Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, University of Western Australia, Perth, Western Australia, Australia; Busselton Population Medical Research Institute, University of Western Australia, Perth, Western Australia, Australia; School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.
Respirology. 2013 Nov;18(8):1256-60. doi: 10.1111/resp.12147.
The prevalence of reported doctor-diagnosed 'asthma' increased between 1990 and 2005-2007 in Busselton, Western Australia, accompanied by increased reported cough and phlegm but not recent wheeze. Possible reasons for the increase in diagnosed asthma include environmental exposures and diagnostic transfer. The aim of this study was to relate subject characteristics and exposures to the presence of wheeze and/or current cough/phlegm in the 2005-2007 survey.
A gender- and age-stratified random sample of 2862 adults from the Busselton shire completed questionnaires regarding doctor-diagnosed asthma, respiratory symptoms and environmental exposures; and measures of anthropometry, spirometry, exhaled nitric oxide (eNO), airway hyperresponsiveness (AHR) and atopy. Associations between respiratory symptoms and subject characteristics were assessed in 2656 subjects.
Wheeze was reported by 23% of subjects, cough/phlegm by 22% and both by 9%. The significant and independent correlates of wheeze were reflux symptoms, lung function, AHR, eNO, atopy, body mass index and smoking. The significant and independent correlates of cough/phlegm were reflux symptoms, lung function, smoking and dusty job. Subjects more likely to report only wheeze than only cough/phlegm were female, aged <40 years, atopic, had lower percentage predicted forced expiratory volume in one second (FEV1) or higher percentage predicted force vital capacity.
A variety of risk factors was associated with wheeze or cough/phlegm or both. Increased non-allergic exposures may account for increased prevalence of reported cough and phlegm and may contribute to increased reported asthma in adults.
在澳大利亚西部的巴瑟尔顿，1990 年至 2005-2007 年间报告的医生诊断“哮喘”患病率增加，同时报告的咳嗽和咳痰增多，但近期喘息减少。诊断性哮喘增加的可能原因包括环境暴露和诊断转移。本研究旨在将受试者特征和暴露与 2005-2007 年调查中的喘息和/或当前咳嗽/咳痰的存在相关联。
从巴瑟尔顿郡按性别和年龄分层随机抽取 2862 名成年人完成调查问卷，内容包括医生诊断的哮喘、呼吸道症状和环境暴露；以及人体测量学、肺活量测定、呼出气一氧化氮（eNO）、气道高反应性（AHR）和过敏。在 2656 名受试者中评估了呼吸道症状与受试者特征之间的关系。
23%的受试者报告有喘息，22%的受试者报告有咳嗽/咳痰，9%的受试者同时报告有这两种症状。喘息的显著独立相关因素是反流症状、肺功能、AHR、eNO、过敏、体重指数和吸烟。咳嗽/咳痰的显著独立相关因素是反流症状、肺功能、吸烟和灰尘作业。报告仅喘息而不是仅咳嗽/咳痰的受试者更可能是女性、年龄<40 岁、过敏、第一秒用力呼气量（FEV1）预计百分比较低或用力肺活量预计百分比较高。
各种危险因素与喘息或咳嗽/咳痰或两者均相关。非过敏性暴露的增加可能导致报告的咳嗽和咳痰增加，并可能导致成年人报告的哮喘增加。
