Jackson R T, Beaglehole R, Rea H H, Sutherland D C
Br Med J (Clin Res Ed). 1982 Sep 18;285(6344):771-4. doi: 10.1136/bmj.285.6344.771.
Trends in mortality attributed to asthma in the 5-34-year age group were examined in New Zealand, Australia, England and Wales, the United States, Canada, and West Germany for the years 1959-79. An epidemic of deaths from asthma occurred in the mid-1960s in New Zealand, Australia, and England and Wales but not in the other countries. In Australia and England and Wales the death rate quickly returned to pre-epidemic levels, but in New Zealand the decline in mortality was slow, and by 1974 the death rate was still almost double the pre-epidemic level. Of great concern was an abrupt increase in reported deaths from asthma in New Zealand after 1976 with the mortality rate during 1977-9 being greater than during the previous epidemic. In contrast, asthma mortality had remained relatively stable in the other populations.The new epidemic in New Zealand was investigated and appeared to be real. It could not be explained by changes in the classification of deaths from asthma, inaccuracies in death certification, or changes in diagnostic fashions. The most likely explanation appeared to be related to the management of asthma in New Zealand, and this is being investigated.
1959年至1979年间，对新西兰、澳大利亚、英格兰和威尔士、美国、加拿大以及西德5至34岁年龄组中因哮喘导致的死亡率趋势进行了调查。20世纪60年代中期，新西兰、澳大利亚以及英格兰和威尔士出现了哮喘死亡流行，但其他国家未出现。在澳大利亚以及英格兰和威尔士，死亡率迅速恢复到流行前的水平，但在新西兰，死亡率下降缓慢，到1974年，死亡率仍几乎是流行前水平的两倍。令人极为担忧的是，1976年后新西兰报告的哮喘死亡人数突然增加，1977年至1979年期间的死亡率高于前一次流行期间。相比之下，其他人群中的哮喘死亡率一直相对稳定。对新西兰的新疫情进行了调查，似乎确有其事。它无法用哮喘死亡分类的变化、死亡证明的不准确或诊断方式的变化来解释。最有可能的解释似乎与新西兰哮喘的管理有关，对此正在进行调查。
