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

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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.