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1. Allergic rhinitis and asthma comorbidity in a survey of young adults in Italy

Author

Bugiani, M., Carosso, A., Migliore, E., Piccioni, P., Corsico, A., Olivieri, M., Ferrari, M., Pirina, P., Marinoni, R. de Marco on behalf of ISAYA: Principal researchers: A., Carolei, A., Montomoli, C., Villani, S., Comelli, M., Ponzio, M., Grassi, M., Rezzani, C., Casali, L., Cerveri, I., Zoia, M. C., Colato, S., Moscato, G., Perfetti, L., Alesina, R., Basso, O., Berrayah, L., Brusotti, R., Fanfulla, F., Moi, P., Frati, C., Karytinos, P., Arossa, W., Caria, E., Castiglioni, G., Romano, Canzio, Fabbro, D., Ciccone, G., Magnani, C., Dalmasso, P., Bono, Roberto, Gigli, G., Giraudo, A., Brussino, M. C., Bucca, Caterina, Rolla, Giovanni, Aime, M., Cerutti, A., Chiampo, F., Gallo, W., Sulotto, F., de Marco, R., Verlato, G., Accordini, S., Zanolin, M. E., Locatelli, F., Cazzoletti, L., Pattaro, C., Sartori, S., Poli, A., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Biasin, C., Campello, C., Rossi, F., Cannistra`, A., Cenci, B., Destefani, E., Girotto, M., Lampronti, G., Martini, C., Tardivo, S., Villani, A., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., P. Natale, M. Grosa, Tacconi, A., Frontero, P., and Salomoni, A.

Published
2005

2. The role of climate on the geographic variability of asthma, allergic rhinitis and respiratory symptoms: results from the Italian study of asthma in young adults

Author

Zanolin, M. E., Pattaro, C., Corsico, A., Bugiani, M., Carrozzi, L., Casali, L., Dallari, R., Ferrari, M., Marinoni, A., Migliore, E., Olivieri, M., Pirina, P., Verlato, G., Villani, S., de Marco, R., Buriani, O., Cavallini, R., Saletti, C., Cellini, M., Faustini, M., de Togni, A., Carolei, A., Montomoli, C., Comelli, M., Ponzio, M., Grassi, M., Rezzani, C., Cerveri, I., Zoia, M. C., Colato, S., Moscato, G., Perfetti, L., Viegi, G., Pistelli, F., di Pede, F., Paggiaro, P. L., Santolicandro, A., Giovannetti, P., Ginesu, F., Ostera, S., Pinna, G. P., Farre, A., Imparato, S., Turrini, E., Foglia, M., Giammanco, G., Pignato, S., Rotondo, A., Cuspilici, A., Piccioni, P., Carosso, A., Arossa, W., Caria, E., Castiglioni, G., Romano, C., Fabbro, D., Ciccone, G., Magnani, C., Dalmasso, P., Bono, R., Gigli, G., Giraudo, A., Brussino, M. C., Bucca, C., Rolla, G., Struzzo, P., Orefice, U., Schneider, M., Chittaro, F., Peresson, D., Accordini, S., Locatelli, F., Cazzoletti, L., Sartori, S., Poli, A., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Biasin, C., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., Natale, P., Grosa, M., Tacconi, A., Frontero, P., and Salomoni, A.

Subjects
Adult, medicine.medical_specialty, Allergy, Rhinitis, Allergic, Perennial, Climate, Immunology, Geographic pattern, Allergic, Epidemiology, medicine, Prevalence, Immunology and Allergy, Humans, Asthma epidemiology, Asthma prevalence allergy, Latitude, Asthma, Chronic Disease, Cough, Geography, Regression Analysis, Rhinitis, Allergic, Seasonal, Rhinitis, Seasonal, business.industry, Phlegm, Respiratory disease, Odds ratio, medicine.disease, Perennial, respiratory tract diseases, Chronic cough, Etiology, medicine.symptom, business, Demography
Abstract

Background: Variations in the prevalence of respiratory symptoms according to geo-climatic factors could provide important clues to the knowledge of the aetiology of asthma. Methods: Geo-climatic variations in the prevalence of current asthma, allergic rhinitis and chronic cough, and phlegm were assessed on a random sample of 18 873 subjects (response rate = 72.7%) from different climatic regions of Italy. An ecological analysis, supported by robust statistical methods, was employed to investigate potential trends. Results: The prevalence of all symptoms was significantly heterogeneous throughout the peninsula. Only asthma-like symptoms showed a north–south trend: the prevalence increased at a decreasing latitude [odds ratio (OR) varies from 0.92 to 0.96, P

Published
2004

3. The role of climate on the geographic variability of asthma, allergicrhinitis and respiratory symptoms: results from the Italian study of asthma in young adults

Author

Zanolin, M. E., Pattaro, C., Corsico, . A., Bugiani, M., Carrozzi, L., Casali, . L., Dallari, R., Ferrari, M., Marinoni, . A., Migliore, E., Olivieri, M., P. P. i. r. i. n. a., . G. Verlato, Villani, . S., Demarco, R., Buriani, . O., Cavallini, R., Saletti, C., Cellini, M., Faustini, M., de Togni, A., Marinoni, A., Carolei, A., Montomoli, C., Villani, S., Comelli, M., Ponzio, . M., Grassi, M., Rezzani, C., Casali, L., Cerveri, I., Zoia, M. C., Corsico, A., Colato, S., Moscato, G., Perfetti, . L., Viegi, G., Pistelli, F., Di Pede, F., Paggiaro, P. L., Santolicandro, A., Giovannetti, P., Ginesu, F., Pirina, P., Ostera, S., Pinna, G. P., Farre, A., Imparato, S., Turrini, E., Foglia, . M., Giammanco, G., Pignato, S., Rotondo, . A., Cuspilici, A., Piccioni, P., Carosso, . A., Arossa, W., Caria, E., Castiglioni, G., Romano, Canzio, Fabbro, D., Ciccone, G., Magnani, . C., Dalmasso, P., Bono, Roberto, Gigli, G., Giraudo, A., Brussino, Luisa, Bucca, Caterina, Rolla, Giovanni, Struzzo, P., Orefice, . U., Schneider, M., Chittaro, F., Peresson, D., de Marco, R., Verlato, G., Accordini, S., Locatelli, F., Cazzoletti, L., Sartori, S., Poli, . A., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Biasin, C., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., P. Natale, M. Grosa, Tacconi, A., Frontero, P., and Salomoni, A.

Subjects
climate, asthma, allergic rhinitis, respiratory symptoms
Published
2004

4. Chronic cough and phlegm in young adults

Author

Cerveri, I., Accordini, S., Corsico, A., Zoia, M. C., Carrozzi, L., Cazzoletti, L., Beccaria, M., Marinoni, A., Viegi, G., de Marco, R., Ginesu, F., Pirina, P., Ostera, S., Pinna, G. P., Farre, A., Imparato, S., Dallari, R., Turrini, E., Foglia, M., Giammanco, G., Pignato, S., Rotondo, A., Cuspilici, A., Bugiani, M., Piccioni, P., Carosso, A., Arossa, W., Caria, E., Castiglioni, G., Migliore, E., Romano, C., Fabbro, D., Ciccone, G., Magnani, C., Dalmasso, P., Bono, R., Gigli, G., Giraudo, A., Brussino, M. C., Bucca, C., Rolla, G., Struzzo, P., Orefice, U., Schneider, M., Chittaro, F., Peresson, D., Verlato, G., Zanolin, M. E., Locatelli, F., Battisti, L., Pattaro, C., Poli, A., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Olivieri, M., Ferrari, M., Biasin, C., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., Natale, P., Grosa, M., Tacconi, A., Frontero, P., and Salomoni, A.

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, Pediatrics, medicine.medical_specialty, Chronic Obstructive, Cross-sectional study, Health surveys, Population, chronic obstructive pulmonary disease, cross-sectional studies, health surveys, risk factors, smoking, Pulmonary Disease, Pulmonary Disease, Chronic Obstructive, Sex Factors, Epidemiology, medicine, Prevalence, Chronic obstructive pulmonary disease, Cross-sectional studies, Risk factors, Smoking, Asthma, Chronic Disease, Cough, Cross-Sectional Studies, Female, Humans, Italy, Socioeconomic Factors, Sputum, Young adult, education, education.field_of_study, business.industry, Phlegm, medicine.disease, Obstructive lung disease, respiratory tract diseases, Chronic cough, medicine.symptom, business
Abstract

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines underline that the presence of chronic cough and sputum production before airflow obstruction offers a unique opportunity to identify subjects at risk of chronic obstructive pulmonary disease for an early intervention. Current epidemiological data on these subjects are scant. Between 1998-2000, the authors evaluated the prevalence and characteristics of these symptoms by a multicentre cross-sectional survey of Italian people aged between 20-44 yrs from the general population (Italian Study on Asthma in Young Adults (ISAYA)). Besides the questions on asthma, more than 18,000 subjects answered the question: "Have you had cough and phlegm on most days for as much as 3 months per year and for at least two successive years?" The adjusted prevalence of subjects with chronic cough and phlegm was 11.9%, being 11.8% in males and 12.0% in females. From these subjects approximately 20% reported coexisting asthma and approximately 30%, predominately females, were nonsmokers. The survey showed that sex (female), smoking and low socioeconomic status were significantly and independently associated with chronic cough and phlegm, current smoking playing the major role. The prevalence of subjects with chronic cough and phlegm is startlingly high among young adults. Further follow-up studies are needed to establish how many of them will go on to develop chronic obstructive pulmonary disease.

Published
2003

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

Author

Verlato, G, Corsico, A, Villani, S, Cerveri, I, Migliore, E, Accordini, S, Carolei, A, Piccioni, P, Bugiani, M, Lo Cascio, V, Marinoni, A, Poli, A, Ecrhs, de Marco R., Marinoni, ISAYA group Principal researchers: A., Carolei, A., Montomoli, C., Villani, S., Comelli, M., Ponzio, M., Grassi, M., Rezzani, C., Casali, L., Cerveri, I., Zoia, M. C., Corsico, A., Colato, S., Moscato, G., Perfetti, L., Alesina, R., Basso, O., Berrayah, L., Brusotti, R., Fanfulla, F., Moi, P., Frati, C., Karytinos, P., Bugiani, M., Piccioni, P., Carosso, A., Arossa, W., Caria, E., Castiglioni, G., Migliore, E., Romano, C., Fabbro, D., Ciccone, G., Magnani, C., Dalmasso, Paola, Bono, Roberto, Gigli, G., Giraudo, A., Brussino, Luisa, Bucca, Caterina, Rolla, Giovanni, Aime, M., Cerutti, A., Chiampo, F., Gallo, W., Sulotto, F., de Marco, R., Verlato, G., Accordini, S., Zanolin, M. E., Locatelli, F., Cazzoletti, L., Pattaro, C., Sartori, S., Poli, A., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Olivieri, M., Ferrari, M., Biasin, C., Campello, C., Rossi, F., Cannistrà, A., Cenci, B., Destefani, E., Girotto, M., Lampronti, G., Martini, C., Tardivo, S., Villani, A., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., Natale, P., Grosa, M., Tacconi, A., Frontero, P., and Salomoni, A.

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Allergy, Rhinitis, Allergic, Perennial, temporal trend, Immunology, Logistic regression, asthma, allergic rhinitis, temporal trend, epidemiology, Epidemiology, Prevalence, Immunology and Allergy, Medicine, Humans, Non-response bias, Young adult, Asthma, Response rate (survey), allergic rhinitis, business.industry, Rhinitis, Allergic, Seasonal, Odds ratio, asthma, medicine.disease, Italy, Female, epidemiology, business
Abstract

The prevalence of asthma and allergic rhinitis has increased worldwide during the 1970s and 1980s.This study was aimed at evaluating whether the increasing trend in prevalence persisted during the 1990s in the young adult Italian population.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).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).Asthma prevalence has not increased during the last decade in Italy. The persistence of an increasing trend in allergic rhinitis prevalence deserves attention.

Published
2003

6. Incidence and remission of asthma: a retrospective study on the natural history of asthma in Italy

Author

De Marco, R., Locatelli, F., Cerveri, I., Bugiani, M., Marinoni, A., Giammanco, G., Accordini, S., Verlato, G., Zanolin, E., Buriani, O., Carrozzi, L., Dallari, R., Ginesu, F., Poli, A., Struzzo, P., Cavallini, R., Saletti, C., Cellini, M., Faustini, M., De Togni, A., Carolei, A., Montomoli, C., Villani, S., Comelli, M., Ponzio, M., Grassi, M., Rezzani, C., Casali, L., Zoia, M. C., Corsico, A., Colato, S., Moscato, G., Perfetti, L., Viegi, G., Pistelli, F., Di Pede, F., Paggiaro, P. L., Santolicandro, A., Giovannetti, P., Pirina, P., Ostera, S., Pinna, G. P., Farre, A., Imparato, S., Turrini, E., Foglia, M., Pignato, S., Rotondo, A., Cuspilici, A., Piccioni, P., Carosso, A., Arossa, W., Caria, E., Castiglioni, G., Migliore, E., Romano, C., Fabbro, D., Ciccone, G., Magnani, C., Dalmasso, P., Bono, R., Gigli, G., Giraudo, A., Brussino, M. C., Bucca, C., Rolla, G., Orefice, U., Schneider, M., Chittaro, F., Peresson, D., Zanolin, M. E., Cazzoletti, L., Battisti, L., Pattaro, C., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Olivieri, M., Ferrari, M., Biasin, C., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., Natale, P., Grosa, M., Tacconi, A., Frontero, P., and Salomoni, A.

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Adolescent, National Health Programs, Remission, Cross-sectional study, Immunology, Population, Remission, Spontaneous, Rate ratio, Asthma remission, Asthma incidence, Persistence of asthma, Asthma, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Incidence, Infant, Infant, Newborn, Italy, Retrospective Studies, medicine, Immunology and Allergy, Young adult, Preschool, education, education.field_of_study, business.industry, Spontaneous, Incidence (epidemiology), Retrospective cohort study, Newborn, medicine.disease, Natural history, business
Abstract

The knowledge of the natural history of asthma from birth to adulthood could provide important clues for its cause and for the understanding of epidemiologic findings.This study is aimed at assessing the incidence and remission of asthma from birth to the age of 44 years by using data from 18,873 subjects involved in a large, nationally representative, cross-sectional study carried out in Italy from 1998 through 2000.The onset of asthma was defined as the age at the first attack, and remission was considered present when a subject was neither under treatment nor had experienced an asthma attack in the last 24 months. Person-years and survival techniques were used for the analysis.The average annual incidence rate for the 1953 to 2000 period was 2.56/1000 persons per year. Incidence peaked in boys less than 10 years of age (4.38/1000 persons per year) and in women 30 years of age or older (3.1/1000 persons per year) and showed a generational increase (incident rate ratio = 2.63 and 95% CI = 2.20-3.12 for 1974-1979 vs 1953-1958 birth cohort). The overall remission rate was 45.8% (41.6% in women and 49.5% in men, P.001). Asthmatic patients in remission had an earlier age at onset (7.8 vs 15.9 years, P.001) and a shorter duration of the disease (5.6 vs 16.1 years, P.001) than patients with current asthma. The probability of remission was strongly (P.001) and inversely related to the age at onset (62.8% and 15.0% in the10- andor =20-years age-at-onset groups, respectively).With respect to its natural history, asthma presents 2 different forms: early-onset asthma, which occurs early in childhood, affects mainly boys, and has a good prognosis, and late-onset asthma, which generally occurs during or after puberty, mainly affects women, and has a poor prognosis. The minority of patients with early-onset asthma who do not remit represents more than 35% of patients with current asthma in the general young adult population.

Published
2002

7. Incidence and remission of asthma: A retrospective study on the natural history of asthma in Italy

Author

de Marco, R, Locatelli, F, Cerveri, I, Bugiani, M, Marinoni, A, Giammanco, G, Buriani, for the Italian Study on Asthma in Young Adults study group Principal researchers: O., Cavallini, R., Saletti, C., Cellini, M., Faustini, M., de Togni, A., Marinoni, A., Carolei, A., Montomoli, C., Villani, S., Comelli, M., Ponzio, M., Grassi, M., Rezzani, C., Casali, L., Cerveri, I., Zoia, M. C., Corsico, A., Colato, S., Moscato, G., Perfetti, L., Carrozzi, L., Viegi, G., Pistelli, F., Di Pede, F., Paggiaro, P. L., Santolicandro, A., Giovannetti, P., Ginesu, F., Pirina, P., Ostera, S., Pinna, G. P., Farre, A., Imparato, S., Dallari, R., Turrini, E., Foglia, M., Giammanco, G., Pignato, S., Rotondo, A., Cuspilici, A., Bugiani, M., Piccioni, P., Carosso, A., Arossa, W., Caria, E., Castiglioni, G., Migliore, E., Romano, Canzio, Fabbro, D., Ciccone, G., Magnani, C., Dalmasso, Paola, Bono, Roberto, Gigli, G., Giraudo, A., Brussino, Luisa, Bucca, Caterina, Rolla, Giovanni, Struzzo, P., Orefice, U., Schneider, M., Chittaro, F., Peresson, D., de Marco, R., Verlato, G., Accordini, S., Zanolin, M. E., Locatelli, F., Cazzoletti, L., Battisti, L., Pattaro, C., Poli, A., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Olivieri, M., Ferrari, M., Biasin, C., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., P. Natale, M. Grosa, Tacconi, A., Frontero, P., and Salomoni, A.

Published
2002

9. Asthmatics and ex-smokers respond early, heavy smokers respond late to mailed surveys in Italy

Author

Verlato, Giuseppe, Melotti, Roberto, Olivieri, Mario, Corsico, Angelo, Bugiani, Massimiliano, Accordini, Simone, Villani, Simona, Migliore, Enrica, Marinoni, Alessandra, Pirina, Pietro, Carrozzi, Laura, Bortolami, Oscar, Rava, Marta, de Marco, Roberto, Accordini, S., Verlato, G., Zanolin, E., Bugiani, M., Buriani, O., Carrozzi, L., Dallari, R., Giammanco, G., Ginesu, F., Marinoni, A., Poli, A., Struzzo, Pierluigi, Cavallini, R., Saletti, C., Cellini, M., Faustini, M., de Togni, A., Carolei, A., Montomoli, C., Villani, S., Comelli, M., Ponzio, M., Grassi, M., Rezzani, C., Casali, L., Cerveri, I., Zoia, M. C., Corsico, A., Colato, S., Moscato, G., Perfetti, L., Viegi, G., Pistelli, F., Di Pede, F., Paggiaro, P. L., Santolicandro, A., Giovannetti, P., Pirina, P., Ostera, S., Pinna, G. P., Farre, A., Imparato, S., Turrini, E., Foglia, M., Pignato, S., Rotondo, A., Cuspilici, A., Piccioni, P., Carosso, A., Arossa, W., Caria, E., Castiglioni, G., Migliore, E., Romano, C., Fabbro, D., Ciccone, G., Magnani, C., Dalmasso, P., Bono, R., Gigli, G., Giraudo, A., Brussino, M. C., Bucca, C., Rolla, G., Struzzo, P., Orefice, U., Schneider, M., Chittaro, F., Peresson, D., de Marco, R., Zanolin, M. E., Locatelli, F., Cazzoletti, L., Pattaro, C., Sartori, S., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Ferrari, M., Biasin, C., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., Natale, P., Grosa, M., Tacconi, A., Frontero, P., Salomoni, A., Verlato, Giuseppe, Melotti, Roberto, Olivieri, Mario, Corsico, Angelo, Bugiani, Massimiliano, Accordini, Simone, Villani, Simona, Migliore, Enrica, Marinoni, Alessandra, Pirina, Pietro, Carrozzi, Laura, Bortolami, Oscar, Rava, Marta, de Marco, Roberto, Accordini, S., Verlato, G., Zanolin, E., Bugiani, M., Buriani, O., Carrozzi, L., Dallari, R., Giammanco, G., Ginesu, F., Marinoni, A., Poli, A., Struzzo, Pierluigi, Cavallini, R., Saletti, C., Cellini, M., Faustini, M., de Togni, A., Carolei, A., Montomoli, C., Villani, S., Comelli, M., Ponzio, M., Grassi, M., Rezzani, C., Casali, L., Cerveri, I., Zoia, M. C., Corsico, A., Colato, S., Moscato, G., Perfetti, L., Viegi, G., Pistelli, F., Di Pede, F., Paggiaro, P. L., Santolicandro, A., Giovannetti, P., Pirina, P., Ostera, S., Pinna, G. P., Farre, A., Imparato, S., Turrini, E., Foglia, M., Pignato, S., Rotondo, A., Cuspilici, A., Piccioni, P., Carosso, A., Arossa, W., Caria, E., Castiglioni, G., Migliore, E., Romano, C., Fabbro, D., Ciccone, G., Magnani, C., Dalmasso, P., Bono, R., Gigli, G., Giraudo, A., Brussino, M. C., Bucca, C., Rolla, G., Struzzo, P., Orefice, U., Schneider, M., Chittaro, F., Peresson, D., de Marco, R., Zanolin, M. E., Locatelli, F., Cazzoletti, L., Pattaro, C., Sartori, S., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Ferrari, M., Biasin, C., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., Natale, P., Grosa, M., Tacconi, A., Frontero, P., and Salomoni, A.

Subjects
Male, Questionnaires, Allergy, asthmatics, ex-smokers, survey, Allergic rhinitis, Mail survey, Epidemiology, Prevalence, Smoking habit, Medicine, Respiratory symptoms, Young adult, Response bias, Medicine (all), Respiratory disease, Phlegm, Smoking, Health Survey, Middle Aged, Chronic cough, Italy, Bias (Epidemiology), Female, medicine.symptom, Human, Adult, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Logistic Model, Response bia, Young Adult, Allergic rhiniti, Humans, Smoking habits, Asthma, Questionnaire, business.industry, medicine.disease, Health Surveys, Surgery, respiratory tract diseases, Logistic Models, Cough, mail survey, response bias, respiratory symptoms, asthma, allergic rhinitis, smoking habits, Respiratory symptom, Patient Compliance, business, Demography
Abstract

Summary Rationale and objectives Response to mailed epidemiological surveys has decreased in recent decades. Since subjects with respiratory symptoms are usually early responders to surveys performed in Southern Europe, this trend could bias prevalence estimates. The present study aimed at evaluating the impact of non-response bias on prevalence estimates of respiratory symptoms and smoking habits. Methods In 9 centres, participating in the Italian Study on Asthma in Young Adults (ISAYA), random samples of people aged 20–45 years were administered a mailed questionnaire between 1998 and 2000. Non-responders were contacted again first by mail and then by phone. Cumulative response percentage was 30.5%, 52.4% and 72.7% (18,873/25,969), respectively, after the 1st, 2nd and 3rd contact. Results The prevalence of self-reported current asthma, asthma-like symptoms, and chronic cough/phlegm was more than halved from the first contact (5.6%, 17.8%, 14.6% respectively) to the third contact (2.7%, 6.4%, 6.9%). This pattern was less pronounced when considering allergic rhinitis and past asthma, whose prevalence decreased, respectively, from 21.5% to 15.6% and from 3.5% to 2.6%. At the same time the proportion of current smokers increased from 29.2% to 38%, while the proportion of ex-smokers decreased from 16.5% to 10.1%. In a multinomial logistic model current asthma, asthma-like symptoms, chronic cough/phlegm and smoking habits, and to a lower extent past asthma and allergic rhinitis, were significant predictors of late response. Conclusions In Italy when response percentage is low, the prevalence of current asthma, chronic cough/phlegm and ex-smokers is overestimated, while the proportion of current smokers is underestimated.

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