Thursday, 19th July, 2018

10 facts about asthma that will make you rethink the condition

We’ve all heard of asthma, and chances are we all know someone with the condition. But just how prevalent is it? And who will it affect? 

From poor inhalation to an afflicted island population, here are ten facts about asthma that provide a fascinating insight into this well-known but largely misunderstood chronic respiratory disease.

1) Asthma is the most common lung condition in the world


It's also the most common chronic disease among children.

The World Health Organisation estimates that asthma affects as many as 235 million people worldwide, and that the number of global asthma deaths will increase over the next ten years if preventative action is not taken.

Asthma occurs in all countries, regardless of level of development. The condition is also frequently undiagnosed and undertreated - and not just in developing nations. In the United States, it’s the number one cause of school absenteeism, with 14 million days missed annually.

Although the fundamental causes of the condition are not completely understood, risk factors have been identified.

2) 8 million people living in the UK have been diagnosed with asthma


That’s over 12 per cent of the population. However, this doesn’t mean that 8 million people currently have the condition, as many children who are diagnosed with asthma grow out of it.

According to Asthma UK, 5.4 million receive treatment for their condition. Broken down, this comes to 4.3 million adults (1 in 12) and 1.1 million children (1 in 11). In fact, the UK has one of the highest prevalence rates of asthma symptoms in children worldwide.

Here are some more mind-boggling figures to give you a better idea of the scale of asthma in the UK:

  • 43,349,129 items of reliever and preventer inhalers were prescribed in 2017 (NHS PCA).
  • In the past five years alone, 142 million salbutamol inhalers and 123 million corticosteroid inhalers have been prescribed across NHS England (NHS Prescription Cost Analyses, 2013-17). The total weight of the loaded canisters inside these inhalers adds up to a whopping 7.69 million kg!
  • Last year, 96,105 people were treated with a nebuliser in A&E. This is the most common A&E treatment for an asthma attack (NHS England. Hospital accident and emergency activity 2016-17).

We know, these are big numbers.

3) The NHS spends around £1bn a year on asthma treatment and care


Although a large chunk of the population are treated for symptoms of asthma, 1 billion pounds is still a staggeringly large amount of spending.

Up to 90 per cent of the NHS asthma budget is spent on medicines. £685,775,311.71 was spent on reliever and preventer inhalers (the two most commonly used treatments) in 2017 (NHSPCA), while the average cost for an emergency asthma admission is £743.

As we’ll see with fact number 4, much of this outlay could be significantly reduced by better condition management.

4) Nearly half of asthmatics don’t take their inhalers properly


According to a study in the Primary Care Respiratory Medicine journal, 45.6 per cent of people with asthma have ‘critical errors’ with inhaler technique. The study states that a critical error in exhalation technique can “...impact the effectiveness of the delivered drug and thereby lead to the suboptimal disease control of asthma and COPD.”

Good inhaler technique ensures you take the medicine correctly and receive the right dosage. By properly using your inhaler, you’ll also ensure that the medicine reaches your airways rather than getting stuck in your mouth or the back of your throat.

Getting trained in good inhaler technique is vital. Poor technique indicates poor control, and puts you at risk of a potentially life-threatening asthma attack. This Asthma UK article provides a step-by-step guide to using your inhaler properly.

5) Asthma attacks are common


Every 10 seconds someone in the UK has an asthma attack, and many of these will be serious.

In fact, asthma attacks hospitalise someone every 8 minutes, and 185 people are admitted to hospital because of asthma attacks every day. A child is admitted to hospital every 20 minutes due to an asthma attack.

According to Asthma UK, three people die from asthma every day in the UK - and two thirds of these deaths could be prevented by adequate asthma treatment. Given the manageability of asthma, this number should be much lower.

If you or someone you know is showing signs of an asthma attack, follow this emergency advice from Asthma UK. It could just be worth your while.

6) Poor air quality may be linked to the onset of asthma


According to a study by the Royal College of Physicians, air pollution is associated with the development and worsening of asthma in both children and adults.

It has been noted in further studies that the common pollutants ozone and nitrogen dioxide actually induce ‘airway inflammation’ and ‘airway hyper-responsiveness’ in asthmatics, which are the two characteristics of an attack.

Asthma UK’s 2018 survey revealed that just under two-thirds of asthmatics feel that air pollution makes their condition worse. Air pollution is a trigger that is hard to avoid, so it’s vital that you manage your condition well.

7) Asthma may have a genetic basis


The tiny, remote island of Tristan da Cunha. The high prevalence of asthma among the population here suggests genetics may play a role in the onset of the condition.

Although we don’t know the exact causes of asthma, evidence suggests there may also be a genetic link.

On the South Atlantic island of Tristan da Cunha - the most remote permanently inhabited place in the world - between a third and a half of residents are thought to have asthma.

What makes this interesting is the homogeneous genepool of the islanders, who are all descended from fifteen ancestors. It’s thought that a faulty version of the ESE3 gene shared by many of the islanders causes the airway walls to become thickened and more constricted, making it difficult to breathe.

With a lack of industry and strong ocean winds, it’s safe to rule out air pollution as a factor in causing asthma among the population of Tristan da Cunha - suggesting there may indeed be a genetic predisposition to asthma.

Although the ‘asthma genes’ have not all been identified and fully understood, further research into the causes of asthma is currently ongoing.

8) It’s possible to develop asthma on the job


Every year, many people develop occupational asthma because they are frequently exposed to dangerous substances at work. According to Asthma UK, “occupational asthma is the most common cause of adult onset asthma and makes up 9 to 15 per cent of cases of asthma in adults of working age”.

There are two types of occupational asthma:

  1. Allergic occupational asthma. Some people have symptoms of asthma triggered by allergens in the workplace (such as flour dust, animal dander or car fumes). Jobs with the highest rates of allergic occupational include vehicle spray painting, woodworking, baking, healthcare work, and hairdressing.
  2. Irritant-induced occupational asthma. Though not as common as allergic occupational asthma, this can happen when you breathe in a chemical at work and it irritates your airways causing asthma symptoms. Examples include chlorine (from swimming pools) and ammonia (a common cooling agent in refrigerators).  

In some industries, up to 10 per cent of the workforce will develop occupational asthma. For more on work aggravated asthma, this in-depth summary from Asthma UK contains some useful information.

9) Asthma is common among athletes


David Beckham: the world's most famous asthmatic?

Although asthma is a respiratory illness, many successful athletes are known to live with the condition.

A 2014 study found that 70 per cent of top UK swimmers and a third of Team Sky cyclists suffered from asthma, particularly exercise-induced asthma. Considering that these are athletes performing at the top of their game in sports that require immense physical exertion, these figures will come as a surprise to many.

Here's a roll call of prominent athletes with asthma:

  • David Beckham
  • Sir Mo Farah
  • Paula Radcliffe
  • Sir Bradley Wiggins
  • Chris Froome
  • Paul Scholes
  • Laura Kenny
  • Justine Henin
  • Greg Louganis
  • Peter Vanderkaay
  • Tom Dolan

The fact that these sport stars have gone on to have illustrious careers despite having asthma is not only testament to their willpower and the vital role of medicine; it’s also hugely encouraging for anyone with asthma who might feel held back by their condition.

10) The future is looking up for asthmatics


As part of the push to save NHS money and improve public health, innovation is helping people properly manage their asthma. New technologies at the forefront of this push include:

  • Smart inhalers. Though only in the trial phase, these bluetooth-enabled inhalers can track inhaler use and feed this data back into a smart device. Although they’re not yet available on the NHS, Asthma UK are working to make them widely available in the near future.
  • Asthma Tracker. This mHealth app tracks peak flow, medication, and any symptoms you might be experiencing - encouraging positive self-management of your condition.
  • Plume Air Report. Another mHealth app, this reports air quality and levels of pollution and smog - ideal if you’re an asthmatic living in a big city.

And last but not least...

  • Echo. We remind you when to use your preventer inhaler - ensuring you never miss a dose.

Further information

If you think that your asthma could be better managed, talk to your GP to ensure that your treatment plan is right for you. Here are some insightful asthma-related resources:

  • Asthma UK is a thorough resource for asthmatics and people who want to learn more about the condition.
  • The NHS Choices asthma page provides a good summary of medical advice for asthma sufferers.
  • If you’ve been prescribed an asthma medication or are simply interested in learning more about managing the condition, check out our A-Z of asthma article.
  • For more on the differences between generic and brand-name inhalers, take a look at our Ventolin vs salbutamol article.

Worried about your risk of having an asthma attack? Asthma UK’s Asthma attack risk checker provides you with a personal asthma report and simple tips to help you deal with the condition.

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Clinically reviewed by Ana Ciubotaru MRPharmS: 18/7/18