Commentary: Asthma time trends—mission accomplished?

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Abstract
Until recently most studies had reported that asthma prevalence has increased in recent decades and that the magnitude of the increase had, in some cases, been substantial.1 The best indication of what is now happening globally will be provided by the forthcoming findings of Phase III of the ISAAC study. However, some individual ISAAC centres in Western countries, as well as several studies in adults, have already reported either no increase, or even a decrease in asthma prevalence over the last ten years.2 Furthermore, Phase II of the European Respiratory Health Survey (ECRHS) found no increase in current or severe asthma symptoms, but a significant increase in diagnosed asthma.3 The most likely explanation for these patterns is that asthma prevalence has peaked or even begun to decline, whereas the observed increases in diagnosed asthma reflect changes in diagnostic labelling and/or medical treatment for mild and/or moderate asthma.2