Thursday, 19th July, 2018
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.
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.
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:
We know, these are big numbers.
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.
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.
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.
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.
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.
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:
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.
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:
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.
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:
And last but not least...
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:
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