The burden of asthma revisited

According to the Global Initiative for Asthma (GINA) Report, asthma is a worldwide problem, with an estimated 300 million affected individuals and 250,000 annual deaths. There is also good evidence that asthma prevalence, which in some agegroups of some countries seems to have now reached a plateau, has been increasing in many industrialized countries, especially in Anglo-Saxon countries and in younger ages, and an increase in asthma prevalence has been shown also in countries where the prevalence was low. Currently, neither an improved recognition or labeling of the disease nor a change in the utilization of medical care (especially medication) could explain the observed increase. Both environmental and host susceptibility changes seem to contribute: beside the risk factors, such as tobacco smoking, occupational exposures, and air pollution, particular attention is now given to other factors which showed frequency changes corresponding to those in asthma prevalence, e.g. reduced size of families, diet poor of antioxidants, reduced bacterial infections in early infancy