Asthma mortality in California, 1960-1989. Demographic patterns and occupational associations.
Schenker-MB; Gold-EB; Lopez-RL; Beaumont-JJ
Am Rev Respir Dis 1993 Jun; 147(6)(Pt 1):1454-1460
A study of demographic patterns and occupational associations in asthma mortality in California was conducted. Data tapes of the California Department of Health Services were searched to identify all asthma deaths occurring between 1960 and 1989. Sex, age, and race specific asthma mortality rates were calculated using information contained in the California State Census Data Center database. Age adjusted mortality rates were standardized to the US 1970 age distribution. Associations between asthma mortality and occupation were assessed by computing standard mortality ratios (SMRs) from data obtained in the 1979 to 1981 California Occupational Mortality Study. A total of 10,526 asthma deaths occurred during the study period. They occurred at an overall annual rate of 350 deaths per year. The mortality rates showed a strong age dependence, ranging from less than 1 death per 10(5) person years for persons under 35 years of age to 7 to 9 deaths/10(5) person years for persons 65 years or older. Only small, inconsistent sex related differences in mortality rate were seen. Asthma mortality decreased by 50% between 1960 and 1970; however, a continuing progressive increase in asthma mortality occurred starting after 1975. The rate of increase was greater in blacks than in whites and in females than in males. Age adjusted asthma mortality rates in blacks under 65 years of age were two to four times greater than in whites. Mortality rates in blacks over 65 years of age were comparable to those of whites. For the period 1985 to 1989, age adjusted asthma mortality rates in Hispanics and Asians under the age of 65 were 0.4 to 0.8 and 1.0 to 1.2 times those of whites. For Hispanics and Asians over the age of 65, the mortality rates were 1.1 to 1.8 times those of whites. Only two occupational groups (carpenters, and police and guards) had significantly elevated risks for asthma mortality, SMRs 3.6 and 2.9, respectively. Health aides, other health professionals, and textile workers had a nonsignificantly elevated risk for asthma mortality. The authors conclude that asthma mortality has increased in California since the mid 1970s.
Bronchial-asthma; Epidemiology; Mortality-data; Age-factors; Racial-factors; Occupations; Respiratory-system-disorders
Dr. M. Schenker, Division of Occupational/Environmental Medicine and Epidemiology, ITEH, University of California, Davis, CA 95616-8648
American Review of Respiratory Disease
University of California - Davis