Asthma :: Spain is below the average European rate for child asthma

Spain is below the average European rate for child asthma, according to research undertaken by the International Study of Asthma and Allergies in Childhood (ISAAC).

Doctor Margarita Fern?ndez Ben?tez, specialist in allergies at the University Hospital of the University of Navarra, a member of the Asthma Committee of the Spanish association of Clinical Immunology and Paediatric Allergy (SEICAP) and a regular participant in international research, has stated that the rate of asthma amongst children in the Spanish population is higher in coastal areas such as Bilbao, Barcelona, Cartagena or Cadiz, than in interior zones such as Pamplona or Valladolid, the index varying between 5.5% and 14.6%.

Asthma is a chronic illness of the respiratory passages, characterised by bronchial inflammation that causes hypersensitivity to a wide range of triggering factors. The presence of these stimuli provokes an increase in the inflammation of the respiratory passages which, in turn, generates an obstruction in the air flow. Symptomatology is variable and reversible.

The onset of coughing on doing physical exercise or hissing sounds from the thorax in children may be the warning signs of incipient asthma. Despite these symptoms being associated with the presence of respiratory illness, for the specialist at the University Hospital of Navarra, ?t is still a pathology that is infradiagnosed.

ISAAC study in three phases

The ISAAC study was carried out in three phases. The first involved the gathering of data ? between 1994 and 1995 – from all over the world, a total of 721,601 children from 56 countries having been studied (463,801 adolescents between 13 and 14 years old and 257,800 children between the ages of 6 and 7. In this first phase of the study, the rate of asthma amongst adolescents was very variable ? between 2.1 and 32.2%, depending on the country. Amongst the countries with this highest index were English-speaking countries and Latin American countries.

The second stage involved the undertaking of objective trials. The third phase was given over to investigating the evolution of the asthma rate in each population under study.

General increase in allergies

From the data culled from the most recent phase of the ISAAC study, 10% of children have suffered from asthma at some time and 7.1% from sibilancy (thoracic noises) over the past 12 months. The rates obtained during phase I were 8.7% of children who has suffered from this respiratory infection at some time while 5.5% had shown sibilancy symptoms during the past 12 months.

The increase in allergic illnesses is generalised worldwide. Amongst the main factors influencing this rise in asthma and sibilancy are environmental conditions and improvements in living conditions, amongst which the hypothesis of the influence of enhanced hygiene is being considered. The study also shows that the presence of asthma is greater in coastal areas than in the interior, while other respiratory illnesses, such as allergic rhinitis, is more frequent amongst populations in the interior.

In general, the rise in allergic illnesses is influenced by environmental and lifestyle factors.

Less smoking

Nevertheless, in the comparative analysis between the data from phase I and that from phase III, the allergy specialist underlines the lower presence of genetic factors amongst children with asthma in this final stage. In this study, the genetic factor was very much to the fore. In phase I the existence of a family history for asthma appeared in 16.3% of the children studied, while in phase III this factor was registered for only 7.3% of the cases. A greater control of asthma amongst adults or ignorance about family antecedents may be the cause of the drop in the rate fue to this factor.

Amongst the other most important risk agents is smoking, the rate also dropping with respect to phase l, where 8.1% of adolescents smoked between 1 and 10 cigarettes a day. In the most up-to-date study, the smokers? rate has dropped to 4.2%, a difference which Dr Fern?ndez Ben?tez believes to be significant. Nonetheless, the percentage of parents smoking has remained similar between the two phases studied. In the two phases of the study, asthma amongst adolescents is significantly associated with smoking.

Apart from this risk factor, we can add the presence of animals ? cats and dogs in the home ? in 95% of children with asthma, their condition worsens if they live with these animals.


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