Asia Pac Allergy.  2019 Oct;9(4):e35. 10.5415/apallergy.2019.9.e35.

Continued loss of asthma control following epidemic thunderstorm asthma

• Foo CT
• Yee EL
• Young A
• Denton E
• Hew M
• O'Hehir RE
• Radhakrishna N
• Matthews S
• Conron M
• Harun NS
• Lachapelle P
• Douglass J
• Irving L
• Lee J
• Stevenson
• McDonald C
• Langton D
• Banks C
• Thien F

• KMID: 2461107
• DOI: http://doi.org/10.5415/apallergy.2019.9.e35

Abstract

BACKGROUND
Epidemic thunderstorm asthma (ETSA) severely affected Melbourne, Australia in November 2016. There is scant literature on the natural history of individuals affected by ETSA.
OBJECTIVE
A multicentre 12-month prospective observational study was conducted assessing symptomatology and behaviors of ETSA-affected individuals.
METHODS
We used a structured phone questionnaire to assess asthma symptom frequency, inhaled preventer use, asthma action plan ownership and healthcare utilization over 12 months since the ETSA. Analysis of results included subgroup analyses of the "current,""past,""probable," and "no asthma" subgroups defined according to their original 2016 survey responses.
RESULTS
Four hundred forty-two questionnaires were analyzed. Eighty percent of individuals reported ongoing asthma symptoms at follow-up, of which 28% were affected by asthma symptoms at least once a week. Risk of persistent asthma symptoms was significantly higher in those with prior asthma diagnosis, current asthma, and probable undiagnosed asthma (all p < 0.01). Of 442 respondents, 53% were prescribed inhaled preventers, of which 51% were adherent at least 5 days a week. Forty-two percent had a written asthma action plan and 16% had sought urgent medical attention for asthma in the preceding year.
CONCLUSIONS
Following an episode of ETSA, patients experience a pivotal change in asthma trajectory with both loss of asthma control and persistence of de novo asthma. Suboptimal rates of inhaled preventer adherence and asthma action plan ownership may contribute to asthma exacerbation risk and susceptibility to future ETSA episodes. Longer-term follow-up is needed to determine the extent and severity of this apparent change.

Keyword

Asthma; Environmental exposure; Physiopathology; Public health; Weather

MeSH Terms

Asthma*
Australia
Delivery of Health Care
Diagnosis
Environmental Exposure
Follow-Up Studies
Humans
Natural History
Observational Study
Ownership
Prospective Studies
Public Health
Surveys and Questionnaires
Weather