Increased occurrence of asthma and allergy: critical appraisal of studies using allergic sensitization, bronchial hyperresponsiveness and lung function measurements

Background Many studies have reported an increase in the occurrence of asthma and respiratory allergies in recent decades, but this increase is mostly based on studies using rather subjective measurements of asthma and allergies, such as questionnaires and doctor's diagnosis. None of the reviews specifically focused on studies using more 'objective' measurements, such as sensitization (specific IgE or skin prick testing (SPT)), bronchial hyper-responsiveness (BHR) or lung function (LF). Objective To review articles studying a time trend of occurrence of these 'more objective' measurements. Methods A MEDLINE-search (1966-February 2000) was performed. The following criteria were used: population-based, using IgE, SPT, BHR or LF measurements in the same age-group at least twice, with at least 2 years between and using similar methods. Results The MEDLINE-search resulted in only 16 articles, performed in 13 populations in seven different countries. Nine articles used the same objective measurements twice in the whole population. Three of these reported a non-significant increase or decrease. The other six articles found a significant increase in at least one objective measurement and of these only three reported a consistent significant increase. Conclusions The increase in the occurrence of reported asthma and allergy is supported by only a few articles confirming these results with 'more objective measurements'.