Dictionary of Allergies .. Asthma mortality

Studies have suggested increases in hospitalization for asthma and in asthma mortality during the early 1980s. Weiss and Wagener using U.S.[1] Vital Records, examined asthma mortality from 1968 through 1987 to describe the rates of change among children and young adults (aged 5 to 34 years) with time and in small geographic areas. During the 1970s, U.S. asthma mortality declined by 7.8% per annum (+-1.0%), declining faster among women and nonwhites. During the 1980s, mortality increased by 6,2% per annum (+-1,2%), increasing faster among those aged 5 to 14 years than among those aged 15 to 34 years.

Small-area geographic analysis revealed four areas with persistently high asthma mortality. Neither changes in international classification of diseases coding nor improved recognition of asthma, as demonstrated by trends in autopsy rates or rates of in-hospital deaths, seems to explain the increasing mortality to the 1980s. Despite better understanding of pathophysiology and improved treatment protocols for allergic diseases, overall morbidity and even mortality rates of asthma have increased in the last two decades (Woolcock, 1997).  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.

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[3]

1. Weiss, K.B., Wagener, D.K.: Changing patterns of asthma mortality.

JAMA (1990) 264, No. 13, p. 1683-1687.

2. Woolcock AJ. Learning from asthma deaths. BMJ 1997;314:1427-1428.

3. Wijesinghe M, Weatherall M, Perrin K, Crane J, Beasley R. International trends in asthma mortality rates in the 5- to 34-year age group: a call for closer surveillance. Chest. 2009 Apr;135(4):1045-9