title: The contribution of 'holiday deaths' to seasonal variations in asthma mortality in England and Wales.
abstract: BACKGROUND
  In younger age groups there is a summer peak in asthma deaths, but whether this is due to social or environmental factors is not known. One suggested social factor is a summer holiday away from home during which there may be a lack of compliance with medication or greater difficulty in getting medical help. In older age groups there is a winter peak in asthma deaths.
  
  
  OBJECTIVE
  To study the contribution of 'holiday deaths' to seasonal variations in asthma mortality in England and Wales.
  
  
  METHODS
  Routinely collected mortality statistics were used (all asthma deaths of persons dying in England and Wales, 1991-93 and 1995). Deaths occurring 40 miles or more from home were estimated using the District Health Authority in which the person was usually resident; the registration district of death; and the 'transferability code' (derived by the Office for National Statistics).
  
  
  RESULTS
  There were 484 asthma deaths in people aged 0-34 years, and 6337 asthma deaths in people aged 35 years or more. Deaths estimated to occur 40 miles or more from home contributed little (16%) to the summer peak in asthma deaths age 0-34 years, and nothing to the winter peak in asthma deaths age 35 years or more.
  
  
  CONCLUSIONS
  Holidays away from home do not play an important part in explaining the seasonal variation of either young or old asthma deaths. Other social or environmental factors are more important.
authors.affiliation: St George's Hospital Medical School, London, UK.
authors.forename: T
authors.initials: T
authors.lastname: Nichols
authors.forename: A
authors.initials: A
authors.lastname: Hansell
authors.forename: D
authors.initials: D
authors.lastname: Strachan
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001249:Asthma / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D006693:Holidays / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012621:Seasons; D014852:Wales / Q000453:epidemiology