The socio-economic burden of asthma is substantial in Europe

S. Accordini*, A. Corsico, I. Cerveri, D. Gislason, A. Gulsvik, C. Janson, D. Jarvis, A. Marcon, I. Pin, P. Vermeire, E. Almar, M. Bugiani, L. Cazzoletti, E. Duran-Tauleria, R. Jõgi, A. Marinoni, J. Martínez-Moratalla, B. Leynaert, R. De Marco, U. Ackermann-LiebrichJ. M. Antó, P. Burney, S. Chinn, T. Gislason, J. Heinrich, J. Knox, N. Künzli, C. Luczynska, F. Neukirch, J. Schouten, J. Sunyer, C. Svanes, M. Wjst

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

85 Citations (Scopus)


Background: Few data are available on the asthma burden in the general population. We evaluated the level and the factors associated with the asthma burden in Europe. Methods: In 1999-2002, 1152 adult asthmatics were identified in the European Community Respiratory Health Survey (ECRHS)-II and the socio-economic burden (reduced activity days and hospital services utilization in the past 12 months) was assessed. Results: The asthmatics with a light burden (only a few reduced activity days) were 13.2% (95% CI: 11.4-15.3%), whereas those with a heavy burden (many reduced activity days and/or hospital services utilization) were 14.0% (95% CI: 12.1-16.1%). The burden was strongly associated with disease severity and a lower quality of life. Obese asthmatics had a significantly increased risk of a light [relative risk ratio (RRR) = 2.17; 95% CI: 1.18-4.00] or a heavy burden (RRR = 2.77; 95% CI: 1.52-5.05) compared with normal/underweight subjects. The asthmatics with frequent respiratory symptoms showed a threefold (RRR = 2.74; 95% CI: 1.63-4.61) and sixfold (RRR = 5.76; 95% CI: 3.25-10.20) increased risk of a light or a heavy burden compared with asymptomatic asthmatics, respectively. Moreover, the lower the forced expiratory volume in 1 s % predicted, the higher the risk of a heavy burden. The coexistence with chronic cough/phlegm only increased the risk of a heavy burden (RRR = 1.88; 95% CI: 1.16-3.06). An interaction was found between gender and IgE sensitization, with nonatopic asthmatic females showing the highest risk of a heavy burden (21.6%; 95% CI: 16.9-27.1%). Conclusions: The asthma burden is substantial in Europe. A heavy burden is more common in asthmatics with obesity, frequent respiratory symptoms, low lung function, chronic cough/phlegm and in nonatopic females.

Original languageEnglish
Pages (from-to)116-124
Number of pages9
JournalAllergy: European Journal of Allergy and Clinical Immunology
Issue number1
Publication statusPublished - Jan 2008
Externally publishedYes


  • Asthma epidemiology
  • Burden of asthma
  • Burden, determinants
  • General population


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