The socio-economic burden of asthma is substantial in Europe.
BACKGROUND
Few data are available on the asthma burden in the general population. We evaluated the level and the factors associated with the asthma burden in Europe.


METHODS
In 1999-2002, 1152 adult asthmatics were identified in the European Community Respiratory Health Survey (ECRHS)-II and the socio-economic burden (reduced activity days and hospital services utilization in the past 12 months) was assessed.


RESULTS
The asthmatics with a light burden (only a few reduced activity days) were 13.2% (95% CI: 11.4-15.3%), whereas those with a heavy burden (many reduced activity days and/or hospital services utilization) were 14.0% (95% CI: 12.1-16.1%). The burden was strongly associated with disease severity and a lower quality of life. Obese asthmatics had a significantly increased risk of a light [relative risk ratio (RRR) = 2.17; 95% CI: 1.18-4.00] or a heavy burden (RRR = 2.77; 95% CI: 1.52-5.05) compared with normal/underweight subjects. The asthmatics with frequent respiratory symptoms showed a threefold (RRR = 2.74; 95% CI: 1.63-4.61) and sixfold (RRR = 5.76; 95% CI: 3.25-10.20) increased risk of a light or a heavy burden compared with asymptomatic asthmatics, respectively. Moreover, the lower the forced expiratory volume in 1 s % predicted, the higher the risk of a heavy burden. The coexistence with chronic cough/phlegm only increased the risk of a heavy burden (RRR = 1.88; 95% CI: 1.16-3.06). An interaction was found between gender and IgE sensitization, with nonatopic asthmatic females showing the highest risk of a heavy burden (21.6%; 95% CI: 16.9-27.1%).


CONCLUSIONS
The asthma burden is substantial in Europe. A heavy burden is more common in asthmatics with obesity, frequent respiratory symptoms, low lung function, chronic cough/phlegm and in nonatopic females.
Unit of Epidemiology and Medical Statistics, Department of Medicine and Public Health, University of Verona, Verona, Italy.
S
S
Accordini
A
A
Corsico
I
I
Cerveri
D
D
Gislason
A
A
Gulsvik
C
C
Janson
D
D
Jarvis
A
A
Marcon
I
I
Pin
P
P
Vermeire
E
E
Almar
M
M
Bugiani
L
L
Cazzoletti
E
E
Duran-Tauleria
R
R
Jõgi
A
A
Marinoni
J
J
Martínez-Moratalla
B
B
Leynaert
R
R
de Marco
D000328:Adult; D001249:Asthma / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D005102:Health Expenditures; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011336:Probability; D011788:Quality of Life; D018570:Risk Assessment; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors