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European commission respiratory health survey

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This proposal is to extend the European Community Respiratory Health Survey (ECRHS) to include new research teams in central and eastern Europe. The ECRHS was funded as a Concerted Action (COMAC-Epid) and continued under the BIOMED 1 programme.
It is a multicentre study of asthma prevalence and risk factors for asthma, which has taken place in 40 centres throughtout the EC, as well as centres outside Europe, who have participated at their own expense.
In each centre, information on asthma symptoms has been obtained from 3000 individuals and approx.
500 subjects have participated in clinical tests to characterise respiratory symptoms and exposure factors. The study is unique in its scale, both in terms of the size of the data set and in the number of participating centres. It has provided the opportunity for epidemiologists, pneumonologists, allergologists and statisticians to communicate and interact in the development and execution of a standardised protocol for studying the epidemiology of asthma. Data collection is now complete and central analyses of the data are in progress.
Studies on the prevalence of asthma and atopy in Europe suggest wide variations in the prevalence of symptoms and skin sensitisation to common allergens across different regions.
The differences appear to be in some cases related to the degree of 'modernisation' of lifestyle and environment and traffic density in cities, which is compatible with the observation that asthma is increasing more rapidly in the 'westernised' world.
There are few data available on the prevalence of asthma-like symptoms in eastern Europe.
Extending the ECRHS into eastern Europe would provide a greater variation in the factors associated with asthma prevalence and atopy, and therefore further increase the value of the study in determining the factors responsible for increased asthma prevalence. There are likely to be differences in diagnostic practice, in medical care and in perception of respiratory disease, which may influence the reported incidence of asthma and allergic disease.
It is therefore essential that a high level of standardisation and quality control is ensured if the findings are to be valid.
In addition, these countries are currently undergoing rapid changes, which may have a strong influence on the prevalence and severity of asthma-like symptoms.
Monitoring baseline levels of respiratory health at an early stage in the observed alterations in lifestyle would provide information on the variables associated with any decrease in respiratory health. The PECO 1994 project gives the opportunity for these studies to be carried out at an important stage in the development of eastern Europe. The information obtained from the ECRHS and the comparison with findings from eastern Europe will allow important economic and health policy options to be formulated for recommendations to improve respiratory health in a wider area of Europe.

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United Medical and Dental Schools of Guy's and St Thomas's Hospitals
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