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Background: While the prevalence of childhood wheeze continues to increase in many countries, decreasing trends have also been reported. This may be explained by increased use of asthma medication, which effectively suppresses wheeze symptoms. In this study we investigated trends in wheeze in Dutch school children between 1989 and 2005, and their association with medication use. Methods: In five repeated cross-sectional surveys between 1989 and 2005, parents of all 5- to 6-year-old and 8- to 11-year-old children eligible for a routine physical examination were asked to complete a questionnaire on their child's respiratory health. We identified all children for whom a questionnaire was completed in two successive surveys. Children were grouped according to birth year and classified into one out of four wheeze categories: "no wheeze," "discontinued wheeze," "continued wheeze," or "new-onset wheeze." Results: In total, 3,339 children, born in 1983 (N = 670), 1988 (N = 607), 1992 (N = 980), and 1995 (N = 1,082), participated twice. Over the study period, the proportion of children with "no wheeze" increased from 73.8% to 86.1% (P-trend 0.05 for all wheeze categories). Conclusion: An increasing trend of Dutch school children with " no wheeze," and decreasing trends of children with "discontinued" and "continued" wheeze between 1989 and 2005 could not be explained by (increased) medication use. This suggests that wheeze prevalence is not masked by medication use, but is truly declining. (C) 2014 Wiley Periodicals, Inc.

Background: While the prevalence of childhood wheeze continues to increase in many countries, decreasing trends have also been reported. This may be explained by increased use of asthma medication, which effectively suppresses wheeze symptoms. In this study we investigated trends in wheeze in Dutch school children between 1989 and 2005, and their association with medication use. Methods: In five repeated cross-sectional surveys between 1989 and 2005, parents of all 5- to 6-year-old and 8- to 11-year-old children eligible for a routine physical examination were asked to complete a questionnaire on their child's respiratory health. We identified all children for whom a questionnaire was completed in two successive surveys. Children were grouped according to birth year and classified into one out of four wheeze categories: "no wheeze," "discontinued wheeze," "continued wheeze," or "new-onset wheeze." Results: In total, 3,339 children, born in 1983 (N = 670), 1988 (N = 607), 1992 (N = 980), and 1995 (N = 1,082), participated twice. Over the study period, the proportion of children with "no wheeze" increased from 73.8% to 86.1% (P-trend 0.05 for all wheeze categories). Conclusion: An increasing trend of Dutch school children with " no wheeze," and decreasing trends of children with "discontinued" and "continued" wheeze between 1989 and 2005 could not be explained by (increased) medication use. This suggests that wheeze prevalence is not masked by medication use, but is truly declining. (C) 2014 Wiley Periodicals, Inc.

To establish whether asthma affects physical activity levels in children (aged 7-10 years) we evaluated physical activity levels in children with undiagnosed asthma (UDA), diagnosed asthma (DA), and healthy controls (HCs). A cross-sectional community-based study was performed which included a parental questionnaire on their child's respiratory health, and testing of airway reversibility and bronchial hyperresponsiveness (BHR). DA was defined as the parents' confirmation of a physician's diagnosis of asthma in the past 12 months. UDA was defined by asthma symptoms combined with airway reversibility or BHR in children without a physician's diagnosis of asthma. Physical activity was measured during 5 days with an accelerometer and a diary, and with the habitual activity estimation scale which reviews the physical activity during the past 2 weeks. The final study population comprised 1,614 children of whom 81 (5%) had DA, 130 (8%) UDA, and 202 HCs. Baseline FEV(1) % was lowest in children with UDA (UDA FEV(1) 94% predicted, DA FEV(1) 98% predicted, HCs FEV(1) 100% predicted). Using the three methods, no differences were found in the physical activity between children with UDA, DA, and HCs. Childhood asthma does not appear to be associated with a decreased level of daily physical activity in our study population.