Original Articles
Incidence and Characteristics of Adult-Onset Asthma
Xavier Casasa, Eduard Monsóa,b,
, Xavier Orpellac, Ramona Hervása, Josep Anton Gonzálezc, Elisabeth Arellanoa, Carlos Martíneza, Gerardo Martínezd, Àlex Ascosad, Jesús Comínd, Rafael Ruizd, Berta Monsóe, Irma Casasf, Maria Estevef, Josep Moreraa
Corresponding author
emonso.germanstrias@gencat.cat
Correspondence: Dr E. Monsó Servei de Pneumologia, Hospital Germans Trias i Pujol Ctra. del Canyet, s/n 08916 Badalona, Barcelona, Spain
Correspondence: Dr E. Monsó Servei de Pneumologia, Hospital Germans Trias i Pujol Ctra. del Canyet, s/n 08916 Badalona, Barcelona, Spain
a Servei de Pneumologia, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
b Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, Spain
c Unidad de Salud Laboral Barcelonés Nord i Maresme, Badalona, Barcelona, Spain
d Àreas Bàsiques de Salut del Barcelonés Nord i Maresme, Badalona, Barcelona, Spain
e Universitat Pompeu Fabra, Barcelona, Spain
f Servei de Medicina Preventiva, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
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"identificador" => "aff1" ] ] ] ] "afiliaciones" => array:6 [ 0 => array:3 [ "entidad" => "Servei de Pneumologia, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Unidad de Salud Laboral Barcelonés Nord i Maresme, Badalona, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] 3 => array:3 [ "entidad" => "Àreas Bàsiques de Salut del Barcelonés Nord i Maresme, Badalona, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] 4 => array:3 [ "entidad" => "Universitat Pompeu Fabra, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff5" ] 5 => array:3 [ "entidad" => "Servei de Medicina Preventiva, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff6" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr E. Monsó Servei de Pneumologia, Hospital Germans Trias i Pujol Ctra. del Canyet, s/n 08916 Badalona, Barcelona, Spain" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-07-03" "fechaAceptado" => "2008-02-19" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155393" "palabras" => array:9 [ 0 => "Asthma" 1 => "Adult-onset asthma" 2 => "Incidence" 3 => "Occupational asthma" 4 => "Household cleaning" 5 => "Course" 6 => "Chronic asthma" 7 => "Atopy" 8 => "Occupation" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155394" "palabras" => array:9 [ 0 => "Asma" 1 => "Asma del adulto" 2 => "Incidencia" 3 => "Asma relacionada con el trabajo" 4 => "Limpieza doméstica" 5 => "Evolución" 6 => "Asma crónica" 7 => "Atopia" 8 => "Ocupación" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To determine the incidence of adult-onset asthma, along with lung function and immunologic characteristics, causes, and clinical course of the disease.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">After identifying incident cases of asthma among adult residents of the district of North Barcelona, Spain, we proceeded to characterize the disease using a questionnaire, lung function tests, and skin allergy tests. Patients with an occupation associated with asthma, wheezing at work, and/or sensitization to workplace allergens were considered as having occupational asthma. The risk factors for developing chronic asthma were determined by multivariate analysis.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">In the 2-year study period, 218 incident cases of adult-onset asthma were identified (in a population of 68 067 adults, corresponding to an annual incidence of 160 per 100 000 per year). In total, 152 patients agreed to participate in the study (response rate, 70%); 140 reported wheezing and/or asthma in the last year (92%). The skin tests showed atopy in 57 cases (41%). Occupational asthma was diagnosed in 19 cases (14%). Domestic mammals were identified as causal agents in 8 patients (6%), drugs in 7 (5%), and environmental allergens in 44 (31%). Household cleaning was the occupation most frequently associated with the disease (26%). Of the 102 patients examined again after 2 years, 70 had chronic asthma (69%). Atopy (odds ratio [OR], 3.39; 95% confidence interval [CI], 1.15–9.99) and risk occupation when the disease was diagnosed (OR, 5.54; 95% CI, 1.05–29.11) were the factors associated with development of chronic disease.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Occupation was related to adult-onset asthma in a little over 10% of the cases and was the main determinant of the development of chronic symptoms.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Determinar la incidencia del asma del adulto, junto con las características funcionales e inmunológicas de la enfermedad, sus causas y su evolución.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Tras la identificación de los habitantes de Barcelona Norte con un primer diagnóstico de asma del adulto, se procedió a la caracterización de la enfermedad por cuestionario, función respiratoria y pruebas cutáneas de alergia. Los pacientes con una ocupación causante de asma, sibilancias durante el trabajo y/o sensibilización a un alérgeno laboral se consideraron afectados de asma relacionada con la ocupación. Los factores de riesgo de cronificación del asma se determinaron por medio de análisis multivariante.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">En 2 años se identificaron 218 primeros diagnósticos de asma del adulto (población: 68.067 adultos; incidencia anual: 160/100.000). Aceptaron participar en el estudio 152 pacientes (índice de respuesta: 70%), de los que se caracterizó a 140 que referían sibilancias y/o asma bronquial en el último año (92%). Las pruebas cutáneas mostraron atopia en 57 casos (41%). Se diagnosticó asma relacionada con la ocupación en 19 casos (14%), por mamíferos domésticos en 8 (6%), por fármacos en 7 (5%) y por alérgenos ambientales en 44 (31%), siendo la limpieza doméstica la ocupación más frecuentemente asociada a la enfermedad (26%). De los 102 pacientes examinados de nuevo a los 2 años, 70 presentaban asma crónica (69%); la atopia (<span class="elsevierStyleItalic">odds ratio</span> [OR] = 3,39; intervalo de confianza [IC] del 95%, 1,15–9,99) y una ocupación de riesgo cuando se diagnosticó la enfermedad (OR = 5,54; IC del 95%, 1,05–29,11) fueron los factores de cronificación del asma.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La ocupación del paciente está relacionada con el asma del adulto en algo más de una décima parte de los casos y es un determinante principal de la cronicidad de sus síntomas.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">Study partly financed by the Catalan Foundation for Pulmonology and the Catalan Society for Pulmonology.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:46 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A community-based study of the epidemiology of asthma: incidence rates, 1964–1983" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "JW Yunginger" 1 => "CE Reed" 2 => "EJ O'Connell" 3 => "J Melton III" 4 => "MW O'Fallon" 5 => "MD Silverstein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm/146.4.888" "Revista" => array:6 [ "tituloSerie" => "Am Rev Respir Dis" "fecha" => "1992" "volumen" => "146" "paginaInicial" => "888" "paginaFinal" => "894" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1416415" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence of asthma in Swedish teenagers: relation to sex and smoking habits" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L Larsson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "1995" "volumen" => "50" "paginaInicial" => "260" "paginaFinal" => "264" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7660339" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence and incidence of asthma and rhinoconjunctivitis in Swedish teenagers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E Norrman" 1 => "L Nystrom" 2 => "E Jonsson" 3 => "N Stjernberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Allergy" "fecha" => "1998" "volumen" => "53" "paginaInicial" => "28" "paginaFinal" => "35" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10096804" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence and prevalence of physician-diagnosed asthma in a suburban population of young adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "DR Ownby" 1 => "CC Johnson" 2 => "EL Peterson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1081-1206(10)63325-X" "Revista" => array:6 [ "tituloSerie" => "Ann Allergy Asthma Immunol" "fecha" => "1996" "volumen" => "77" "paginaInicial" => "304" "paginaFinal" => "308" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8885808" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Occurrence, predictors and consequences of adult asthma in NHANES-I and follow-up survey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "WP McWhorter" 1 => "MA Polis" 2 => "RA Kaslow" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm/139.3.721" "Revista" => array:7 [ "tituloSerie" => "Am Rev Respir Dis" "fecha" => "1989" "volumen" => "139" "paginaInicial" => "721" "paginaFinal" => "724" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2923372" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109709008730" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence of physician-diagnosed asthma in adults. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 4 | 6 |
| 2024 October | 30 | 17 | 47 |
| 2024 September | 25 | 16 | 41 |
| 2024 August | 45 | 24 | 69 |
| 2024 July | 31 | 23 | 54 |
| 2024 June | 30 | 26 | 56 |
| 2024 May | 44 | 43 | 87 |
| 2024 April | 27 | 26 | 53 |
| 2024 March | 17 | 13 | 30 |
| 2024 February | 22 | 21 | 43 |
| 2023 March | 8 | 5 | 13 |
| 2023 February | 22 | 16 | 38 |
| 2023 January | 14 | 30 | 44 |
| 2022 December | 24 | 32 | 56 |
| 2022 November | 23 | 27 | 50 |
| 2022 October | 19 | 35 | 54 |
| 2022 September | 12 | 21 | 33 |
| 2022 August | 20 | 37 | 57 |
| 2022 July | 25 | 40 | 65 |
| 2022 June | 19 | 27 | 46 |
| 2022 May | 15 | 26 | 41 |
| 2022 April | 16 | 20 | 36 |
| 2022 March | 14 | 35 | 49 |
| 2022 February | 27 | 26 | 53 |
| 2022 January | 18 | 37 | 55 |
| 2021 December | 17 | 54 | 71 |
| 2021 November | 19 | 47 | 66 |
| 2021 October | 23 | 55 | 78 |
| 2021 September | 20 | 63 | 83 |
| 2021 August | 11 | 29 | 40 |
| 2021 July | 14 | 27 | 41 |
| 2021 June | 15 | 33 | 48 |
| 2021 May | 10 | 32 | 42 |
| 2021 April | 41 | 65 | 106 |
| 2021 March | 16 | 28 | 44 |
| 2021 February | 16 | 27 | 43 |
| 2021 January | 8 | 17 | 25 |
| 2020 December | 11 | 19 | 30 |
| 2020 November | 13 | 15 | 28 |
| 2020 October | 6 | 6 | 12 |
| 2020 September | 10 | 7 | 17 |
| 2020 August | 10 | 18 | 28 |
| 2020 July | 15 | 15 | 30 |
| 2020 June | 8 | 6 | 14 |
| 2020 May | 12 | 17 | 29 |
| 2020 April | 17 | 21 | 38 |
| 2020 March | 12 | 11 | 23 |
| 2020 February | 18 | 26 | 44 |
| 2020 January | 16 | 23 | 39 |
| 2019 December | 26 | 17 | 43 |
| 2019 November | 16 | 18 | 34 |
| 2019 October | 6 | 15 | 21 |
| 2019 September | 8 | 22 | 30 |
| 2019 August | 20 | 19 | 39 |
| 2019 July | 15 | 17 | 32 |
| 2019 June | 10 | 12 | 22 |
| 2019 May | 11 | 25 | 36 |
| 2019 April | 22 | 48 | 70 |
| 2019 March | 15 | 24 | 39 |
| 2019 February | 6 | 16 | 22 |
| 2019 January | 7 | 17 | 24 |
| 2018 December | 9 | 28 | 37 |
| 2018 November | 17 | 20 | 37 |
| 2018 October | 33 | 38 | 71 |
| 2018 September | 12 | 27 | 39 |
| 2018 May | 8 | 2 | 10 |
| 2018 April | 13 | 5 | 18 |
| 2018 March | 7 | 15 | 22 |
| 2018 February | 5 | 9 | 14 |
| 2018 January | 6 | 6 | 12 |
| 2017 December | 6 | 13 | 19 |
| 2017 November | 4 | 23 | 27 |
| 2017 October | 5 | 25 | 30 |
| 2017 September | 5 | 23 | 28 |
| 2017 August | 5 | 34 | 39 |
| 2017 July | 6 | 13 | 19 |
| 2017 June | 8 | 28 | 36 |
| 2017 May | 3 | 25 | 28 |
| 2017 April | 5 | 11 | 16 |
| 2017 March | 6 | 25 | 31 |
| 2017 February | 1 | 2 | 3 |
| 2017 January | 3 | 11 | 14 |
| 2016 December | 6 | 6 | 12 |
| 2016 November | 12 | 12 | 24 |
| 2016 October | 10 | 12 | 22 |
| 2016 September | 18 | 14 | 32 |
| 2016 August | 20 | 5 | 25 |
| 2016 July | 14 | 5 | 19 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 2 | 0 | 2 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 28 | 11 | 39 |
| 2015 September | 41 | 4 | 45 |
| 2015 August | 40 | 8 | 48 |
| 2015 July | 37 | 5 | 42 |
| 2015 June | 50 | 3 | 53 |
| 2015 May | 51 | 4 | 55 |
| 2015 April | 32 | 6 | 38 |
| 2015 March | 49 | 2 | 51 |
| 2015 February | 31 | 3 | 34 |
| 2015 January | 31 | 6 | 37 |
| 2014 December | 33 | 2 | 35 |
| 2014 November | 28 | 4 | 32 |
| 2014 October | 36 | 8 | 44 |
| 2014 September | 40 | 2 | 42 |
| 2014 August | 49 | 9 | 58 |
| 2014 July | 30 | 7 | 37 |
| 2014 June | 43 | 10 | 53 |
| 2014 May | 41 | 9 | 50 |
| 2014 April | 37 | 6 | 43 |
| 2014 March | 58 | 9 | 67 |
| 2014 February | 47 | 7 | 54 |
| 2014 January | 38 | 5 | 43 |
| 2013 December | 39 | 7 | 46 |
| 2013 November | 32 | 10 | 42 |
| 2013 October | 34 | 11 | 45 |
| 2013 September | 31 | 10 | 41 |
| 2013 August | 35 | 11 | 46 |
| 2013 July | 55 | 11 | 66 |
| 2013 June | 37 | 13 | 50 |
| 2013 May | 47 | 10 | 57 |
| 2013 April | 12 | 7 | 19 |
| 2013 March | 9 | 1 | 10 |
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