Dáil Éireann debate -
Thursday, 26 Sep 1996

Vol. 469 No. 2

Written Answers. - Asthma in Ireland.

Peadar Clohessy

Question:

20 Mr. Clohessy asked the Minister for Health the incidence of asthma in the population; whether the condition is on the increase in Ireland; the research, if any, being carried out into its causes and its treatment; whether the incidence of asthma is higher in some areas of the country; and if he will make a statement on the matter. [16965/96]

Trevor Sargent

Question:

64 Mr. Sargent asked the Minister for Health when he will provide a national asthma register. [17063/96]

Minister for Health (Mr. Noonan,

Limerick East): I propose to take Questions Nos. 20 and 64 together.

Precise medical diagnosis of asthma can often be problematic, and the term is frequently used to cover a range of respiratory conditions including bronchitis. In addition, asthma is not a notifiable disease. For these reasons, national figures on the prevalence of asthma in the community are not available.

The establishment of the new public health departments in the health boards, with their emphasis on epidemiology, will greatly improve the level and quality of information on all diseases and conditions, including asthma, in each local area. Accordingly, I have no plans to establish a national asthma register.

The results of a three-year study of asthma funded by the Health Research Board as part of an EU concerted action programme are currently being finalised prior to publication. Provisional results indicate an increase in asthma prevalence rates in the Dublin area between 1991 and 1995. It was not possible to ascertain trends in rural prevalence rates since the study of rural areas was confined to 1993. After controlling for age structure, smoking and other factors, no significant difference was found between urban and rural prevalence rates.

The Health Research Board is also involved in an international collaborative research project on asthma called ISAAC, International Study on Asthma and Allergies in Children. The Irish component of the study is based on a representative survey of more than 3,000 school children throughout the country aged 13 to 14 years. Preliminary results were presented at the European Respiratory Society Annual Congress, Stockholm, Sweden in September this year. Based on preliminary figures, the results suggest an increasing prevalence with a current rate of 15.2 per cent in this age group, but show no significant difference between urban and rural areas.

Further research, carried out under the auspices of the Department of Respiratory Medicine in James Connolly Memorial Hospital, obtained an estimate of 5.0 per cent prevalence of Irish adults who had physician diagnosed asthma and 2.2 per cent receiving active treatment for PDA. No significant inter-county differences were observed. The results, based on a postal questionnaire, were published in the Journal of the Irish College of Physicians and Surgeons in October 1994. The relatively low response rate obtained for this survey, (43 per cent), makes it difficult to interpret these results with a high degree of confidence.

In a recent study of asthma in the 4-19 year old age group, published in the January-February 1996 issue of theIrish Medical Journal, a prevalence rate of 11.9 per cent is reported. This compares with a rate of 4.4 per cent from a similar study conducted in 1983-1984. The prevalence of asthma was not found to be significantly different between urban and rural areas in this age group.

National results from the Hospital In-Patient Enquiry, HIPE, can be used to compute asthma hospitalisation rates by age group and urban/rural area of residence. An analysis of the figures for the years 1993, 1994 and 1995 indicate a concentration of asthma prevalence in the 0-14 years age-group and there is some evidence of an increased rate of hospitalisation for urban areas. No overall trend in rates over the three years is evident.

The above studies, together with other international studies, would appear to suggest an increased prevalence of asthma. This research would also suggest that the reported increase in prevalence may be due to some extent to earlier recognition of symptoms by clinicians and a relabelling of other respiratory symptoms.