European Community Respiratory Health Survey (ECRHS II)

Professor Michael Abramson · Dr Frank Thien · Professor Haydn Walters

This is a follow-up study which involved 638 adults in Melbourne who originally took part in a similar study in 1992. Data collection was completed in early 2000. The aim of this study is to determine whether there have been any changes in the prevalence of asthma and other respiratory diseases. The study is being conducted in conjunction with approximately 28 other centres worldwide (mainly in Europe). Participants completed a respiratory questionnaire, performed simple breathing and allergy tests and information was gathered on quality of life. Some participants were visited in their home for collection of dust and air samples in order to examine the environmental risk factors for asthma. This information is to be used to further examine the risk factorsr associated with asthma.

One component investigated Quality of Life (QoL) in asthma defined by differing criteria, to see which may be most appropriate in epidemiological studies.

Methods: The 426 adults were participants in the follow-up phase of the European Community Respiratory Health Survey (ECRHS) in Melbourne. As part of the laboratory visit, participants completed the SF-36 Quality of Life questionnaire, a detailed respiratory questionnaire and underwent lung function testing and a methacholine challenge test for bronchial hyperreactivity (BHR).

Results: Both the physical component summary (PCS) and the mental component summary (MCS) scores were significantly worse in those with wheeze in the last 12 months compared to those without wheeze. Only the MCS was significantly worse in those with current asthma compared to those without. While for those with only BHR, neither of the summary scales were significantly different between those with BHR alone and those without.

Conclusions: QoL is severely impaired in individuals with wheeze in the last 12 months. While individuals with current asthma or BHR alone did not appear to have significantly reduced QoL.

The National Asthma Campaign (NAC) was launched in Australia in 1990 with the major objective of improving asthma management through the implementation of a six-step asthma management plan.

Aim: The objective of this study was to analyse the management of asthma in a cohort of adults with self-reported asthma a decade since the commencement of the National Asthma Campaign (NAC).

Methods: The subjects were participants in the laboratory phase of a cross-sectional epidemiological study conducted in Melbourne in 1999/2000. Participants completed the detailed European Community Respiratory Health Survey (ECRHS) which included questions specifically about their asthma management. Participants were included in this analysis if they had a positive response to question “Have you ever had asthma”, resulting in a total of 435 subjects.

Results: Of the subjects with self-reported asthma, over half of participants reported a doctor had ever measured their breathing (52.9%). While only 10.1% reported they owned a peak flow meter and only 13.3% reported they had ever been given a written action plan. In comparison with data reported from 1993, doctor measurement of lung function has decreased significantly (p<0.0001), as has peak flow meter ownership (p<0.0001) and importantly possession of a written action plan (p=0.0004).

Conclusions: Asthma management among adults still falls well short of NAC guidelines. The decline in some key features over recent years suggests that new management and dissemination strategies are required.

Papers published:

Wood RK, Abramson M, Bailey M, Walters EH. International prevalence of reported food allergies and intoleances. Comparisons arising from the European Community Respiratory Health Survey (ECRHS) 1991-1994. Eur J Clin Nutr 2001;55:298-304.

Matheson M, Raven J, Woods RK, Thien F, Walters EH, Abramson M. Quality of life in young adults with asthma. Thorax 2002;57:165-167

Matheson M, Wicking J, Raven J, Woods R, Thien F, Walters EH, Abramson M. Asthma management: how effective is it in the community? Int Med J. 2002 (In press)