Survey of health monitoring data at European level for asthma

In recognition that some public health objectives may be best achieved through action at European level, the Maastricht Treaty gave the European Union (EU) new powers and responsibilities. The EU public health programme recognises there is a need for collection, collation and publication of objective health data and that asthma is a disease that may warrant surveillance. The European Commission commissioned a report to evaluate the quantity and quality of health data about asthma currently available. Mortality data are available from the World Health Organisation (WHO), which does not disaggregate asthma from other airway diseases, the Avoidable Mortality Atlas, which provides useful but delayed information, and from the European Statistical Office (Eurostat) which provides absolute numbers of deaths from several respiratory diseases aggregated. Age-standardised mortality rates for age 5-44 vary from 0.08/100 000/year in Greece to 1.00/100 000/year in England and Wales (Avoidable Mortality Atlas, in press). Information about prevalence of asthma is available from research projects or state health interview surveys but is collected using a variety of procedures, though two recent collaborative studies have used standardised methods. The prevalence of wheeze with shortness of breath in the last year in 20 to 44 year old Europeans varies from 1.4% to 16.3% (European Community Respiratory Health Survey, 1996). Hospital utilisation data are collected in many countries and published by the Organisation for Economic Cooperation and Development (OECD), though there are no standardised methods of data collection. The data available suggest that there is wide variation in discharge rates and length of stay for asthma. There is very little collection of primary care utilisation data in member states and none at EU level. Asthma medication use is collated and published by the OECD as Defined Daily Doses/1000 population, a presentation method recommended by the WHO, but data are only available for the Scandinavian countries. At present there is no system in place for the collection and collation of accurate and timely data collected using consistent methods for asthma monitoring in the EU.