title: The impact of asthma, chronic bronchitis and allergic rhinitis on all-cause hospitalizations and limitations in daily activities: a population-based observational study.
abstract: BACKGROUND
  Chronic respiratory diseases are a significant cause of morbidity and mortality worldwide. We sought to evaluate the impact of asthma, chronic bronchitis and allergic rhinitis on all-cause hospitalizations and limitations in daily activities in adults.
  
  
  METHODS
  In the Gene Environment Interactions in Respiratory Diseases study (2007/2010), a screening questionnaire was mailed to 9,739 subjects aged 20-44 (response rate: 53.0%) and to 3,480 subjects aged 45-64 (response rate: 62.3%), who were randomly selected from the general population in Italy. The questionnaire was used to: identify the responders who had asthma, chronic bronchitis, allergic rhinitis or asthma-like symptoms/dyspnoea/other nasal problems; evaluate the total burden [use of hospital services (at least one ED visit and/or one hospital admission) and number of days with reduced activities (lost working days and days with limited, not work related activities) due to any health problems (apart from accidents and injuries) in the past three months]; evaluate the contribution of breathing problems to the total burden (hospitalizations and number of days with reduced activities specifically due to breathing problems).
  
  
  RESULTS
  At any age, the all-cause hospitalization risk was about 6% among the subjects without any respiratory conditions, it increased to about 9-12% among the individuals with allergic rhinitis or with asthma-like symptoms/dyspnoea/other nasal problems, and it peaked at about 15-18% among the asthmatics with chronic bronchitis aged 20-44 and 45-64, respectively. The expected number of days with reduced activities due to any health problems increased from 1.5 among the subjects with no respiratory conditions in both the age classes, to 6.3 and 4.6 among the asthmatics with chronic bronchitis aged 20-44 and 45-64, respectively. The contribution of breathing problems to the total burden was the highest among the asthmatics with chronic bronchitis (23-29% of the hospitalization risk and 39-50% of the days with reduced activities, according to age).
  
  
  CONCLUSIONS
  The impact of asthma, chronic bronchitis and allergic rhinitis on all-cause hospitalizations and limitations in daily activities is substantial, and it is markedly different among adults from the general population in Italy. The contribution of breathing problems to the total burden also varies according to the respiratory condition.
authors.affiliation: Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Verona, Italy. simone.accordini@univr.it.
authors.forename: Simone
authors.initials: S
authors.lastname: Accordini
authors.affiliation: Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy. angelo.corsico@unipv.it.
authors.forename: Angelo Guido
authors.initials: AG
authors.lastname: Corsico
authors.affiliation: Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Verona, Italy. lucia.calciano@univr.it.
authors.forename: Lucia
authors.initials: L
authors.lastname: Calciano
authors.affiliation: Department of Public Health and Pediatrics, University of Turin, Turin, Italy. roberto.bono@unito.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bono
authors.affiliation: Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy. icerveri@smatteo.pv.it.
authors.forename: Isa
authors.initials: I
authors.lastname: Cerveri
authors.affiliation: Institute of Respiratory Diseases, University of Sassari, Sassari, Italy. fois.ale@libero.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fois
authors.affiliation: Institute of Respiratory Diseases, University of Sassari, Sassari, Italy. pirina@uniss.it.
authors.forename: Pietro
authors.initials: P
authors.lastname: Pirina
authors.affiliation: Department of Public Health and Pediatrics, University of Turin, Turin, Italy. roberta.tassinari@unito.it.
authors.forename: Roberta
authors.initials: R
authors.lastname: Tassinari
authors.affiliation: Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Verona, Italy. giuseppe.verlato@univr.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Verlato
authors.affiliation: Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Verona, Italy. roberto.demarco@univr.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: de Marco
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001249:Asthma / Q000453:epidemiology*; D029481:Bronchitis, Chronic / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D065631:Rhinitis, Allergic / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult