Fatal asthma attacks, while rare, seem to run in cycles. In the 1960's an epidemic of deaths from asthma surfaced in England and Wales. Later in the 1970's a similar rash of deaths was reported in Australia and New Zealand. In the United States, the death rate from asthma rose from 1,674 to 4,869 during the period between 1977 and 1989.
Many of these deaths around the world seem to center around several common characteristics.
- Most victims resided in the inner cities of large metropolitan areas.
- Most victims were in the 10 - 14 year old age group or were elderly.
- Deaths were more common among women
- Victims tended to be living in poverty.
- The attacks were sudden
- Many victims were found clutching their inhalers
- Many victims were NOT severe asthmatics.
- Most deaths occurred at home.
Researchers concluded after studying the victims medical histories that two causes appear to be responsible for the asthma death epidemic. First, asthma has evolved into a more wide spread and severe disease than it had been previously. Secondly, physicians were undertreating asthma, assuming falsely that it was a minor problem, not one of life threatening proportions.
Since this discovery, physicians have changed the way they treat asthma, and as a result, the epidemic of asthma deaths has slowed dramatically. Now we find that most deaths are preventable, especially if these five strategies are followed.
- Early identification of patients who are at risk. These include patients with a history of hospitalizations or emergency room visits for asthma, those with a history of sudden severe attacks, those without regular medical care for their disease, and those who are non-compliant.
- Identifying and removing from the patient's environment the triggers for asthma.
- Aggressive monitoring of asthma severity. Use of a mini-peak flow meter can act as an early warning signal that an attack is eminent.
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