Asthma and atopy: has peak prevalence been reached?

Numerous studies have been published concerning the changing epidemiology of asthma and atopy, and studies from “western countries” have consistently shown a dramatic increase in prevalence over the last two to three decades. However, in this issue of the European Respiratory Journal , Braun-FahrlAnder et al. 1 report interesting new evidence concerning the prevalence rates of asthma and atopy in a group of Swiss teenagers. Their repeated cross-sectional survey of 14‐yr-old children shows that the prevalence of asthma and current asthmatic symptoms remained constant between 1992 and 2000. Likewise, no further increase was found in hay fever rates and allergic sensitisation during the same period. Asthma and hay fever diagnoses were based on written and/or video questionnaires, and sensitisation was determined by multiscreen SX1 tests (and afterwards confirmed by measurements of specific immunoglobulin E levels). Therefore, although additional years of data collection are necessary to confirm a change in trend, their observations clearly suggest that the increase in asthma and atopy may have come to an end, at least in some societies. These data are in line with some recently published studies showing a plateau in the prevalence of both childhood asthma 2–4, including asthma attack prevalence in the past 12 months and hospitalisations …