J ALLERGY CLIN IMMUNOL

VOLUME 127, NUMBER 2

Abstracts AB81

SUNDAY

301 Assessing the Impact of Asthma and Exercise-InducedBronchospasm/Exercise-Induced Asthma in the GeneralPopulation: Results from the EIB Landmark Survey

S. Stoloff1, G. Colice2, M. Hayden3, T. Craig4, N. Ostrom5, N. Eid6, J. Par-

sons7; 1University of Nevada School of Medicine, Reno, NV, 2Washington

Hospital Center, Silver Spring, MD, 3University of Virginia, Charlottes-

ville, VA, 4Pennsylvania State University, Hershey, PA, 5Allergy &

Asthma Medical Group and Research Center, San Diego, CA, 6University

of Louisville School of Medicine, Louisville, KY, 7Ohio State University

Asthma Center, Columbus, OH.

RATIONALE: Determine prevalence of asthma, respiratory symptoms,

diagnosis of exercise-induced bronchospasm/exercise-induced asthma

(EIB/EIA), and impact of exercise-related respiratory symptoms on phys-

ical activity in the general population.

METHODS: The EIB landmark survey is the first comprehensive study

focusing on exercise-related respiratory symptoms in the US. Adults

(>_18 years) in the general public, selected by random-digit dialing, were

surveyed between December 7-21, 2009.

RESULTS: Of 1085 respondents (asthma population, n586; non-asthma

population, n5999) who completed the survey, 14% were diagnosed with

asthma and 5% were diagnosed with EIA/EIB (29% asthma population;

2% non-asthma population). However, 29% reported experiencing >_1 of

6 EIB-related symptoms during or immediately after exercise: shortness

of breath, wheezing, coughing, difficulty taking a deep breath, noisy

breathing, or chest tightness. A modest correlation between EIB-related

symptoms and diagnosis of EIA/EIB existed, with a rate of diagnosis being

7% for those with 1-2 EIB symptoms increasing to 35% with all 6 symp-

toms. The majority (65%) of adults with respiratory symptoms during or

shortly after exercise had never been diagnosed with EIA/EIB.

Respondents reported that their health affected their everyday lives ‘‘a

lot’’ or a ‘‘moderate amount’’ (40% with asthma; 17% without asthma).

CONCLUSIONS: Exercise-related respiratory symptoms limit common

physical activities and negatively impact daily lives of persons with

asthma. Adults in the US lack awareness of EIB. EIB is under-diagnosed

in persons with or without underlying asthma. Findings from this survey

support the need for a stronger focus on EIB and better communication

about EIB in the community.

302 Pollen Counts Predict Rates Of Emergency Department VisitsFor Asthma And Other Respiratory Related Illnesses

A. Mehra1, P. Lall2, P. Hemmers3, Y. Adjepong4; 1Mehraji LLC, New

York, NY, 2Bridgeport Hospital (Yale New Haven), Bridgeport, CT, 3Al-

lergy Associates of Fairfield County, Allergy Center of Connecticut,

Bridgeport, CT, 4Yale University School of Medicine, Bridgeport, CT.

RATIONALE: Although tree and grass pollen are known to exacerbate

asthma in individual patients, the published data is conflicting about the as-

sociation between seasonal variations in pollen counts and Emergency

Department (ED) visits. The current study examines the effect of tree

and grass pollen concentration on all upper respiratory related illnesses

(URRI) and specifically acute asthmaEDvisits in Bridgeport, Connecticut.

METHODS: Data on ED visits for patients of all ages with asthma or up-

per respiratory-related illnesses were obtained for the period April-August.

Average weekly counts of tree and grass pollen were obtained from a cer-

tified station from the Bridgeport area. The relationship between pollen

concentrations and ED visits was examined using regression models.

RESULTS: The total pollen count ranged from 0 to 686 particle/m3 with a

mean of 130.6 6208.8. The mean grass pollen count was 8.3617.5 and

mean tree pollen was 100.36198.8. There were 1872 URRI ED visits;

341 of these were asthma visits. There was a significant linear association

between tree pollen count and asthmavisits (regression coefficient5 18.7, r

5 0.72, p<0.001). There was no significant association with grass pollen,

rain, humidity or ambient temperature.

CONCLUSIONS: Tree pollen levels independently predict rates of

asthma related emergencies and other upper respiratory related illnesses ir-

respective of the effect of weather conditions. The peak ED visits for

asthma during first week of April to first week of May was associated

with the highest pollen counts for that period.

303 Epidemiological Characteristics in Japanese asthmaticadolescents

M. Furukawa1, K. Yoshida2, T. Itazawa3, Y. Murakami4, Y. Adachi3, H.

Odajima5, A. Akasawa1; 1Tokyo Metropolitan Children’s Medical Center,

TOKYO, JAPAN, 2National Center for Child Health and Development,

TOKYO, JAPAN, 3University of Toyama, TOYAMA, JAPAN, 4Fukuoka

National Hospital, FUKUOKA, JAPAN, 5Fukuoka National Hospital,

FUKUOKA, JAPAN.

RATIONALE: We conducted the first nationwide survey on the preva-

lence of allergic diseases in adolescents in Japan. We focused on the prev-

alence of asthma symptoms in adolescence.

METHODS: Cross sectional survey of junior high school students and se-

nior high school students (13 to 18 year old) was carried out using ISAAC

written questionnaire from April to July 2008. We randomly selected pub-

lic junior and senior schools from each prefecture in Japan. Nationwide, a

total of 511 schools (321 junior high schools and 190 senior high schools)

cooperated.

RESULTS: Questionnaires were distributed to 131,303 adolescents and

responses were obtained from 105,354 (80.2%). The prevalence of current

wheeze, exercise induced wheeze and severe asthma was 8.9%, 14.5% and

3.8%. The prevalence of current wheeze was 9.5-9.7% among children

aged 13-15 years, but decreased to 8.5%,8.2% and 7.2%, among those

aged 16 years, 17 years and 18 years respectively. Similarly, the prevalence

of exercise induced wheeze was 15.8% among children aged 13years, and

gradually decreased to 11.7% among those aged 18 years. However, The

prevalence of severe asthma had a peak of 4.3% among children aged 15

years, which was a trend more clear in the female population.

CONCLUSIONS: The change of asthma symptoms due to aging differed

depending on the severity and gender in the adolescence.This studywas sup-

ported by a grant from Japanese Ministry of Health, Labour and Welfare.

304 Relationship Between ''Morning Dipping'' in Peak ExpiratoryFlow (PEF) or Peak Expiratory Flow Variability (PEFV) andStudy Withdrawals: Post Hoc Analysis of a Randomized12-Week Study in Patients with Moderate to Severe Asthma

J. G. Zangrilli, U. J. Martin; AstraZeneca LP, Wilmington, DE.

RATIONALE: Early study discontinuations may indicate poor asthma

control. We assessed the relationship between morning PEF dips or

PEFVand study discontinuation due to an asthma event based on prespe-

cified criteria (lung function, rescue medication use, awakenings, need

for healthcare utilization).

METHODS: This post hoc analysis of a randomized, double-blind 12-

week study (NCT00652002 [Drugs. 2006;66:2235-54]) included moder-

ate-severe persistent asthma patients receiving placebo and as-needed

albuterol with >_2 weeks of observation (first 2 weeks censored to wash

out any inhaled corticosteroid run-in effects). Patients recorded morning

and evening PEF daily via e-diary.Morning dipping was defined as percent

decrease in morning versus evening PEF, averaged over the treatment pe-

riod. PEFV was calculated as (maximal PEF-minimum PEF)/mean PEF

over the treatment period. Associations between percent morning dipping

or PEFVand study withdrawals were assessed.

RESULTS: Of 125 placebo patients, 70 were included in this analysis, of

whom 27% did not demonstrate morning dipping as defined; 64% and 9%

had morning dipping<7.5% and >_7.5%, respectively. Most patients (69%)

had PEFV <7.5%. Compared with completers (n547 [67% of patients]),

patients with early withdrawal (n523 [33% of patients]) had twice the

mean percent morning dipping (3.9% vs 1.7%) and PEFV (10.4% vs

5.2%). The most commonly met discontinuation criterion was decreased

forced expiratory volume in 1 second.

CONCLUSIONS: Increased morning dipping and PEFV was associated

with premature discontinuation from the placebo arm of a clinical trial

due to predefined asthma event. These findings support the value of morn-

ing dipping and PEFVas relevant asthma control indicators.