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Sundström, J., Söderholm, M., Söderberg, S., Alfredsson, L., Andersson, M., Bellocco, R., . . . Wiberg, B. (2019). Risk factors for subarachnoid haemorrhage: a nationwide cohort of 950 000 adults. International Journal of Epidemiology, Article ID dyz163.
Open this publication in new window or tab >>Risk factors for subarachnoid haemorrhage: a nationwide cohort of 950 000 adults
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2019 (English)In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, article id dyz163Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Subarachnoid haemorrhage (SAH) is a devastating disease, with high mortality rate and substantial disability among survivors. Its causes are poorly understood. We aimed to investigate risk factors for SAH using a novel nationwide cohort consortium.

METHODS: We obtained individual participant data of 949 683 persons (330 334 women) between 25 and 90 years old, with no history of SAH at baseline, from 21 population-based cohorts. Outcomes were obtained from the Swedish Patient and Causes of Death Registries.

RESULTS: During 13 704 959 person-years of follow-up, 2659 cases of first-ever fatal or non-fatal SAH occurred, with an age-standardized incidence rate of 9.0 [95% confidence interval (CI) (7.4-10.6)/100 000 person-years] in men and 13.8 [(11.4-16.2)/100 000 person-years] in women. The incidence rate increased exponentially with higher age. In multivariable-adjusted Poisson models, marked sex interactions for current smoking and body mass index (BMI) were observed. Current smoking conferred a rate ratio (RR) of 2.24 (95% CI 1.95-2.57) in women and 1.62 (1.47-1.79) in men. One standard deviation higher BMI was associated with an RR of 0.86 (0.81-0.92) in women and 1.02 (0.96-1.08) in men. Higher blood pressure and lower education level were also associated with higher risk of SAH.

CONCLUSIONS: The risk of SAH is 45% higher in women than in men, with substantial sex differences in risk factor strengths. In particular, a markedly stronger adverse effect of smoking in women may motivate targeted public health initiatives.

Keywords
Stroke, cohort study, epidemiology
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-162427 (URN)10.1093/ije/dyz163 (DOI)31363756 (PubMedID)
Note

2019-08-22: Epub ahead of print. Granskad. /LiL

Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2019-08-22Bibliographically approved
Jonsson, E., Järvholm, B. & Andersson, M. (2019). Silica dust and sarcoidosis in Swedish construction workers. Occupational Medicine, Article ID kqz118.
Open this publication in new window or tab >>Silica dust and sarcoidosis in Swedish construction workers
2019 (English)In: Occupational Medicine, ISSN 0962-7480, E-ISSN 1471-8405, article id kqz118Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: The aetiology of sarcoidosis is not well established. In previous studies, smoking has been negatively associated with sarcoidosis and there are some indications of an association between exposure to silica dust and sarcoidosis.

AIMS: To study the risk of sarcoidosis in relation to silica dust exposure.

METHODS: A longitudinal cohort of construction workers linked with a registry of Swedish inpatient diagnoses. Workers were designated as exposed or unexposed to silica based on job titles in a job-exposure matrix. The relative risk (RR) was analysed with Poisson regression adjusting for age and smoking.

RESULTS: We identified 371 cases of sarcoidosis among 297 917 male workers. There was an increased risk of sarcoidosis in the medium- to high-exposure group [RR 1.83 (95% confidence interval {CI} 1.14-2.95)]. A stratified analysis according to smoking showed that ever-smoking workers had an increased risk of sarcoidosis if highly exposed to silica dust [RR 2.44 (95% CI 1.37-4.33)] compared to non-exposed ever-smokers. The risk of non-smokers highly exposed to silica was not significantly increased [RR 1.07 (95% CI 0.72-1.58)] compared to non-exposed non-smokers.

CONCLUSION: The study indicates an increased risk of developing sarcoidosis in ever-smoking men exposed to silica.

Keywords
Occupation, occupational health, sarcoidosis, silica, smoking
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-163976 (URN)10.1093/occmed/kqz118 (DOI)31504840 (PubMedID)
Available from: 2019-10-10 Created: 2019-10-10 Last updated: 2019-10-15
Torén, K., Andersson, M., Olin, A.-C., Blanc, P. D. & Järvholm, B. (2018). Airflow limitation classified with the fixed ratio or the lower limit of normal and cause-specific mortality: a prospective study. Respiratory Medicine, 144, 36-41
Open this publication in new window or tab >>Airflow limitation classified with the fixed ratio or the lower limit of normal and cause-specific mortality: a prospective study
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2018 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 144, p. 36-41Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: There is controversy as to whether airflow limitation should be defined as forced expiratory volume in 1 s (FEV1)/vital capacity (VC) < 0.7 or as FEV1/VC< the lower limit of normal (LLN). The aim was to examine whether different definitions of airflow limitation differ in predicting mortality.

METHODS: Longitudinal prospective study of a national cohort of Swedish workers (199,408 men; 7988 women), aged 20-64 years with spirometry without bronchodilation at baseline followed from 1979 until death, or censorship at 2010. Airflow limitation (AL) by Global Obstructive Lung Disease criteria, ALGOLD, was defined as FEV1/VC < 0.7; ALLLN as FEV1/VC < LLN. All all-cause, COPD and cardiovascular disease mortality was analyzed among men and women in relation to ALGOLD and ALLLN, adjusted for age and smoking.

RESULTS: Among men, all-cause mortality risks were similar by airflow limitation criteria: ALGOLD RR = 1.32, 95% CI 1.26-1.38; ALLLN, RR = 1.37, 95% CI 1.31-1.44. The risk estimates were also similar by airflow limitation definition for cardiovascular mortality and for COPD mortality. Among women, all-cause mortality was also similar by airflow limitation criteria, but significantly higher as compared to men: ALGOLD RR = 2.10, 95% CI 1.66-2.66; ALLLN, RR = 2.09, 95% CI 1.66-2.62. Also cardiovascular and COPD mortality by airflow limitation criteria was significantly higher among women as compared to men.

CONCLUSIONS: Defined either as FEV1/VC < 0.7 or as FEV1/VC < LLN, airflow limitation predicted excess mortality risk of similar magnitude. Mortality in relation to airflow limitation was higher among women compared to men.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
COPD, Epidemiology, GOLD, Never smokers, Spirometry, Women
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-153027 (URN)10.1016/j.rmed.2018.10.001 (DOI)000448159000006 ()30366582 (PubMedID)
Available from: 2018-11-02 Created: 2018-11-02 Last updated: 2018-12-07Bibliographically approved
Schyllert, C., Andersson, M., Lindberg, A., Rönmark, E. & Hedman, L. (2018). Childhood asthma affects job and education in young adults. Paper presented at 28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE. European Respiratory Journal, 52
Open this publication in new window or tab >>Childhood asthma affects job and education in young adults
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2018 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 52Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Asthma is associated with socioeconomic status, affects daily life, and school attendance among adolescents. Rhinitis affect job choices, but it is unclear whether asthma in childhood and adolescence affects socioeconomic status (SES) with regard to occupation and education in early adulthood.

Method: In 1996, all children aged 7-8 years (y) in three municipalities in northern Sweden were invited to a parental questionnaire survey, and 97% participated. The cohort was followed up, and 2017 individuals (59% of the original cohort) participated at 7-8, 11-12, 19 and 27-28y. Current asthma was defined as physician diagnosis of asthma with wheeze or use of asthma medication during the last 12 months. Asthma groups: “early-onset, in remission” (asthma at 7-8 or 11-12 y but not at 19y), “early-onset, persistent” (asthma at 7-8 or 11-12 y and at 19 y) and “late-onset” (no asthma at 7-8 or 11-12 y but asthma at 19 y). In multinomial regression analyses adjusted for sex, BMI, smoking habits and family history of asthma, the association between asthma and SES (level of education and occupation) at age 27-28y were analyzed by using never asthma as reference.

Results: Subjects with early-onset persistent asthma had an increased risk of not reaching higher education than primary school (OR 3.54, 95%CI 1.17-10.74), or finishing university studies less than 3 years long (OR 2.05, 95%CI 1.05-4.01) compared with non-asthmatics. They also avoid occupations in the socioeconomic status group of non-manual employees, intermediate level with occupations such as clerks, assistant nurses, police officers, musicians, foremen etc, (OR 0.41 95%CI 0.17-0.99).

Conclusion: Persistent asthma since childhood affected length of education and job choice in early adulthood.

Place, publisher, year, edition, pages
European Respiratory Society, 2018
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-155986 (URN)10.1183/13993003.congress-2018.OA298 (DOI)000455567100194 ()
Conference
28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE
Note

Supplement: 62

Meeting Abstract: OA298

Available from: 2019-02-07 Created: 2019-02-07 Last updated: 2019-02-07Bibliographically approved
Andersson, M., Backman, H., Nordberg, G., Hagenbjörk, A., Hedman, L., Eriksson, K., . . . Rönmark, E. (2018). Early life swimming pool exposure and asthma onset in children: a case-control study. Environmental health, 17, Article ID 34.
Open this publication in new window or tab >>Early life swimming pool exposure and asthma onset in children: a case-control study
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2018 (English)In: Environmental health, ISSN 1476-069X, E-ISSN 1476-069X, Vol. 17, article id 34Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Trichloramine exposure in indoor swimming pools has been suggested to cause asthma in children. We aimed to investigate the risk of asthma onset among children in relation to individual trichloramine exposure.

METHODS: A longitudinal nested case-control study of 337 children with asthma (cases) and 633 controls aged 16-17 years was performed within a population-based cohort from The Obstructive Lung Disease in Northern Sweden studies (OLIN). Year of asthma onset and exposure time at different ages were obtained in telephone interviews. Trichloramine concentrations in the pool buildings were measured. Skin prick test results for inhalant allergens were available from previous examinations of the cohort. The risk for asthma was analyzed in relation to the cumulative trichloramine exposure before onset of asthma.

RESULTS: Swimming pool exposure in early life was associated with a significantly higher risk of pre-school asthma onset. A dose-response relationship between swimming pool exposure and asthma was indicated in children with asthma onset at 1 year of age. Children who were both sensitized and exposed had a particularly high risk.

CONCLUSIONS: Early life exposure to chlorinated swimming pool environments was associated with pre-school asthma onset.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Asthma, Children, Swimming, Trichloramine
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-146654 (URN)10.1186/s12940-018-0383-0 (DOI)000429733700001 ()29642932 (PubMedID)
Available from: 2018-04-16 Created: 2018-04-16 Last updated: 2018-06-09Bibliographically approved
Hedman, L., Backman, H., Stridsman, C., Andersson, M. & Rönmark, E. (2018). Incidence and risk factors for asthma from childhood to young adulthood. Paper presented at 28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE. European Respiratory Journal, 52
Open this publication in new window or tab >>Incidence and risk factors for asthma from childhood to young adulthood
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2018 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 52Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Aim: to estimate the incidence of physician-diagnosed asthma from 7-8 to 27-28 years of age and to study the strength of association with established risk factors by age at asthma onset.

Method: In a longitudinal study about asthma and allergy within the Obstructive Lung Disease in Northern Sweden (OLIN) studies, a cohort of children (n=3430) participated in questionnaire surveys and skin prick tests (SPT) at 7-8, 11-12 and 19y. At age 27-28y n=2088 (76% of invited) completed a postal questionnaire. Factors (sex, family history of asthma, allergic sensitization and in utero exposure to tobacco smoke (ETS)) related to the incidence of asthma at the different ages were analyzed by multinomial logistic regression with ‘never asthma’ as reference.

Results: The incidence rates of physician-diagnosed asthma are presented in Figure 1. The incidence up to age 7-8y was related to allergic sensitization (OR 5.2) and family history of asthma (OR 3.6), and the associations became stronger for the incidence from 7-8 to 11-12y with ORs of 9.8 and 4.0 respectively. However, for the incidence from 11-12 to 19y, these associations became weaker and remained significant only for allergic sensitization (OR 3.0), and incidence after age 19y was not significantly associated with any variables. In utero ETS was a risk factor for the incidence of asthma from 11-12 to 19y (OR 1.6).

Conclusion: The incidence rate of asthma differed by sex: it peaked at age 7-8y for boys and at 19y for girls. Family history of asthma and allergic sensitization were strongly related to the incidence of asthma in childhood up to age 12 years but the strength of association decreased with increasing age.

Place, publisher, year, edition, pages
European Respiratory Society, 2018
Identifiers
urn:nbn:se:umu:diva-155996 (URN)10.1183/13993003.congress-2018.PA1147 (DOI)000455567101216 ()
Conference
28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE
Note

Supplement: 62

Meeting Abstract: PA1147

Available from: 2019-02-07 Created: 2019-02-07 Last updated: 2019-02-07Bibliographically approved
Schyllert, C., Andersson, M., Hedman, L., Ekström, M., Backman, H., Lindberg, A. & Rönmark, E. (2018). Job titles classified into socioeconomic and occupational groups identify subjects with increased risk for respiratory symptoms independent of occupational exposure to vapour, gas, dust, or fumes. European Clinical Respiratory Journal, 5(1), Article ID 1468715.
Open this publication in new window or tab >>Job titles classified into socioeconomic and occupational groups identify subjects with increased risk for respiratory symptoms independent of occupational exposure to vapour, gas, dust, or fumes
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2018 (English)In: European Clinical Respiratory Journal, ISSN 2001-8525, Vol. 5, no 1, article id 1468715Article in journal (Refereed) Published
Abstract [en]

Objectives: To evaluate the ability of three different job title classification systems to identify subjects at risk for respiratory symptoms and asthma by also taking the effect of exposure to vapours, gas, dust, and fumes (VGDF) into account.

Background: Respiratory symptoms and asthma may be caused by occupational factors. There are different ways to classify occupational exposure. In this study, self-reported occupational exposure to vapours, gas, dust and fumes was used as well as job titles classifed into occupational and socioeconomic Groups according to three different systems.

Design: This was a large population-based study of adults aged 30–69 years in Northern Sweden (n = 9,992, 50% women). Information on job titles, VGDF-exposure, smoking habits, asthma and respiratory symptoms was collected by a postal survey. Job titles were used for classification into socioeconomic and occupational groups based on three classification systems; Socioeconomic classification (SEI), the Nordic Occupations Classification 1983 (NYK), and the Swedish Standard Classification of Occupations 2012 (SSYK). Associations were analysed by multivariable logistic regression.

Results: Occupational exposure to VGDF was a risk factor for all respiratory symptoms and asthma (odds ratios (ORs) 1.3–2.4). Productive cough was associated with the socioeconomic groups of manual workers (ORs 1.5–2.1) and non-manual employees (ORs 1.6–1.9). These groups include occupations such as construction and transportation workers, service workers, nurses, teachers and administration clerks which by the SSYK classification were associated with productive cough (ORs 2.4–3.7). Recurrent wheeze was significantly associated with the SEI group manual workers (ORs 1.5–1.7). After adjustment for also VGDF, productive cough remained significantly associated with the SEI groups manual workers in service and non-manual employees, and the SSYK-occupational groups administration, service, and elementary occupations.

Conclusions: In this cross-sectional study, two of the three different classification systems, SSYK and SEI gave similar results and identified groups with increased risk for respiratory symptoms while NYK did not give conclusive results. Furthermore, several associations were independent of exposure to VGDF indicating that also other job-related factors than VGDF are of importance.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
asthma, occupational exposure, socioeconomic status
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-147961 (URN)10.1080/20018525.2018.1468715 (DOI)000432538500001 ()29785256 (PubMedID)
Available from: 2018-05-23 Created: 2018-05-23 Last updated: 2019-05-21Bibliographically approved
Hedman, L., Backman, H., Stridsman, C., Andersson, M., Lindberg, A. & Rönmark, E. (2018). Late Breaking Abstract - E-cigarette use among Swedish teenagers. Paper presented at 28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE. European Respiratory Journal, 52
Open this publication in new window or tab >>Late Breaking Abstract - E-cigarette use among Swedish teenagers
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2018 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 52Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Electronic (e) cigarettes are portrayed as a substitute for conventional cigarettes and as a means for smoking cessation. In contradiction, much of the marketing is designed to appeal to teenagers and nonsmokers. Aim: to estimate the prevalence of e-cigarette use in relation to smoking habits and demographic factors in teenagers. Within the Obstructive Lung Disease in Northern Sweden (OLIN) studies a cohort study of schoolchildren (n=2430) was initiated at age 7-8y, with follow-ups at age 11-12y, 14-15y and 19y by completion of an extended ISAAC questionnaire. Questions on smoking and snus use were included from age 14-15y and use of e-cigarettes at 19y. At age 19y, 22.0% (95%CI 20.3-23.7) had ever tried e-cigarettes, with higher proportion in boys than girls, 28.3 vs 15.2% p<.001. The prevalence of current use was 4.4% (95%CI 3.6-5.2), also higher among boys, 5.4 vs 3.4% p=.01. Current smoking (10.3%) was slightly higher in girls than boys, 11.1 vs 9.0% p=.20. Of current e-cigarette users, 39% were smokers, 22% ex-smokers and 39% nonsmokers. ‘Ever tried’ e-cigarettes was related to tobacco use at age 14-15y: 60.9% in smokers and 50.8% in snus users, however 19.6% of nonsmokers had tried e-cigarettes. In adjusted logistic regression analysis, current e-cigarette use was related to male sex (OR 2.1 95%CI 1.7-2.7), former smoking (OR 3.6 95%CI 2.5-5.3), current smoking (OR 5.3 95%CI 3.9-7.4), use of snus (OR 1.6 95%CI 1.3-2.1) and inversely related to eating healthy diet (OR 0.9 95%CI 0.8-0.9). There were no significant associations with parental smoking, socioeconomic status, physical activity or having asthma. In summary, e-cigarette use was common among smokers but alarmingly almost 40% of e-cigarette users at age 19y were nonsmokers.

Place, publisher, year, edition, pages
European Respiratory Society, 2018
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-155983 (URN)10.1183/13993003.congress-2018.OA5220 (DOI)000455567101011 ()
Conference
28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE
Note

Supplement: 62

Meeting Abstract: OA5220

Available from: 2019-02-07 Created: 2019-02-07 Last updated: 2019-02-07Bibliographically approved
Bunne, J., Moberg, H., Hedman, L., Andersson, M., Bjerg, A., Lundbäck, B. & Rönmark, E. (2017). Increase in allergic sensitization in schoolchildren: two cohorts compared 10 years apart. Journal of Allergy and Clinical Immunology: In Practice, 5(2), 457-463
Open this publication in new window or tab >>Increase in allergic sensitization in schoolchildren: two cohorts compared 10 years apart
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2017 (English)In: Journal of Allergy and Clinical Immunology: In Practice, ISSN 2213-2198, E-ISSN 2213-2201, Vol. 5, no 2, p. 457-463Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Time trends of incidence of allergic sensitization are unknown and recent trends of prevalence and risk factors are lacking.

OBJECTIVE: To estimate the incidence, prevalence, remission, risk factors, and time trends for allergic sensitization among schoolchildren followed from age 7 to 8 years to age 11 to 12 years.

METHODS: In 2006, all children in grades 1 and 2 aged 7 to 8 years in 2 municipalities in northern Sweden were invited to a questionnaire survey and to skin prick testing to 10 common airborne allergens. The cohort was reexamined in 2010, with additional blood sampling for specific IgE. Participation rates were 90% (n = 1700) at age 7 to 8 years and 85% (n = 1657) at age 11 to 12 years. The results were compared with a cohort examined by identical methods 10 years earlier.

RESULTS: The prevalence of positive skin prick test result to any allergen increased from 30% at age 7 to 8 years to 41% at age 11 to 12 years (P < .001). The cumulative 4-year incidence was 18%, while remission was low. Sensitization to pollen and furred animals was most common. A family history of allergy was significantly associated with incident sensitization, whereas the presence of furred animals at home was negatively associated. The prevalence at age 7 to 8 years and at age 11 to 12 years and the 4-year incidence were all significantly higher compared with the cohort examined 10 years earlier.

CONCLUSIONS: The prevalence of allergic sensitization increased by age as a consequence of a high incidence and a low remission. The trends of increasing incidence and prevalence among schoolchildren imply future increases in the prevalence of allergic diseases.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Allergic sensitization, Prevalence, Incidence, Risk factors, Longitudinal study, Schoolchildren
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-128113 (URN)10.1016/j.jaip.2016.09.025 (DOI)000405922600031 ()27838328 (PubMedID)
Available from: 2016-11-23 Created: 2016-11-23 Last updated: 2018-06-09Bibliographically approved
Backman, H., Räisänen, P., Hedman, L., Stridsman, C., Andersson, M., Lindberg, A., . . . Rönmark, E. (2017). Increased prevalence of allergic asthma from 1996 to 2006 and further to 2016: results from three population surveys. Clinical and Experimental Allergy, 47(11), 1426-1435
Open this publication in new window or tab >>Increased prevalence of allergic asthma from 1996 to 2006 and further to 2016: results from three population surveys
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2017 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 47, no 11, p. 1426-1435Article in journal (Refereed) Published
Abstract [en]

Background: During the latter half of the 20th century, the prevalence of asthma and many other allergic diseases has increased. Information on asthma prevalence trends among adults after 2010, especially regarding studies separating allergic asthma from non-allergic asthma, is lacking.

Objective: The aim was to estimate prevalence trends of current asthma among adults, both allergic and non-allergic, from 1996 to 2016.

Methods: Three cross-sectional samples from the same area of Sweden, 20-69 years, participated in surveys with the same questionnaire in 1996 (n=7104 participants, 85% response rate), 2006 (n=6165, 77%) and 2016 (n=5466, 53%), respectively. Allergic rhino-conjunctivitis (ARC) was used as a marker for allergic sensitization to define allergic asthma.

Results: The prevalence of current asthma increased from 8.4% (95% CI: 7.8-9.0) in 1996 to 9.9% (95% CI: 9.2-10.6) in 2006 and 10.9% (95% CI: 10.1-11.7) in 2016 (P<.001). Allergic asthma increased from 5.0% (95% CI: 4.5-5.5) in 1996 to 6.0% (95% CI: 5.4-6.6) in 2006 and further to 7.3% (95% CI: 6.6-8.0) in 2016 (P<.001), while the prevalence of non-allergic asthma remained stable around 3.4%-3.8%. The increase in current asthma was most pronounced among women and among the middle-aged. Physician-diagnosed asthma, asthma medication use and ARC also increased significantly, while the prevalence of symptoms common in asthma such as wheeze and attacks of shortness of breath decreased slightly or was stable. The prevalence of current smoking decreased from 27.4% in 1996 to 12.3% in 2016.

Conclusions and clinical relevance: The prevalence of allergic asthma increased from 1996 to 2006 and further to 2016, while the prevalence of non-allergic asthma remained on a stable prevalence level. The prevalence of symptoms common in asthma decreased slightly or was stable despite a substantial decrease in the prevalence of current smoking. Clinicians should be aware that the previously observed increase in prevalence of allergic asthma is still ongoing.

Keywords
asthma, epidemiology, rhinitis
National Category
Occupational Health and Environmental Health Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-140682 (URN)10.1111/cea.12963 (DOI)000416493200009 ()28608416 (PubMedID)
Available from: 2017-10-16 Created: 2017-10-16 Last updated: 2018-06-09Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7222-6402

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