To Örebro University

The same questionnaire and study design was used in two surveys of asthma among all thechildren attending the 9-y compulsory school in Sundsvall in 1985 (n= 10 527) and 1995(n= 9 165). A detailed questionnaire was distributed by post to the parents of all children who hadanswered in the affirmative to a simple screening question on asthmatic symptoms at the beginningof the autumn term. The questionnaire contained detailed questions on symptoms and asthmamanagement. Our findings indicated a moderate increase in reported asthma-like symptoms andphysician-diagnosed asthma between 1985 and 1995. The severity of symptoms was unchanged,despite a large community-based asthma campaign and a tenfold increase in the number ofchildren receiving inhaled steroids. A validation analysis included an interview by a physician, askin prick test, determination of specific IgE antibodies and spirometry. The oral interviewssuggested that undertreatment was common. Many children had adequate medication at home, butthis medication was not used properly. Finally, all 13–14-y-old children also replied to written andvideo questionnaires from the International Study of Asthma and Allergies in Childhood (ISAAC).It is likely that differences in study design explained the much higher prevalence of wheezing inthis part of the study.