THE CHANGING PREVALENCE OF ASTHMA AND CHRONIC OBSTRUCTIVE AIRWAY DISEASE IN AUSTRALIA

呼吸系统疾病很常见，哮喘症状影响澳大利亚社区高达15%的成年人和30%的儿童。慢性阻塞性肺疾病（COPD）也很常见。该术语包括肺气肿和支气管炎，主要是由于吸烟。虽然慢性阻塞性肺病不像哮喘那么常见，但它会导致更持久的残疾，特别是在老年人中。哮喘与肺功能随年龄增长而更快下降有关，也可能最终导致COPD。哮喘的诊断已经变得越来越普遍，特别是在儿童中，尽管这可能是由于意识的提高和可用的治疗。在过去的10年里，人们对成人哮喘和COPD患病率的变化知之甚少。这些气道疾病与气道炎症和气道结构变化有关。自1966年以来，肺功能和气道反应性测试已在西澳大利亚西南部的沿海城镇布塞尔顿反复使用，以提供气道结构（口径）变化的信息。最近，已经开发出可以提供炎症证据的非侵入性测试。虽然哮喘的治疗可以控制症状并改善肺功能，但气道炎症往往会持续存在。在社区中没有抱怨呼吸道症状的人的气道中存在炎症和异常结构的程度尚不清楚。这项研究将确定与过去35年的估计值相比，布塞尔顿人群中哮喘和COPD的频率是否实际上在增加。它将确定未被识别的气道炎症在社区中存在的程度以及检测它的最佳方法。研究结果将有助于寻找哮喘的原因，确定气道炎症在社区中的严重程度，以及它与异常气道结构，肺功能，气道反应性和呼吸道症状的关系。

Respiratory illnesses are common with asthma symptoms affecting up to 15% of adults and 30% of children in the Australian community. Chronic obstructive pulmonary disease (COPD) is also common. The term encompasses emphysema and bronchitis and is mainly due to cigarette smoking. Although COPD is less common than asthma it causes more persistent disability especially in older people. Asthma is associated with faster decline in lung function with age and may also ultimately cause COPD. A diagnosis of asthma has become more common especially in children although this may be due to increased awareness and available treatments. Less is known about changes in the prevalence of asthma and COPD in adults over the last 10 years. These airway diseases are associated with inflammation in the airways and changes in airway structure. Tests of lung function and airway responsiveness have been used repeatedly in Busselton a coastal town in the south west of Western Australia since 1966 to provide information on changes in airway structure (calibre). Recently non invasive tests that can provide evidence of inflammation have been developed. Although treatment of asthma can control symptoms and improve lung function, airway inflammation tends to persist. The extent to which inflammation and abnormal structure are present in the airways of people in the community who do not complain of respiratory symptoms is not known. This study will determine if the frequency of asthma and COPD are actually increasing in the population of Busselton in comparison to previous estimates over the past 35 years. It will determine the degree to which unrecognised airway inflammation is present in the community and the best ways of detecting it. The results of the study will help to look for causes of asthma, determine how big a problem airway inflammation is in the community, and how it relates to abnormal airway structure, lung function, airway responsiveness and respiratory symptoms.