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

呼吸系统疾病很常见，哮喘症状影响了澳大利亚社区15%的成年人和30%的儿童。慢性阻塞性肺疾病（COPD）也很常见。这个词包括肺气肿和支气管炎，主要是由吸烟引起的。虽然慢性阻塞性肺病不像哮喘那么常见，但它会导致更多的持续性残疾，尤其是在老年人中。哮喘与肺功能随年龄的快速下降有关，并可能最终导致慢性阻塞性肺病。哮喘的诊断已经变得越来越普遍，尤其是在儿童中，尽管这可能是由于意识的提高和现有的治疗方法。在过去10年中，成人哮喘和慢性阻塞性肺病患病率的变化鲜为人知。这些气道疾病与气道炎症和气道结构改变有关。自1966年以来，在西澳大利亚西南部的沿海城镇Busselton多次使用肺功能和气道反应性测试，以提供有关气道结构（口径）变化的信息。最近已经发展出可以提供炎症证据的非侵入性检查。虽然治疗哮喘可以控制症状和改善肺功能，但气道炎症往往持续存在。在社区中没有呼吸道症状的人的呼吸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年的估计相比，Busselton人口中哮喘和COPD的频率是否确实在增加。它将确定社区中存在的未被识别的气道炎症的程度以及检测它的最佳方法。这项研究的结果将有助于寻找哮喘的原因，确定社区中气道炎症的问题有多大，以及它与气道结构异常、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.