title: Respiratory symptoms/diseases prevalence is still increasing: a 25-yr population study.
abstract: BACKGROUND
  Few epidemiological surveys on general population samples estimated changes in prevalence of respiratory symptoms/diseases over a long time interval; our study aims to quantify the temporal changes in the prevalence rates of asthma, allergic rhinitis and Chronic Obstructive Pulmonary Disease (COPD) after 25 years from baseline.
  
  
  METHODS
  A general population sample participated in 3 cross-sectional surveys carried out in Central Italy (Pisa) in 1985-88 (n = 3865), 1991-93 (n = 2841), 2009-11 (n = 1620). 2276 (47%) subjects participated in at least 1 survey, 1723 (35.5%) in at least 2 surveys and 849 (17.5%) in all the 3 surveys. All subjects filled in a standardized questionnaire about health status and risk factors; a sub-sample performed spirometry. Chi-square test was used to compare adjusted prevalence rates of respiratory symptoms/diseases and descriptive characteristics among the surveys. Generalised estimating equations (GEE) were used to analyze the association between respiratory symptoms/diseases and risk factors.
  
  
  RESULTS
  There was an increasing trend in prevalence rates of all respiratory symptoms/diseases throughout the surveys: current asthma attacks (1st-3rd survey prevalence: 3.4-7.2%), allergic rhinitis (16.2-37.4%), usual phlegm (8.7-19.5%) and COPD (2.1-6.8%) more than doubled. The GEE model confirmed these increasing trends, indicating higher risk of having respiratory symptoms/diseases in the second and third surveys.
  
  
  CONCLUSIONS
  While asthma and allergic rhinitis increasing trends were confirmed, with respect to other international studies, also a COPD increasing prevalence rates was shown.
authors.affiliation: Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy. Electronic address: saramaio@ifc.cnr.it.
authors.forename: Sara
authors.initials: S
authors.lastname: Maio
authors.affiliation: Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Baldacci
authors.affiliation: Unit of Pulmonology 1, CardioThoracic and Vascular Department, University Hospital of Pisa, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Carrozzi
authors.affiliation: Unit of Pulmonology 1, CardioThoracic and Vascular Department, University Hospital of Pisa, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pistelli
authors.affiliation: Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Angino
authors.affiliation: Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Marzia
authors.initials: M
authors.lastname: Simoni
authors.affiliation: Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sarno
authors.affiliation: Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Cerrai
authors.affiliation: Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Franca
authors.initials: F
authors.lastname: Martini
authors.affiliation: Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Fresta
authors.affiliation: Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Silvi
authors.affiliation: Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Pede
authors.affiliation: Department of Computer Science, University of Verona, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Guerriero
authors.affiliation: Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy; CNR Institute of Biomedicine and Molecular Immunology, Palermo, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Viegi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D065631:Rhinitis, Allergic / Q000453:epidemiology*; D012307:Risk Factors; D013147:Spirometry; D055815:Young Adult
keywords: General population; Prevalence trends; Risk factors