[Incidence and characteristics of adult-onset asthma].
OBJECTIVE
To determine the incidence of adult-onset asthma, along with lung function and immunologic characteristics, causes, and clinical course of the disease.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Casas
Xavier
X
Servei de Pneumologia, Hospital Germans Trias i Pujol, Barcelona, España.
Monsó
Eduard
E
Orpella
Xavier
X
Hervás
Ramona
R
González
Josep Antón
JA
Arellano
Elisabeth
E
Martínez
Carlos
C
Martínez
Gerardo
G
Ascosa
Alex
A
Comín
Jesús
J
Ruiz
Rafael
R
Monsó
Berta
B
Casas
Irma
I
Esteve
Maria
M
Morera
Josep
J
D000328:Adult; D017668:Age of Onset; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D013030:Spain / Q000453:epidemiology; D014505:Urban Population