Physician-diagnosed asthma

Chuang W-Y, Huang S-L, Pan W-H Nutritional factors associated with physician-diagnosed asthma in teenagers - Analyses of the first Nutrition and Health Survey in Taiwan (NAHSIT). Am J Respir Crit Care Med 2001 163 A39. 

Senthilselvan A, Lawson J, Rennie DC, Dosman JA (2003) Stabilization of an increasing trend in physician-diagnosed asthma prevalence in Saskatchewan, 1991 to 1998. Chest 124 438 48 Shrestha IL, Shrestha SL (2005) Indoor air pollution from biomass fuels and respiratory health of the exposed population in Nepalese households. Int J Occup Environ Health 11 150-160 Skorge TD, Eagan TM, Eide GE, Gulsvik A, Bakke PS (2005) Indoor exposures and respiratory symptoms in a Norwegian community sample. Thorax 60 937-942... 

Approximately 17% of the U.S. population suffers from some sort of allergic disease (76). Most of those individuals are hypersensitive to pollens or have atopic eczema. Six percent of the population has physician-diagnosed asthma, the prevalence of which has increased by approximately 30% over the last 15 years. Air pollution exposure has long been considered a risk factor for the exacerbation of asthma attacks in asthmatic individuals. Health care statistics in Canada and the United States show that hospital admissions for asthma increase dur-... 

Other workers with flavoring-related BO were not appropriately diagnosed, even after reports of flavoring-related BO were published in the scientific literature (Kreiss et ah, 2002a Lockey et ah, 2002 Parmet and von Essen, 2002), public health commimications (CDC, 2002), and the press. Frequent misdiagnoses by physicians included asthma, bronchitis, and emphysema due to a presumptive diagnosis, an incomplete medical evaluation, and/or failure to make a coimection with occupational exposures. 

Children with asthma are major consumers of health services [33]. An average of 6.4% of the annual income of middle class families, and 10% of the income of low-income families, is spent for the management of childhood asthma in the USA [34]. Children with asthma miss school more frequently [35], make more visits to emergency departments and physician s offices [36], and spend more time in the hospital than healthy children [37]. Asthma has been linked to poor school performance [38, 39], especially among children of low socio-economic status [40]. Children with asthma also have problems related to poor psychological adjustment [41], low self-image [9(Ia)], and disruption of family life [32, 37]. The failure to diagnose asthma and the subsequent lack of adequate treatment [42] may cause morbidity later in adult life [43]. 

Shortness of breath, cough, and wheeze are common symptoms of respiratory diseases (Table 3.2). These shared symptoms make misdiagnosis by physicians common if the diagnosis is based solely on reported symptoms. Medical tests help to distinguish the respiratory diseases from each other (Table 3.3). Other pitfalls in medical diagnosis include diagnosing common diseases (such as asthma, emphysema, and chronic bronchitis) instead of the actual rarer diseases (such as BO) and not considering occupational exposures as the cause. 

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