Why are asthma deaths so high for young people in the UK?

Young people in the UK are more likely to die from asthma than those in other wealthy countries, new research has suggested.

Death rates for asthma in 10 to 24-year-olds was highest in the UK among all 14 European nations included in an analysis of 19 high-income countries.

The study, from the Nuffield Trust think tank and the Association for Young People’s Health, analysed 17 measures of health and wellbeing for 10 to 24-year-olds in countries that included Germany, France and Italy, as well as Japan, the US and Australia.

The research revealed that the UK has the worst death rate among 10 – 24 year olds in Europe, a figure double that of the next worst European country a study.

The World Health Organisation estimates that there are 235 million asthma sufferers worldwide. Of these, 5.4 million receive treatment for asthma in the UK today, costing the NHS approximately £1 billion per year.

While fatality rates are highest in developing countries, almost 1,500 die from asthma in the UK each year – an average of four deaths a day – and more than half of these deaths are people who have only mild or moderate asthma.

According to Asthma UK someone in the UK has an asthma attack every three seconds, which is more than previously thought, as previous studies have estimated the average as being more like one every 10 seconds.

But why is asthma in the UK so prevalent?

Many experts believe the UK’s air pollution could be a major contributing factor.

In recent years concerns have been growing about the role of air pollution in asthma deaths. The tragic death of nine-year-old Ella Kissi-Debrah from London as a result of an asthma attack has been linked to illegal levels of pollutants, while doctors have also expressed concern at the number of cases of children needing hospital treatment for their asthma, which they suspect could be a result of air pollution.

Asthma UK has reported that around two thirds of people with asthma suggest that poor air quality exacerbates their condition, making potentially life-threatening attacks more frequent and severe.

Dr Thomas Antalffy, inventor of Smart Peak Flow, a medically certified asthma monitoring device that plugs into a smartphone, believes a lack of focus may also be a contributing factor.

“Most asthma care happens in primary care, ie by GPs,” he explains. “GPS have annual check-ups with asthma patients but their workload doesn’t allow them to give each patient the necessary attention.”

“The other contributor is the low adherence rate of patients,” he continues. “Asthma is a lifelong condition with regular ups and downs. Preventer inhalers are very effective but need to be taken twice a day effectively lifelong.

“Many patients (understandably) have second thoughts about inhaling steroids twice a day directly into their lungs. So when their asthma is doing well, patients tend to drop off their inhalers and that opens the gates to relapses.”

Following the most recent results experts are calling for more to be done to improve asthma care and education.

Prof Chris Griffiths, co-director of the Asthma UK Centre for Applied Research, told the Guardian that the findings were disappointing but not surprising and that urgent action needed to be taken.

“Technical advances may help, such as inhalers that electronically monitor and prompt adherence, and digital smartphone asthma action plans, but we need to deliver on the basics of good care,” he said.

Dr Samantha Walker, director of research and policy at Asthma UK, told BBC: “We are now urging the NHS to move with the times and put technology at the heart of asthma management, helping to engage this tech-savvy generation.”

Dr Antalffy believes more patient education would help patient attitudes, and consultant respiratory nurses could help GPs.

“New technology that helps patients monitor their condition and share information with their GP more conveniently will also help,” he says.

“The National Review of Asthma Deaths (NRAD) has not seen much change in the past decades: around 1,400 people die of asthma every year in the UK,” he continues. “During the same period, countries like Finland have introduced national monitoring programs that have sharply reduced asthma deaths.”

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