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PubMed1993

Maternal prevalence of Toxoplasma antibody based on anonymous neonatal serosurvey: a geographical analysis.

A total of 12,902 neonatal samples collected on absorbent paper for routine metabolic screening were tested anonymously for antibodies to toxoplasma. Seroprevalence varied from 19.5% in inner London, to 11.6% in suburban London, and 7.6% in non-metropolitan districts. Much of this variation appeared to be associated with the proportions of livebirths in each district to women born outside the UK. However, additional geographical variation remained and seroprevalence in UK-born women was estimated to be 12.7% in inner London, 7.5% in suburban London, and 5.5% in non-metropolitan areas. These estimates are considerably lower than any previously reported in antenatal sera in the UK. The wide geographical variation highlights a need for further research to determine the relative importance of different routes of transmission.

Antibodies, Protozoan↗
PubMed2005

Dimensions of adolescent rebellion: risks for academic failure among high- and low-income youth.

The central question addressed in this study was whether upper class, suburban teenagers can engage in various problem behaviors and still maintain adequate academic grades, because of environmental safety nets, unlike their low-income, inner-city counterparts. Three problem behavior dimensions were assessed among tenth graders, that is, substance use, delinquency, and low school engagement. Academic achievement was assessed in terms of grades across four major subjects. Variable-based analyses indicated unique links with grades for self-reported delinquency and school disengagement in high- and low-income samples, but for substance use only among the former. Person-based analyses showed that in both schools, grades were clearly compromised among youth with disturbances in all three problem domains. In addition, in the suburban school only, grades were low in the cluster characterized chiefly by high substance use. Results are discussed in terms of stereotypes regarding risks (or lack thereof) stemming from families' socioeconomic status; implications for theory and interventions are also considered.

Adaptation, Psychological↗
PubMedDate not supplied

Patient-initiated refusals of prehospital care: ambulance call report documentation, patient outcome, and on-line medical command.

INTRODUCTION: There is a growing interest in cases in which emergency medical services (EMS) providers evaluate a patient, but do not transport the patient to a hospital. A subset of these cases, the patient-initiated refusal (PIR) in which the patient refused care and transport, was studied and evaluated. The objectives of the study were to examine the adequacy of ambulance call report documentation in PIR, to examine the clinical outcome of these patients in one hospital-based, suburban EMS system, and to assess the potential impact of on-line medical command (OLMC) on cases of PIR. METHODS: The system studied is a hospital-based, transport-capable, advanced life support service in a suburban EMS system, with an annual call volume of 4,200 runs. During the 6-month study period, all ambulance call reports completed by the paramedics and medical command control forms completed by medical command physicians were examined, and cases of PIR collected. Each ambulance call report was examined for adequacy of documentation. Patient outcome was determined from emergency department records and telephone follow-up. RESULTS: Eighty-five PIRs were documented during the study period. Four cases were excluded because of a missing ambulance call reports and/or medical command control forms, leaving 81 PIRs for analysis. Despite policy requiring OLMC in cases of PIR, OLMC was established in only 23 PIRs (28%). Of these, two (9%) had inadequate ambulance call report documentation. Of the 58 PIR in which OLMC was not established, 25 (43%) had inadequate ambulance call report documentation (p < 0.001, Fisher's exact test). Follow-up was obtained for 54 (67%) PIR. Of these, 37 (68%) did not subsequently see a physician, and all needed no further medical care. Seven (13%) saw their own physicians within a few days of the initial refusal of prehospital care, and had no further problems. Ten patients were seen in an emergency department within a few days. Three (6%) were discharged, and did well. Seven (13%) were admitted to the hospital, with four (7%) admitted to monitored beds, and three (6%) to unmonitored beds. There were no deaths. CONCLUSIONS: Ambulance call report documentation is better with OLMC than without. Patients who initially refuse care may be ill, and some ultimately will be hospitalized. Further research may elucidate a role for OLMC in preventing refusals by incompetent patients, convincing patients who are competent but appear ill to accept transport, and assisting paramedics with other difficult or unusual circumstances.

Adult↗
PubMedDate not supplied

Requiring on-line medical command for helicopter request prolongs computer-modeled transport time to the nearest trauma center.

INTRODUCTION: Rapid transport from scene to closest trauma center requires optimal use of public safety first responder (FR), basic life support (BLS), advanced life support (ALS), and transport resources (ground or air). In some parts of this regional emergency medical services (EMS) system, on-scene ALS requires contact with on-line medical command (OLMC) to obtain authorization for air medical helicopter (AMH) dispatch, because some EMS medical directors believe that this may decrease overutilization of AMH services. HYPOTHESIS: The hypothesis of this study was that requiring prior OLMC for AMH dispatch prolongs mean time to a trauma center versus either FR or BLS request for AMH. METHODS: Computer mapping programs were used to model the most rapid driving time to the closest trauma center from 167 actual AMH responses to the scene of a motor vehicle accident. In an OLMC-ALS model, only OLMC-ALS can request an AMH. In a BLS model, BLS units arrive on the scene and the crew requests simultaneous dispatch of an ALS response and an AMH. In the FR model, on arrival at the scene, a FR requests simultaneous dispatch of a BLS unit, an ALS unit, and an AMH. RESULTS: The OLMC-ALS model resulted in a longer mean value for time to trauma center by an AMH than did the computer model for all ground transport settings. The FR model yielded a shorter mean time for AMH compared with the mean values for time to trauma center for all settings. Differences in mean values for time in urban settings were small (ground: 42 minutes, air: 36 minutes), whereas those for the suburban (ground: 52 minutes, air: 41 minutes), and those for rural (ground: 69 minutes, air: 47 minutes) were significant clinically. For the BLS model, these differences persisted, but were significant clinically only in the rural setting (ground: 68 minutes, air: 53 minutes). CONCLUSIONS: Optimal use of AMH requires balancing the need for early helicopter dispatch to fully exploit its speed advantage with the disadvantage of expensive overutilization. This computer model indicates that the best person to request AMH varies by venue: in urban settings, the OLMC physician should request AMH dispatch; in suburban venues, BLS should request AMH dispatch; and in rural venues, FRs should request AMH dispatch.

Air Ambulances↗
PubMed2004

Tire-wear particles as a source of zinc to the environment.

Tire-tread material has a zinc (Zn) content of about 1 wt %. The quantity of tread material lost to road surfaces by abrasion has not been well characterized. Two approaches were used to assess the magnitude of this nonpoint source of Zn in the U.S. for the period 1936-1999. In the first approach, tread-wear rates from the automotive engineering literature were used in conjunction with vehicle distance-driven data from the U.S. Department of Transportation to determine Zn releases. A second approach calculated this source term from the volume of tread lost during lifetime tire wear. These analyses showed that the quantity of Zn released by tire wear in the mid-1990s was of the same magnitude as that released from waste incineration. For 1999, the quantity of Zn released by tire wear in the U.S. is estimated to be 10 000-11 000 metric tons. A specific case study focused on Zn sources and sinks in an urban-suburban watershed (Lake Anne) in the Washington, DC, metropolitan area for a time period of the late 1990s. The atmospheric flux of total Zn (wet deposition) to the watershed was 2 microg/cm2/yr. The flux of Zn to the watershed estimated from tire wear was 42 microg/cm2/yr. The measured accumulation rate of total Zn in age-dated sediment cores from Lake Anne was 27 microg/cm2/yr. These data suggest that tire-wear Zn inputs to urban-suburban watersheds can be significantly greater than atmospheric inputs, although the watershed appears to retain appreciable quantities of vehicular Zn inputs.

Cities↗
PubMed1999

A comparison of the ability of forest and agricultural soils to mineralize chlorinated aromatic compounds.

Soils were sampled from two agricultural fields, two relatively pristine forests, and one suburban forest in Ontario, Canada. The ability of these soils to mineralize 2,4-dichlorophenoxyacetate, 3-chlorobenzoate, 4-chlorophenol, 2,4-dichlorophenol, pentachlorophenol, and atrazine was determined using 14C-labeled substrates. Direct pre-exposure was necessary before atrazine mineralization could be detected; however, it was not necessary for degradation of any of the other chemicals. 2,4-dichlorophenoxyacetate and pentachlorophenol mineralization was much higher in the agricultural soils relative to the pristine forest soils, but 3-chlorobenzoate and 2,4-dichlorophenol mineralization rates showed the opposite trend. Mineralization of 4-chlorophenol was about equivalent in all soils. Suburban forests soils were indistinguishable from agricultural soils with respect to their degradation of 2,4-dichlorophenoxyacetate and chlorobenzoate. Additionally, they were better able than any of the soils to withstand the toxic effects of pentachlorophenol. Pentachlorophenol mineralization was highly variable in the pristine forest soils, ranging from about 6 to 50%. Abiotic factors such as pH, soil type, and organic and moisture content did not account for these significant site differences. The selective forces responsible for these differences, and the possible differences in microbial populations are discussed.

Agriculture↗
PubMed2001

How urban African American young adolescents spend their time: time budgets for locations, activities, and companionship.

The time budgets of a population of youth provide important information about their daily experience and socialization. This study reports data on the time budgets of a sample of 253 urban African American poor to working- and middle-class 5th-8th graders in Chicago. These youth were found to spend less time in school than other postindustrial adolescent populations, but spent no less time doing homework than White suburban U.S. young adolescents. They spent large quantities of time at home and with their families--at rates comparable to rates for young adolescents in a society with collectivist values like India. Unlike with other populations, early adolescence was not associated with major age changes in time allocations. Amount of time in schoolwork did not differ by grade, and amount of time with family did not show the decline with age that has been found for European American suburban adolescents.

Adolescent↗
PubMed2000

PM10 elemental composition and acute respiratory health effects in European children (PEACE project). Pollution Effects on Asthmatic Children in Europe.

The ability of particles with a 50% cut-off aerodynamic diameter of 10 microm (PM10) to cause respiratory health effects possibly depends on their composition. This study evaluated whether the soluble elemental concentrations in PM10 were related to acute respiratory health effects. The Pollution Effects on Asthmatic Children in Europe (PEACE) study is a multicentre study of the acute effects of PM10 and other air pollution components on the respiratory health of children with chronic respiratory symptoms in urban and suburban panels. Children, 1208, divided among 17 panels were followed for > or =2 months. Exposure to air pollution was monitored on a daily basis. Health status was monitored by twice daily peak expiratory flow (PEF) measurements and a symptom diary. Median concentrations of iron ranged 105-1,110 ng x m(-3) in the urban and 32-517 ng x m(-3) in the suburban locations. The daily concentrations of most elements were not associated with daily variation in PEF, prevalence of respiratory symptoms or bronchodilator use. Silicon and iron concentrations tended to be negatively associated with PEF, and positively associated with the prevalence of phlegm. In two pollutant models, PM10 effect-estimates on phlegm prevalence were reduced and lost significance, whereas the effect-estimates of iron or silicon remained essentially unchanged. The effects of silicon and iron could not be separated. In conclusion, this study provides only weak support for the hypothesis that daily fluctuations in soluble elemental concentrations in ambient particulate matter are responsible for acute health effects.

Air Pollution↗
PubMed1984

Rewards and adolescent health behavior.

Research has indicated that contingent rewards can increase students' acceptance of novel preventive health activities. In the current research on adolescents' use of a fluoride rinse over two school years, however, the rinse habit tended to end when reward contingencies were withdrawn. Although participation in the rinse program was higher with a saturated schedule of reward contingencies in effect, the comparison partial schedule of rewards showed less immediate attrition when the reward contingencies were withdrawn. As a result, the long-term effects of the two schedules were largely equivalent. Other major findings included higher participation levels for girls compared to boys and for urban compared to suburban students. Self-management instruction, a strategy intended to compensate for the withdrawal of tangible rewards, worked temporarily among urban students but at the same time resulted in lower levels of post-reward rinsing among suburban students. This study confirmed the efficacy of contingent rewards for initiating new health habits among adolescents, but neither a partial schedule of reward nor instruction in self-management was sufficient to establish long-term continuation of the behavior. Implications of these findings for health psychologists and public health professionals are discussed briefly.

Adolescent↗
PubMed2002

Observation of volatile and semi-volatile carbonyls in an Algerian urban environment using dinitrophenylhydrazine/silica-HPLC and pentafluorophenylhydrazine/silica-GC-MS.

Lower carbonyls and n-alkanals from C5 to C10 were measured from late autumn 2000 to summer 2001 in two urban areas in the Algerian territory: Algiers and Ouargla. They were collected on silica cartridges coated with dinitrophenylhydrazine (DNPH) and pentafluorophenylhydrazine (PFPH), which were analysed by HPLC-UV and high-resolution GC-MS. respectively. The two methods were used in parallel samplings in a suburban Algiers site and provided consistent results for semi-volatile congeners, as differences in the concentration data did not exceed 21% on average for individual carbonyl levels ranging from 0.0 to 0.5-2.6 microg m(-3). Concentrations of formaldehyde up to 27 and 5 microg m(-3) were monitored during 10 h samplings in the daytime in Algiers and Ouargla, respectively; acetaldehyde reached values of 13 and 5 microg m(-3), whilst acetone was the most abundant ketone with peak levels of 14 and 4 microg m(-3), respectively. High night-time levels of lower carbonyls were also measured at both locations. Among the semi-volatile alkanals, the highest levels were observed in suburban Algiers for hexanal and nonanal (2.2 microg m(-3)) and in downtown Algiers for valeraldehyde (2.6 microg m(-3)), whilst in Ouargla only hexanal and nonanal levels within the C5-C10 fraction exceeded 1 microg m(-3). Moreover, benzaldehyde concentrations as high as 5 microg m(-3) were measured in the centre of Algiers. Algiers data are comparable with those found in photochemically polluted urban areas of Europe and the USA. Strong correlations between formaldehyde and acetaldehyde and between formaldehyde and benzaldehyde were observed; by contrast, acetone did not show any correlation with the lower aldehydes, suggesting the existence of carbonyl sources other than vehicular traffic. Diurnal variations of almost all carbonyls suggested that motor vehicles were the most important source in the winter, whereas photochemical production appeared to predominate during the summer.

Acetaldehyde↗
PubMed1998

Allergenic relationship among four common and dominant airborne palm pollen grains from Eastern India.

BACKGROUND: Palm pollen grains are predominant aeroallergens in the tropics including India. Evidence of allergenic crossreactivity had been reported from various parts of the world on different families, e.g. Poaceae, Asteraceae, etc. No such information is available about the palm pollen of tropical countries. OBJECTIVES: The present study was undertaken to find out the allergenic relationship, if any, in four common and important palm pollen in India. METHODS: A 2-year aerobiological survey was carried out at Madhyamgram situated at the suburban fringe of Calcutta Metropolis using Burkard volumetric sampler to know the seasonal variation of Areca catechu, Borassus flabellifer, Cocos nucifera and Phoenix sylvestris among others. Skin-prick tests (SPT) were performed with the relevant pollen extracts on the respiratory allergic patients. Sera from the subjects were tested directly by ELISA for estimating the allergen specific IgE. ELISA inhibitions and dot blotting were performed with pooled patients sera and four palm pollen extracts to detect the cross-reactivity. RESULTS: Among 70 patients, Areca catechu exhibited the maximum percentage (48.5%) of positive responses followed by Cocos nucifera (45.7%), Phoenix sylvestris (42.85%) and Borassus flabellifer (38.5%). On an average, 30-50% of the patients showed positive skin reactions and enhanced specific IgE level to more than one palm pollen extract. Further evidence of allergenic crossreactivity among the four palm pollen grains were provided by dot blotting and ELISA inhibition studies. In ELISA inhibition, a distinct inhibition was obtained with comparable amounts of the pollen extracts. CONCLUSION: The suburban aerobiological survey of Calcutta and SPT results confirmed that the relevant pollen types are significant contributors of aeroallergen load of the study area. ELISA inhibition studies with the pooled patients sera using antihuman IgE probe revealed the presence of shared allergenic components among the four palm pollen grains.

Adult↗
PubMed2002

Solving inequities in provider distribution: loan repayment.

The distribution of primary health care professionals in England and Wales is inequitable, with relatively lower concentrations of professionals in deprived areas. The objective of the present study was to determine whether graduate health professionals would be willing to work in under-served areas in return for educational loan repayment. The study group consisted of a convenience sample of 50 newly qualified and trainee general practitioners, and 50 newly qualified community nurses and health visitors in mid- and west Wales. At interview, the subjects were presented with descriptions of general practices and asked to indicate their preferred practice. Practice descriptions varied systematically in terms of location (i.e. urban, suburban and rural), population deprivation (i.e. deprived or mixed affluent/deprived) and availability of loan repayment (i.e. none or loans paid off over a period of between one and 4 years). The main outcome was the probability that a practice with loan repayment was chosen. Compared with a suburban practice, a one-year loan repayment option made the rural and urban deprived practices 1.6 times and 1.2 times more likely to be chosen, respectively. Nurses were generally more willing than doctors to work in a deprived area in return for loan repayment. The findings suggest that loan repayment may offset health professionals' aversion to working in deprived areas. Such a scheme needs to be piloted to see whether it does offer value for money in recruiting health professionals to under-served areas.

Adult↗
PubMed1996

Working with vulnerable families: a health visiting perspective.

The aim of this paper is to describe part of the findings of a research study which explored the health visitor's role in identifying and working with vulnerable families in relation to child protection. One objective of the study was to describe and analyse the work which health visitors undertake with vulnerable families aimed at preventing crisis, ill-health and child abuse. This paper outlines this aspect of the research and looks specifically at health visitors' perceptions of their work and interventions with vulnerable families and children. Health visitors working in an inner city area and a suburban area were sampled and pilot work was undertaken in a third suburban area. Stage one involved a postal survey of 102 health visitors, in which a response rate of 58 (57%) was obtained. Stage two involved 12 in-depth interviews with health visitors. One major finding of this study highlighted the fact that the health visitor's role when working with vulnerable families appears to be one of diversity and conflict. In the light of the current National Health Service reforms it seems of paramount importance that health visitors illustrate to others, both managers and other health/social service professionals alike, the important function of their work with these vulnerable groups. This is essential to ensure that health visitors' work with vulnerable families in relation to child protection is understood and valued and that the needs of vulnerable families continue to be identified. This paper contributes to the knowledge base of health visiting and raises some important issues for professional health visiting practice.

Child↗
PubMed2003

Contribution of indirect computed tomography venography to computed tomography angiography of the chest for the diagnosis of thromboembolic disease in two United States emergency departments.

Recent reports suggest that physicians in non-ambulatory settings can use indirect CT venography (CTV) of the lower extremities immediately following spiral CT angiography (CTA) of the chest to identify patients with a negative CTA who have thromboembolic disease identified on CTV. We sought to determine the frequency of isolated deep venous thrombosis (DVT) discovered on CTV in emergency department (ED) patients with complaints suggestive of pulmonary embolism (PE) yet having a negative CTA. This study was conducted in a suburban and urban ED where patients with symptoms suspicious for PE were primarily evaluated with CTA and CTV. A total of 800 patients were studied, including 360 from the suburban ED and 440 from the urban ED. 88 (11%) patients were diagnosed with thromboembolic disease by CTA, or CTV, or both. Seventy-three patients had a CTA of the chest that was positive for PE, 42 (5.2%) of whom had evidence of both PE on CTA and DVT on CTV. Fifteen patients (2%, 95% CI = 1-3%) had a negative CTA and were subsequently found to have isolated DVT on CTV, all of whom received anticoagulation therapy. These data suggest that indirect CT venography of immediately following CT angiography of the chest significantly increased the frequency of diagnosed thromboembolic disease requiring anticoagulation in ED patients with suspected PE.

Adult↗
PubMed2000

Medical communication: do our patients understand?

The objective of this study was to determine emergency department (ED) patient's understanding of common medical terms used by health care providers (HCP). Consecutive patients over 18 years of age having nonurgent conditions were recruited from the EDs of an urban and a suburban hospital between the hours of 7 a.m. and 11 p.m. Patients were asked whether six pairs of terms had the same or different meaning and scored on the number of correct answers (maximum score 6). Multiple linear regression analysis was used to assess possible relationships between test scores and age, sex, hospital site, highest education level, and predicted household income (determined from zip code). Two hundred forty-nine patients (130 men/119 women) ranging in age from 18 to 87 years old (mean = 39.4, SD = 14.9) were enrolled on the study. The mean number of correct responses was 2.8 (SD = 1.2). The percentage of patients that did not recognize analogous terms was 79% for bleeding versus hemorrhage, 78% for broken versus fractured bone, 74% for heart attack versus myocardial infarction, and 38% for stitches versus sutures. The percentage that did not recognize nonanalogous terms was 37% for diarrhea versus loose stools, and 10% for cast versus splint. Regression analysis (R2 = .13) revealed a significant positive independent relationship between test score and age (P < .024), education (P < .001), and suburban hospital site (P < .004). Predicted income had a significant relationship with test score (P < .001); however, this was no longer significant when controlled for the confounding influence of age, education and hospital site. Medical terminology is often poorly understood, especially by young, urban, poorly educated patients. Emergency health care providers should remember that even commonly used medical terminology should be carefully explained to their patients.

Adolescent↗
PubMed1990

Maternal cigarette smoking during pregnancy, adiposity, social class, and perinatal outcome in Cardiff, Wales, 1965-1977.

There have been several reports in which maternal nutritional status has been implicated as either a mediating or moderating factor in the relationship between maternal cigarette smoking and birthweight and perinatal survival. Also, there is evidence that the effects of maternal cigarette smoking on both intrauterine growth and fetal viability are more intense among women of lower social status. The well-maintained data set of the Cardiff Births Survey from 1965-1977 afforded an opportunity to review these issues among over 50,000 births in south Wales (the survey took place in Cardiff City through 1973 and subsequently included suburban areas of South Glamorgan). The major findings were: (1) Smoking was much more common with descending maternal social status; (2) among upper status women, smokers had similar or slightly greater mean Quetelet's indices (kg/m2) than nonsmokers. Among lower status women, smokers were considerably thinner than nonsmokers; (3) the greater the adiposity of the mother, the less the association between cigarette smoking and depressed birthweight; (4) perinatal mortality was significantly higher among heavy smokers (10 or more cigarettes a day) than among nonsmokers; and (5) neither the decrease in birthweight nor the excess mortality associated with smoking was greater among those of lower rather than upper social status, except among class I women, among whom smoking was only minimally associated with depressed birthweight. With the inclusion of the South Glamorgan suburban population in the survey after 1974, the excess mortality associated with heavy smoking dropped from 53 to 16%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Seroprevalence of human immunodeficiency virus among childbearing women. Estimation by testing samples of blood from newborns.

Attempts to predict the course of the epidemic of acquired immunodeficiency syndrome (AIDS) have been hampered by the lack of an objective, practical way to estimate the prevalence of infection with the human immunodeficiency virus (HIV) in the general population. Testing for the prevalence of HIV infection in women should be a sensitive means to track the epidemic and to study the potential for perinatal transmission. Antibodies in maternal blood are contained in neonatal blood specimens routinely collected on absorbent paper for other purposes, such as screening for phenylketonuria; we therefore tested for HIV antibody in these specimens. Analysis of batches of individually blinded specimens from selected hospitals protected the anonymity of the mothers and babies and was cost efficient. Using the newborn's blood as an indicator of the mother's serologic status, we concluded that 1 of every 476 women (2.1 per 1000) giving birth in Massachusetts was positive for HIV antibody by immunofluorescence assay or enzyme-linked immunosorbent assay, both confirmed by immunoblot (Western blot) testing. The prevalence of HIV infection varied according to the type and location of the maternity hospitals; rates of seropositivity were highest in inner-city hospitals (8.0 per 1000), lower in mixed urban and suburban hospitals (2.5 per 1000), and lowest in suburban and rural hospitals (0.9 per 1000). This method is useful for collecting data needed to plan and evaluate prevention strategies and to predict the health care resources that will be needed to care for women and children who contract AIDS. Because other states have newborn screening programs similar to the Massachusetts program, this approach can be used for national surveillance of AIDS in women.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Is the prevalence of adult asthma and allergic rhinitis still increasing? Results of an Italian study.

BACKGROUND: The prevalence of asthma and allergic rhinitis has increased worldwide during the 1970s and 1980s. OBJECTIVE: This study was aimed at evaluating whether the increasing trend in prevalence persisted during the 1990s in the young adult Italian population. METHODS: In 1998 to 2000 a screening questionnaire was sent by mail to a general population sample aged 20 to 44 years; nonresponders were contacted again first by mail and then by phone, achieving a final response rate of 78.1% (6876 of 8800). Prevalence estimates, adjusted to correct for nonresponse bias, were compared with those recorded in Italy in 1991 to 1993 during the European Community Respiratory Health Survey, when response rate had been slightly higher (87.6%). Temporal variations in symptom prevalence were analyzed by a logistic regression model, controlling for sex, age, site of residence (urban vs suburban areas), season of response, response rate, and type of contact (mail vs phone). RESULTS: The prevalence of asthma attacks did not vary significantly from 1991 to 1993 (3.6%) to 1998 to 2000 (3.2%) (P =.188). The prevalence of asthma-like symptoms (wheezing, chest tightness, shortness of breath) tended to decrease in the age classes of 32.5 to 45 years, while increasing in the youngest age class (20 to 26 years). A clear-cut increase from 15.4% to 18.3% was observed for the prevalence of allergic rhinitis (P <.001), whereas the proportion of people under antiasthmatic treatment increased in suburban areas but not in urban areas (interaction time-site of residence, P <.001). CONCLUSION: Asthma prevalence has not increased during the last decade in Italy. The persistence of an increasing trend in allergic rhinitis prevalence deserves attention.

Adult↗