. To alleviate the Deputy's concerns, I will endeavour to find out the research that is currently taking place, which may indicate the matter is being scientifically examined nationally and internationally. I cannot give the Deputy any more information at present.
Is the Minister concerned about the prevalence of asthma?
Of course I am. Many of the constituents who contact me about medical cards have asthma. I have been a Member of the House for the past 15 years and I am well aware of these issues. The Deputy asked about the objective scientific assessments being done in my Department on the prevalence of asthma. I have outlined them as well as giving international comparisons. I am not suitably qualified to go beyond that remit. If the Deputy wishes to raise other issues, she should table another parliamentary question and I will get the relevant information.
Does the Minister agree it a matter of concern that the studies highlight a greater prevalence of asthma in Ireland and on the British Isles than in many other countries? Australia and New Zealand are the only other countries that appear to have similar levels, but we do not know the reasons for this. Is that not worthy of specific research — if it is not already being done — by this country in conjunction with a group from Great Britain or even a broader group comprising representatives from New Zealand, Australia, Great Britain and Ireland, the countries with the greatest prevalence of asthma?
I presume ongoing research is being carried by specialists in this field. The best I can do now is to outline the research that is being carried out and when it might be completed.
Perhaps it would be advantageous to consider the possibility of a joint research project involving the countries to which I referred.
I will note the Deputy's suggestion and communicate with him in that regard.
