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Abstract

Objectives — To study whether asthma and allergic rhinitis had increased from 1977 to 1991 and if so, in which subpopulations; to study if structural changes of the society or change in the genetic susceptibility of the population could explain the increase.

Design — Cross-sectional surveys with mailed questionnaires in 1977, 1979 and 1991, data from 1977 and 1979 combined; national mortality statistics.

Setting — Finland.

Subjects — A nationwide sample of 12-, 14-, 16- and 18-year-olds. Sample sizes were 4335 and 3059, response rates 88% and 77%. Mortality statistics from 1958 to 1990.

Main outcome measures — Point prevalence rate (%) of self-reported, physician-diagnosed asthma and allergic rhinitis, susceptibility of the population measured by probability of respiratory death.

Results — Prevalence of asthma was 1.0% in 1977–1979 and 2.8% in 1991, that of allergic rhinitis 5.0% and 14.9%. Logistic regression analysis showed that the increase did not differ in socio-demographic subgroups or parents' smoking groups and that changes in the distribution of socio-demographic variables did not explain the difference either. Respiratory deaths in ages 0–4 were fewer in the birth cohorts measured in 1991.

Conclusions — Physician-diagnosed asthma and allergic rhinitis increased three-fold among Finnish adolescents in 1977–1991. Factors which explain the increase affected all subgroups similarly. Such factors could be changes in diagnostic practices and indoor air quality. Increased susceptibility could explain only a small part. It is likely that a major part of this considerable increase is real.

Keywords

Asthma allergic rhinitis adolescents time trend

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Asthma and Allergic Rhinitis among Finnish Adolescents in 1977–1991

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