Asthma prevalence in Melbourne schoolchildren: have we reached the peak?

OBJECTIVE To determine the change in prevalence of asthma, eczema and allergic rhinitis in Australian schoolchildren between 1993 and 2002. DESIGN Questionnaire based survey, using the protocol of the International Study of Asthma and Allergy in Childhood. SETTING Metropolitan Melbourne primary schools within a 20 km radius of the GPO in 1993 and 2002. SUBJECTS All children in school years 1 and 2 (ages 6 and 7) attending a random sample of 84 schools in 1993 and 63 schools in 2002. MAIN OUTCOME MEASURES Parent-reported symptoms of atopic disease; treatment for asthma; country of birth. RESULTS There was a 26% reduction in the 12-month period prevalence of reported wheeze, from 27.2% in 1993 to 20.0% in 2002. The magnitude of reduction was similar for boys (27%) and girls (25%). The 12-month period prevalence of reported eczema increased from 11.1% in 1993 to 17.2% in 2002, and rhinitis increased from 9.7% to 12.7%. There were reductions in the proportion of children attending an emergency department for asthma in the previous year (3.6% to 2.3%), the proportion admitted to hospital (1.7% to 1.1%) and the proportion taking asthma medication (18.5% to 13.4%). Of those who reported frequent wheeze, there was an increase in the proportion taking regular inhaled steroids (34.5% to 40.9%). CONCLUSION There has been a significant reduction in the prevalence of reported asthma in Melbourne schoolchildren, whereas the prevalence of eczema and allergic rhinitis has continued to increase.