Asthma in Adults Fact Sheet

Asthma is a treatable obstructive lung disease, caused by increased reaction of the airways to various stimuli. It is a chronic inflammatory condition with acute exacerbations. Asthma can be a life-threatening disease if not properly managed.

• In 2003, it was estimated that 20 million Americans currently have asthma.  Of these, 11 million Americans (4 million children under 18) had an asthma attack.
  
  
• Current asthma prevalence in adults ranged from 5.6% in Georgia to 9.9% in Maine and Massachusetts.
  
  
• After a long period of steady increase, evidence suggests that asthma mortality and morbidity rates continue to plateau and/or decrease. In 2002, there were 4,261 deaths attributed to asthma -- an age-adjusted rate of 1.5 per 100,000.
  
  
• The number of hospital discharges has decreased 5% between 1995 and 2002 while the discharge rate has declined 13% since it peaked at 19.5 per 10,000 in 1995. During 2002, 484,000 discharges (16.9 per 10,000) were due to asthma.
  
  
• Close to 1.9 million emergency room visits were attributed to asthma in 2002.
  
  
• In 2003, asthma accounted for an estimated 24.5 million lost work days in adults.
  
  
• The annual direct health care cost of asthma is approximately $11.5 billion; indirect costs (e.g. lost productivity) add another $4.6 billion, for a total of $16.1 billion dollars. Prescription drugs represented the largest single indirect cost, at $5 billion. The value of lost productivity due to death represented the largest single indirect cost at $1.7 billion.
  
  
• Asthma breathing problems usually happen in "episodes," but the inflammation underlying asthma is continuous.  An asthma episode is a series of events that result in narrowed airways. These include: swelling of the lining, tightening of the muscle, and increased secretion of mucus in the airway. The narrowed airway is responsible for the difficulty in breathing with the familiar "wheeze."
  
  
• Lung function declines faster than average in people with asthma, particularly in people who smoke and in those with excessive mucus production (an indicator of poor treatment control).
  
  
• Asthma medications help reduce underlying inflammation in the airways and relieve or prevent symptomatic airway narrowing. Control of inflammation should lead to reduction in airway sensitivity and help prevent airway obstruction.
  
  
• Two classes of medications have been used to treat asthma -- anti-inflammatory agents and bronchodilators.  Anti-inflammatory drugs interrupt the development of bronchial inflammation and have a preventive action. They may also modify or terminate ongoing inflammatory reactions in the airways. These agents include corticosteroids, cromolyn sodium, and other anti-inflammatory compounds. A new class of anti-inflammatory medications known as leukotriene modifiers, which work in a different way by blocking the activity of chemicals called leukotrienes that are involved in airway inflammation have recently come on the market.
  
  
• Bronchodilators act principally to open the airways by relaxing bronchial muscle. They include beta-adrenergic agonists, methylxanthines, and anticholinergics.
  
  
• In July of 2003, The Food and Drug Administration approved a new drug for patients with serious asthma. Xolair, is the first in a new class of therapies that are bioengineered to target IgE (the antibody behind allergic asthma) in the treatment of allergic disease. In one study, Xolair cut one-third to one-half the number of asthma attacks suffered by patients whose disease isn't controlled by today's standard treatments. Many dramatically cut back or even eliminated inhaled steroid and other asthma medications.
  
  
• Despite the numerous drugs available, asthma is still poorly controlled.  One study reported that 72 percent of men and 86 percent of women with asthma had symptoms 15 years after they were first diagnosed with the disease. Only 19 percent of these people, however, were still seeing a doctor and only 32 percent used any medication to regularly manage their asthma.
  
  
• A recent survey found that 48 percent of people with asthma say that the disease limits their ability to take part is sports and recreation, 36 percent say it limits their normal physical exertion and 25 percent say it interferes with their social activities.
  
  
• Asthma is characterized by excessive sensitivity of the lungs to various stimuli. Triggers range from viral infections to allergies, to irritating gases and particles in the air.  Each person reacts differently to the factors that may trigger asthma, including: respiratory infections; colds;
  cigarette smoke; allergic reactions to such allergens as pollen, mold, animal dander, feather, dust, food, and cockroaches; indoor and outdoor air pollutants including ozone; vigorous exercise;
  exposure to cold air or sudden temperature change; excitement/stress; and exercise.
  
  
• Asthma may also be triggered by over the counter drugs.  One study found that one adult asthmatic in five can suffer a potentially life-threatening reaction to aspirin.
  
  
• The American Lung Association funds a wide variety of asthma research. The American Lung Association-Asthma Clinical Research Centers (ACRC) network is an American Lung Association-sponsored research program seeking to develop large clinical trials that will provide useful information important to the direct care of people who have asthma. The network, with 20 clinical centers and a data coordinating center, is the largest of its kind and seeks to conduct large practical clinical trails that will provide useful information about asthma that will directly benefit patients.  This work involves large numbers of subjects, making the focus of the network different from current federally funded and commercial research. Thus, the ACRC is playing a unique and important role in asthma research.
  
  
• A recent study by the American Lung Association Clinical Research Center (ACRC) found that the inactivated influenza vaccine is safe to administer to adults and children with asthma, including those with severe asthma.12 Influenza causes substantial morbidity in adults and children with asthma, and vaccination can prevent influenza and its complications. If 50% of asthmatic adults and children received the flu vaccine then $379 million could be saved in hospitalization costs. Currently, fewer than 10% of children and 40.4% of adults with asthma receive the influenza vaccine.

For more information on asthma, please review the Asthma Morbidity and Mortality Trend Report in the Data and Statistics section of www.lungusa.org or call the American Lung Association at 1-800-LUNG-USA (1-800-586-4872).

National Center for Health Statistics. Raw Data from the National Health Interview Survey, U.S., 2003.  (Analysis by the American Lung Association, Using SPSS and SUDAAN software).

Center for Disease Control and Prevention: Behavioral Risk Factor Surveillance System, 2003.

National Center for Health Statistics. Report of Final Mortality Statistics, 2002.

National Center for Health Statistics. National Hospital Discharge Survey, 2002.

National Center for Health Statistics. National Hospital Ambulatory Medical Survey, 2002. (Analysis by the American Lung Association, Using SPSS and SUDAAN software).

National Center for Health Statistics. Raw Data from the National Health Interview Survey, U.S., 2003.  (Analysis by the American Lung Association, Using SPSS and SUDAAN software).

National Heart, Lung and Blood Institute Chartbook, U.S. Department of Health and Human Services, National Institute of Health, 2004.

Lanier BQ, Corren J, Lumry W, Liu J, Fowler-Taylor A, Gupta N. Omalizumab Is Effective In the Long Term Control of Severe Allergic Asthma. Annals of Allergy, Asthma, and Immunology, August 2003; Vol 91: pp 154-159.

Asthma in Adults, March 2002. University of Maryland Medicine. www.umm.edu/patiented/doc04full.html.

Asthma in America Survey Project 1998. GlaxoSmithKline.

Jenkins C, Costello J, Hodge L.  Systematic review of prevalence of aspirin induced asthma and its implications for clinical practice.  British Medical Journal, February 2004; Vol. 328: pp 434.

American Lung Association Asthma Clinical Research Centers. The Safety of Inactivated Influenza Vaccine in Adults and Children with Asthma. New England Journal of Medicine, 2001; 345 (21): 1529-1536.