Seventy years of asthma in Italy: Age, period and cohort effects on incidence and remission of self-reported asthma from 1940 to 2010

Giancarlo Pesce, Francesca Locatelli, Isa Cerveri, Massimiliano Bugiani, Pietro Pirina, Ane Johannessen, Simone Accordini, Maria Elisabetta Zanolin, Giuseppe Verlato, Roberto De Marco

Research output: Contribution to journalArticle

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Abstract

Background: It is well known that asthma prevalence has been increasing all over the world in the last decades. However, few data are available on temporal trends of incidence and remission of asthma. Objective: To evaluate the rates of asthma incidence and remission in Italy from 1940 to 2010. Methods: The subjects were randomly sampled from the general Italian population between 1991 and 2010 in the three population-based multicentre studies: ECRHS, ISAYA, and GEIRD. Individual information on the history of asthma (age at onset, age at the last attack, use of drugs for asthma control, co-presence of hay-fever) was collected on 35,495 subjects aged 20-84 and born between 1925-1989. Temporal changes in rates of asthma incidence and remission in relation to age, birth cohort and calendar period (APC) were modelled using Poisson regression and APC models. Results: The average yearly rate of asthma incidence was 2.6/1000 (3,297 new cases among 1,263,885 person-years). The incidence rates have been linearly increasing, with a percentage increase of +3.9% (95%CI: 3.1-4.5), from 1940 up to the year 1995, when the rates begun to level off. The stabilization of asthma incidence was mainly due to a decrease in the rates of atopic asthma after 1995, while non-atopic asthma has continued to increase. The overall rate of remission was 43.2/1000person-years, and it did not vary significantly across generations, but was associated with atopy, age at asthma onset and duration of the disease. Conclusions: After 50 years of a continuous upward trend, the rates of asthma incidence underwent a substantial stabilization in the late 90s. Despite remarkable improvements in the treatment of asthma, the rate of remission did not change significantly in the last seventy years. Some caveats are required in interpreting our results, given that our estimates are based on selfreported events that could be affected by the recall bias.

Original languageEnglish
Article numbere0138570
JournalPLoS One
Volume10
Issue number10
DOIs
Publication statusPublished - Oct 6 2015

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Cohort Effect
remission
asthma
Italy
Asthma
Stabilization
incidence
Incidence
Pharmaceutical Preparations
Age of Onset
hay fever
atopy
Seasonal Allergic Rhinitis
Drug and Narcotic Control
Population
Multicenter Studies

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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Seventy years of asthma in Italy : Age, period and cohort effects on incidence and remission of self-reported asthma from 1940 to 2010. / Pesce, Giancarlo; Locatelli, Francesca; Cerveri, Isa; Bugiani, Massimiliano; Pirina, Pietro; Johannessen, Ane; Accordini, Simone; Zanolin, Maria Elisabetta; Verlato, Giuseppe; De Marco, Roberto.

In: PLoS One, Vol. 10, No. 10, e0138570, 06.10.2015.

Research output: Contribution to journalArticle

Pesce, G, Locatelli, F, Cerveri, I, Bugiani, M, Pirina, P, Johannessen, A, Accordini, S, Zanolin, ME, Verlato, G & De Marco, R 2015, 'Seventy years of asthma in Italy: Age, period and cohort effects on incidence and remission of self-reported asthma from 1940 to 2010', PLoS One, vol. 10, no. 10, e0138570. https://doi.org/10.1371/journal.pone.0138570
Pesce, Giancarlo ; Locatelli, Francesca ; Cerveri, Isa ; Bugiani, Massimiliano ; Pirina, Pietro ; Johannessen, Ane ; Accordini, Simone ; Zanolin, Maria Elisabetta ; Verlato, Giuseppe ; De Marco, Roberto. / Seventy years of asthma in Italy : Age, period and cohort effects on incidence and remission of self-reported asthma from 1940 to 2010. In: PLoS One. 2015 ; Vol. 10, No. 10.
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abstract = "Background: It is well known that asthma prevalence has been increasing all over the world in the last decades. However, few data are available on temporal trends of incidence and remission of asthma. Objective: To evaluate the rates of asthma incidence and remission in Italy from 1940 to 2010. Methods: The subjects were randomly sampled from the general Italian population between 1991 and 2010 in the three population-based multicentre studies: ECRHS, ISAYA, and GEIRD. Individual information on the history of asthma (age at onset, age at the last attack, use of drugs for asthma control, co-presence of hay-fever) was collected on 35,495 subjects aged 20-84 and born between 1925-1989. Temporal changes in rates of asthma incidence and remission in relation to age, birth cohort and calendar period (APC) were modelled using Poisson regression and APC models. Results: The average yearly rate of asthma incidence was 2.6/1000 (3,297 new cases among 1,263,885 person-years). The incidence rates have been linearly increasing, with a percentage increase of +3.9{\%} (95{\%}CI: 3.1-4.5), from 1940 up to the year 1995, when the rates begun to level off. The stabilization of asthma incidence was mainly due to a decrease in the rates of atopic asthma after 1995, while non-atopic asthma has continued to increase. The overall rate of remission was 43.2/1000person-years, and it did not vary significantly across generations, but was associated with atopy, age at asthma onset and duration of the disease. Conclusions: After 50 years of a continuous upward trend, the rates of asthma incidence underwent a substantial stabilization in the late 90s. Despite remarkable improvements in the treatment of asthma, the rate of remission did not change significantly in the last seventy years. Some caveats are required in interpreting our results, given that our estimates are based on selfreported events that could be affected by the recall bias.",
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AU - Cerveri, Isa

AU - Bugiani, Massimiliano

AU - Pirina, Pietro

AU - Johannessen, Ane

AU - Accordini, Simone

AU - Zanolin, Maria Elisabetta

AU - Verlato, Giuseppe

AU - De Marco, Roberto

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N2 - Background: It is well known that asthma prevalence has been increasing all over the world in the last decades. However, few data are available on temporal trends of incidence and remission of asthma. Objective: To evaluate the rates of asthma incidence and remission in Italy from 1940 to 2010. Methods: The subjects were randomly sampled from the general Italian population between 1991 and 2010 in the three population-based multicentre studies: ECRHS, ISAYA, and GEIRD. Individual information on the history of asthma (age at onset, age at the last attack, use of drugs for asthma control, co-presence of hay-fever) was collected on 35,495 subjects aged 20-84 and born between 1925-1989. Temporal changes in rates of asthma incidence and remission in relation to age, birth cohort and calendar period (APC) were modelled using Poisson regression and APC models. Results: The average yearly rate of asthma incidence was 2.6/1000 (3,297 new cases among 1,263,885 person-years). The incidence rates have been linearly increasing, with a percentage increase of +3.9% (95%CI: 3.1-4.5), from 1940 up to the year 1995, when the rates begun to level off. The stabilization of asthma incidence was mainly due to a decrease in the rates of atopic asthma after 1995, while non-atopic asthma has continued to increase. The overall rate of remission was 43.2/1000person-years, and it did not vary significantly across generations, but was associated with atopy, age at asthma onset and duration of the disease. Conclusions: After 50 years of a continuous upward trend, the rates of asthma incidence underwent a substantial stabilization in the late 90s. Despite remarkable improvements in the treatment of asthma, the rate of remission did not change significantly in the last seventy years. Some caveats are required in interpreting our results, given that our estimates are based on selfreported events that could be affected by the recall bias.

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