Australian Institute of Health and Welfare (2020) Asthma., AIHW, Australian Government, accessed 30 November 2021
Australian Institute of Health and Welfare. (2020). Asthma. Retrieved from https://pp.aihw.gov.au/reports/chronic-respiratory-conditions/asthma
Asthma. Australian Institute of Health and Welfare, 25 August 2020, https://pp.aihw.gov.au/reports/chronic-respiratory-conditions/asthma
Australian Institute of Health and Welfare. Asthma [Internet]. Canberra: Australian Institute of Health and Welfare, 2020 [cited 2021 Nov. 30]. Available from: https://pp.aihw.gov.au/reports/chronic-respiratory-conditions/asthma
Australian Institute of Health and Welfare (AIHW) 2020, Asthma, viewed 30 November 2021, https://pp.aihw.gov.au/reports/chronic-respiratory-conditions/asthma
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Asthma is a common chronic condition that affects the airways (the breathing passage that carries air into our lungs). People with asthma experience episodes of wheezing, shortness of breath, coughing, chest tightness and fatigue due to widespread narrowing of the airways (National Asthma Council Australia 2019a).
The symptoms of asthma are usually reversible, either with or without treatment. The severity of asthma ranges from mild, intermittent symptoms, causing few problems for the individual, to severe and persistent wheezing and shortness of breath. In a few people with asthma, the disease has a severe adverse impact on quality of life and may be life-threatening.
It is worth noting that it can be difficult to distinguish asthma from chronic obstructive pulmonary disease (COPD) because the symptoms of both conditions can be similar—both have obstruction to the airways, both are chronic inflammatory diseases that involve the small airways (Buist 2003). Although the current definitions of asthma and COPD overlap, there are some important features that distinguish typical COPD from typical asthma. For more information, see Chronic obstructive pulmonary disease (COPD).
In addition, clinical symptoms of asthma and bronchiectasis may overlap significantly as symptoms of cough, sputum and dyspnoea can occur in either asthma or bronchiectasis (Kang et al. 2014). Although these two diseases present several common characteristics, they have different clinical outcomes. Therefore, it is important to differentiate them at early stages of diagnosis, so appropriate therapeutic measures can be adopted (Athanazio 2012). For more information, see Bronchiectasis.
The fundamental causes of asthma are not completely understood. The strongest risk factors for developing asthma are a combination of genetic predisposition with environmental exposure to inhaled substances and particles that may provoke allergic reactions or irritate the airways, such as:
Other triggers can include cold air, change in temperature, thunderstorms, extreme emotional arousal such as anger or fear, hormonal changes, pregnancy and physical exercise. Certain medications can also trigger asthma: aspirin and other non-steroid anti-inflammatory drugs, and beta-blockers (used to treat high blood pressure, heart conditions and migraine) (WHO 2017).
Thunderstorm asthma can occur suddenly in spring or summer when there is a lot of pollen in the air and the weather is hot, dry, windy and stormy. People with asthma and/or hay fever need to be extra cautious to avoid flare-ups induced by thunderstorm asthma between September and January in Victoria, New South Wales and Queensland because it can be very serious (National Asthma Council Australia 2019b). In 2016, a serious thunderstorm asthma epidemic was triggered in Melbourne when very high pollen counts coincided with adverse meteorological conditions, resulting in 3,365 people presenting at hospital emergency departments over 30 hours, and 10 deaths (Thien et al. 2018). Following this event, a thunderstorm asthma forecasting system has been developed to give Victorians early warning of possible epidemic thunderstorm asthma events in pollen season (Victoria State Government 2019).
Around 2.7 million Australians (11% of the total population) have asthma, based on self‑reported data from the 2017–18 Australian Bureau of Statistics (ABS) National Health Survey (NHS) (ABS 2018).
Based on the 2017–18 NHS, among those aged 0–14 asthma was more common among boys. Conversely, among those aged 25–34 and 45 and over asthma was more common among women. Prevalence was similar among males and females aged 15–24 and 35–44 (Figure 1). This change in prevalence for men and women in adulthood is likely due to a complex interaction between changing airway size and hormonal changes that occur during adolescent development, as well as differences in environmental exposures (Almqvist et al. 2007).
Note: Asthma refers to people who self-reported that they were diagnosed by a doctor or nurse as having asthma (current and long-term).
Source: ABS 2019a (Data table).
In 2018–19, 16% of Aboriginal and Torres Strait Islander people had asthma (an estimated 128,000 people), with a higher rate among females (18%) compared with males (13%) (ABS 2019b).
The prevalence of asthma among Indigenous Australians was 1.6 times as high as non-Indigenous Australians after adjusting for difference in age structure.
The difference in asthma prevalence between Indigenous Australians and non-Indigenous Australians exists across all age groups, but is more marked for older adults (Figure 2).
Sources: ABS 2019a; ABS 2019b (Data table).
The rate of asthma varies by remoteness and socioeconomic area.
For socioeconomic area:
Asthma has varying degrees of impact on the physical, psychological and social wellbeing of people living with the condition, depending on disease severity and the level of control. People with asthma are more likely to describe themselves as having a poor quality of life. This is more pronounced among people with severe or poorly controlled asthma (Australian Centre for Asthma Monitoring 2004; Australian Centre for Asthma Monitoring 2011). Asthma is described as well-controlled when there are few symptoms and little reliever use (e.g. less than 2 days/week), and no night waking or limitation of activity. A survey conducted in 2012 of 2,686 Australians aged 16 years and over with current asthma found that asthma was not well-controlled in almost half (45%) of people. More than half of this group were not using a preventer inhaler, or were using it infrequently (Reddel et al. 2015).
In 2017–18, self-assessed health status among people with asthma aged 15 and over was, on average, worse than among those without asthma. For example, people with asthma were less likely to describe themselves as having excellent health compared with people without asthma (11% and 23%, respectively), and more likely to describe themselves as having fair health compared with people without asthma (16% and 9.9%, respectively). Conversely, people with asthma were more likely to describe themselves as having poor health compared with people without asthma (7.4% and 3.0%, respectively) (Figure 4).
Note: Rates have been age-standardised to the 2001 Australian Standard Population as at 30 June 2001. Age groups: 15–24, 25–34, 35–44, 45–54, 55–64, 65–74, 75+.
In 2017─18, people with asthma were more likely to experience high (15%) and very high (11%) levels of psychological distress compared with those without asthma (8.7% and 3.4%, respectively) (Figure 5).
In 2017–18, people with asthma were more likely to experience moderate (27%), severe (11%) and very severe (2.8%) bodily pain compared with people without asthma (17%, 5.4% and 1.3%, respectively) (Figure 6).
In 2017–18, people aged 15 to 64 years with asthma were slightly less likely to be employed (73%) compared with people without asthma (77%) (Figure 7).
Note: Rates have been age-standardised to the 2001 Australian Standard Population as at 30 June 2001. Age groups: 15–24, 25–34, 35–44, 45–54, 55–64.
People with asthma often have other chronic and long-term conditions. See Asthma, associated comorbidities and risk factors.
Athanazio R et al. 2012. Airway disease: similarities and differences between asthma, COPD and bronchiectasis. Clinics 67 (11): 1335.
ABS (Australian Bureau of Statistics) 2018. National Health Survey: First Results, 2017–18. ABS Cat no. 4364.0.55.001. Canberra: ABS.
ABS 2019a. Microdata: National Health Survey, 2017–18. ABS cat no. 4324.0.55.001. Canberra: ABS. AIHW analysis of ABS microdata, datalab.
ABS 2019b. National Aboriginal and Torres Strait Islander Health Survey, 2018–19. ABS Cat. no. 4715.0. Canberra: ABS.
ACAM 2011. Asthma in Australia 2011: with a focus chapter on chronic obstructive pulmonary disease. Asthma series no. 4. Cat. no. ACM 22. Canberra: AIHW.
Almqvist C, Worm M, Leynaert B 2007. Impact of gender on asthma in childhood and adolescence: a GA2LEN review. Allergy 63:47–57.
Australian Centre for Asthma Monitoring (ACAM) 2004. Measuring the impact of asthma on quality of life in the Australian population. Cat. no. ACM 3. Canberra: AIHW.
Buist AS 2003. Similarities and differences between asthma and chronic obstructive pulmonary disease: treatment and early outcomes. European respiratory journal 21 (39 supplementary):30s-35s.
Gibson PG & McDonald VM 2015. Asthma-COPD overlap: now we are six. Thorax 70(7): 683-691.
Kang HR, Choi GS, Park SJ, et al. 2014. The Effects of Bronchiectasis on Asthma Exacerbation. Tuberculosis & Respiratory Disease 77(5): 209-214.
Asthma Australia Asthma-COPD overlap. Asthma Australia.
National Asthma Council Australia 2019a. Australian Asthma Handbook, Version 2.0. Melbourne: National Asthma Council Australia. Viewed 1 May 2019.
Asthma Australia Thunderstorm asthma. Asthma Australia.
Reddel HK, Sawyer SM, Everett PW, Flood PV, Peters MJ 2015. Asthma control in Australia: a cross-sectional web-based survey in a nationally representative population. Medical Journal of Australia 202(9):492–6.
Victoria State Government 2019. Epidemic thunderstorm asthma forecast. Melbourne: Victoria State Government.
WHO (World Health Organisation) 2017. Asthma. Geneva: WHO. Viewed 5 February 2020.
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