New Views About Asthma Causes

Anti-Smoker Criminals Spread Defamations Against Smoking!

See the media gloat: "Smokers are already relegated to the outdoors, as virtually every public building is off limits." And, they're just so smug and pleased and proud of themselves, because they rammed it down our throats by systematically spreading lies, covering up corruption, and censoring the truth! "Now, in Monroe County, some officials want to forbid smokers from lighting up in vehicles with children. 'If they're smoking in their car with a child, they're placing their child in jeopardy', says Bob Schmidt, director of the Monroe County Health Department. Second hand smoke, he warns, is dangerous with vehicle windows closed or open.'We're talking about increased respiratory illnesses, we're talking about asthmatic attacks, we're talking about possible sudden infant death syndrome,' said Schmidt."(Monroe County proposes smoking ban extension. Jeremy Brilliant. WTHR TV 13, Oct. 3, 2007.) Oooh, look, everybody, an authority figure says so! Therefore, we must fall on our bellies and unquestioningly worship, like good little retards, because authorities never lie. BS! If that crap was true, then why did the death rates from asthma rise after the anti-smoking movement began? The death rates from asthma were far lower back when nobody on earth would be so gullible as to give that crap a second's credence! But see what do the media do, every single time: As a supposed "reply," they find an ignoramus who doesn't know the facts to whine that it's a "government encroachment," not a vile and despicable defamation against innocent people! They find a clueless patsy to snivel about nannyism and slippery slopes and property rights, when the real issue is LIES! LIES! LIES! This is how the anti-smoker filth purposely and systematically deceive the public by falsely framing the issue as "freedom versus public health," in order to shove Hitler Big Lies down the public's throat! The media scum do this to us every single time, and never, ever, ever challenge those lying phony "authorities" with the facts! The reality is that smokers should have turned to violence long ago! Violence against those phony, nazi "public health" pretenders and their media accomplices as well, to teach them that we will submit to their vicious lies no more!

Asthma Prevalence Increases (Again)

"CDC analyzed asthma data from the 2001–2009 National Health Interview Survey concerning children and adults, and from the 2001, 2005, and 2009 state-based Behavioral Risk Factor Surveillance System concerning adults. Among persons of all ages, the prevalence of asthma increased from 7.3% (20.3 million persons) in 2001 to 8.2% (24.6 million persons) in 2009, a 12.3% increase... The prevalence and number of persons with asthma have increased since 2001, and demographic differences among population subgroups persist despite improvements in outdoor air quality and decreases in cigarette smoking and secondhand smoke exposure." (Vital Signs: Asthma Prevalence, Disease Characteristics, and Self-Management Education --- United States, 2001--2009. HS Zahran, C Bailey, P Garbe. MMWR 2011; 60: 1-7.)

prev2009

Zahran / MMWR 2011 full article

The EPA's Sorry Status Report on Children and Asthma

"America's Children and the Environment. Measures of Contaminants, Body Burdens, and Illnesses," Second Edition, US EPA, Feb. 2003. EPA Administrator Christine Todd Whitman boasts that "This report marks the progress we have made as a nation to reduce environmental risks faced by childen," including "Reducing emissions of diesel pollutants from trucks and buses, which will help prevent hundreds of thousands of asthma attacks in children each year" and "Implementing the Smoke-Free Home Pledge campaign, designed to protect millions of children from the risks of tobacco smoke at home." On pdf p. 75, "Between 1980 and 1995, the percentage of children with asthma doubled, from 3.6 percent in 1980 to 7.5 percent in 1995." [And death rates from asthma during this period nearly tripled. The death rates are a more solid indicator than diagnoses of asthma because, unlike doctor visits, death is not optional.] The graph on pdf page 67 boasts of declines in cotinine levels during this same period. Needless to say, their accomplices in the media will not hold them accountable for their failures, and these leeches will be coming to us with their hands out, demanding more tax dollars (and more regulations) to do more of the same that doesn't work. (PS, good old ICF Consulting, whose history includes the illegal pass-through contracts for the "EPA's" report on secondhand smoke and overbilling the government for various other work, helped prepare this document.)

America's Children, 2003 / US Environmental Protection Agency (pdf)

asthmort

The State of Childhood Asthma, United States, 1980–2005. LJ Akinbami, Centers for Disease Control and Prevention National Center for Health Statistics. Adv Data 2006 Dec 12;(381):1-24. Revised as of Dec. 29, 2006. The report notes that "Despite the plateau in asthma prevalence, ambulatory care use has continued to grow since 2000... Increased ambulatory care use for asthma has continued during an era when overall rate of ambulatory care use for children did not increase." Comment re: Fig. 6, Number of deaths due to asthma per 1,000,000 children 0-17 years of age, United States, 1980-2004, these death rates rose from around 1.7 per million in 1980 to around 3.6 per million in 1996, then dropped to around 2.5 per million. However, this age grouping understates of the magnitude of the increase in the population, because the death rates from asthma are lowest among infants and children under five, while the increase occurred among all age groups above that age, including the elderly. And, they were even lower in 1978 than 1980 as well.

Akinbami 2006 / Centers for Disease Control full article (pdf, 24 pp)

The Death Rates From Asthma, 1960-1995

Since the anti-smoking movement began, the death rates from asthma in the United States have more than doubled in every age group above five years old. This is despite all the people who quit smoking, the smoking bans in public places, and people intimidated out of smoking in their own homes. And, anyone who looks at the death rates from asthma by age can see that they rose simultaneously across all segments of the population, in the manner of an epidemic of infectious disease.

Surveillance for Asthma -- United States, 1960-1995. DM Mannino, DM Homa, CA Pertowski, A Ashizawa, LL Nixon, CA Johnson, LB Ball, E Jack, DS Kang. MMWR CDC Surveill Summ 1998 Apr 24;47(1):1-27. "The self-reported prevalence rate for asthma increased 75% from 1980 to 1994; by 1993-1994, an estimated 13.7 million persons reported asthma during the preceding 12 months. This increasing trend in rates was evident among all race strata, both sexes, and all age groups (p less than 0.05 for all). The most substantial increase occurred among children aged 0-4 years (160%, from 22.2 per 1,000 to 57.8 per 1,000; p less than 0.05) and persons aged 5-14 years (74%, from 42.8 per 1,000 to 74.4 per 1,000; p less than 0.05). During 1993-1994 the self-reported prevalence rate for asthma was slightly higher among persons aged less than or equal to 14 years than among persons aged greater than or equal to 15 years. The increasing trend in asthma prevalence rates during 1980-1994 was evident and significant (p less than 0.05) in every region of the United States, with the prevalence patterns in the overall population similar to those among persons aged 5-34 years." "From 1975 to 1993-1995, the estimated annual number of office visits for asthma more than doubled, from 4.6 million to 10.4 million.... Increasing rates were evident among all race strata, both sexes, and all age groups." "Overall rates of death with asthma as the underlying cause decreased from 1960-1962 through 1975-1977, and gradually increased again in all race, sex, and age strata. (Table_9) and (Table_10)."

Mannino / MMWR CDC Surveill Summ 1998 full article

Asthma Death Rates Are Lower in States With Higher Rates of Smoking

The states of Utah and California, which have the lowest rates of smoking at 13.0 and 17.1 percent of adults respectively, are also among the states with the highest death rates from asthma. (Asthma Deaths, 2000; and: Smoking Among Adolescents, 2001, and Smoking Among Adults, 2001. Centers for Disease Control and Prevention, 2003 State Health Profiles, Atlanta, GA: US Department of Health and Human Services, 2003. The CDC's complete 2003 State Health Profiles, 187 pages and 4,964KB, could once be downloaded from their slow and balky website. http://www.cdc.gov/nchs/datawh/stprofiles.htm link died.)

Smoking vs Asthma

Asthma Deaths, 2000; and Smoking Among Adults, 2001 - 2003 State Profiles, CDC

And, although the anti-smoking propagandists keep the public in the dark, the belief that things like smoking and pollution cause asthma has even lost credibility among experts. Not even the author of the EPA ETS report chapters on asthma, Dr. Fernando Martinez of the University of Arizona, believes in the garbage that he wrote any more. Quote: "Like most people, I assumed tobacco smoke and pollution were the problem -- this was the politically correct way to think. But these factors turned out not to play a major role. In high-pollution areas, in low-pollution areas, among all ethnic groups, there was asthma. Clearly, something else was involved." (Does Civilization Cause Asthma? By Ellen Ruppel Shell. The Atlantic Monthly, 2000 May;285(5):90-100, page 94.)

Shell, The Atlantic Monthly, May 2000 (partial) / UCSF (pdf, 2pp)
Shell, May 2000 / The Atlantic Monthly

(This is not to say that the new politically correct belief, the "hygiene hypothesis" that there is more asthma because people are not exposed to enough pathogens as children (!), is any better than the old beliefs. Inner-city blacks, who have the highest rates of asthma, do not suffer from any deprivation of exposure to germs. And the increase in death rates occurred among the elderly at the same time it occurred among the young.) Martinez was the author of the 1992 EPA ETS report Chapter 7, Passive Smoking and Respiratory Disorders Other Than Lung Cancer, and Chapter 8 (with co-author Steven P. Bayard), Assessment of Increased Risk for Respiratory Illnesses.

There were cracks in the wall at the 1999 conference of the American Lung Association / American Thoracic Society as well.

"Most asthma, especially in children, appears to involve allergic inflammation of the airways mucosa. But clinicians have long suspected that viral infection of the respiratory tract might be important not only as a cause of asthma exacerbations, but perhaps also as a cause or contributor to the pathogenesis of asthma itself." "Until recently, bacterial pathogens were not suspected as important contributors to asthma, except for a handful of epidemiological investigators who noted a strong association between serological evidence of infection with Chlamydia pneumoniae and asthma." (Homer A. Boushey, MD, "The role of infections in asthma," ALA-ATS Conference 1999. Link died, http://www.medscape.com/medscape/cno/1999/ALA_ATS/Story.cfm?story_id=555.)

"Passive cigarette smoke often has been thought to increase the risk of asthma, but studies to date have not demonstrated this association convincingly." D Stempel, MD. ALA-ATS Conference 1999. Link died, http://www.medscape.com/medscape/cno/1999/ALA_ATS/Story.cfm?story_id=543.)

"Reducing allergen exposure, although intuitively obvious as a management approach, has had a less than stellar track record when applied to asthma control in clinical practice..... Even though allergen levels can be significantly reduced through use of such methods [as high efficiency air filtering, vacuuming, and pet washing], clinical disease changes very little in response." EW Gelfand, "Environmental Control and Immune Modulation in Asthma Treatment." ALA-ATS Conference 1999. Link died, http://www.medscape.com/medscape/cno/1999/ALA_ATS/Story.cfm?story_id=557.)

Research has implicated Chlamydia pneumoniae as a cause of asthma.

Infections Cause Asthma

Some enlightened doctors have begun to treat asthma as a potentially curable infectious disease (Asthma Story.com, by Jim Quinlan. "The trail one person took to completely cure his asthma.")

Homepage / AsthmaStory.com

However, there are other strong contenders which have also been overlooked:

Infection is Implicated in Early Childhood Asthma

The study included all singleton children (510,216) born in Kaiser Permanente Southern California hospitals between 1991 and 2007. The incidence of asthma before 8 years of age was significantly higher among preterm versus term children from pregnancies complicated by chorioamnionitis (incidence rate ratio, 2.9; 95% CI 2.6-3.3). (Effect of Chorioamnionitis on Early Childhood Asthma. D Getahun, D Strickland, RS Zeiger, MJ Fassett, W Chen, GG Rhoads, SJ Jacobsen. Arch Pediatr Adolesc Med 2010;164(2):187-192.)

Getahun / Arch Pediatr Adolesc Med 2010 abstract

A news article on the study said, "This association between chorioamnionitis and asthma in preemies persisted (HR 1.68, 95% CI 1.52 to 1.87) after adjustment for important confounding variables, including maternal age, race or ethnicity, smoking during pregnancy, prenatal care, and maternal asthma." (Placental Infection Could Spur Asthma. By Crystal Phend, Senior Staff Writer, MedPage Today, Feb. 2, 2010.)

Placental Infection Could Spur Asthma / MedPage Today

In fact, the "adjustment for important confounding variables, including maternal age, race or ethnicity, smoking during pregnancy, [and] prenatal care" does't prevent confounding; it CAUSES confounding. Those supposed "confounding variables" are themselves the direct RESULT of confounding, due to the use of defective studies which lack placental pathological examinations. Studies like that fail to identify the vast majority of cases of chorioamnionitis, and falsely blame maternal age, race or ethnicity, and smoking as a result. And, prenatal care has had no influence on the rates of chorioamnionitis and preterm birth. This is an example of ill-trained (and brainwashed) investigators using "adjustment" as a "magic" ritual to be accepted on faith, without thinking. So, the unadjusted figure is actually the more correct one.

Chorioamnionitis Causes Perinatal Illnesses Blamed on Smoking

What about rampant C. trachomatis infections?

From 3 to 15% of the adult population may have an untreated C. trachomatis infection. Most infections had no symptoms - at least, not the kind of symptoms they were looking for. C. trachomatis in infants is a cause of pneumonia, followed by respiratory symptoms such as wheezing and reduced lung function for many years after.

Untreated gonococcal and chlamydial infection in a probability sample of adults. CF Turner, SM Rogers, HG Miller, WC Miller, JN Gribble, JR Chromy, PA Leone, PC Cooley, TC Quinn, JM Zenilman. JAMA 2002 Feb 13;287(6):726-733. (News) Many cases of Gonorrhea, Chlamydia are asymptomatic and go undiagnosed. Medscape - Reuters Health Information 2002 Feb. 12.

Turner - JAMA 2002 abstract / PubMed
News re Turner / Medscape - Reuters Health 2002

Chlamydial pneumoniae of infancy: further clinical observations. VH San Joaquin, JR Herrin, JM Hautala. Clin Pediatr (Phila) 1980 Feb;19(2):109-112. They note that "wheezing may be a very prominent feature of the disease," but fail to consider that it may be a cause of asthmatic wheezing.

San Joaquin - Clin Pediatr (Phila) 1980 abstract / PubMed

Pulmonary assessment of children after chlamydial pneumonia of infancy. SG Weiss, RW Newcomb, MO Beem. J Pediatr 1986 May;108(5 Pt 1):659-664. "Our results show that chlamydial pneumonia of infancy is associated with PFT abnormalities and respiratory symptoms 7 to 8 years after recovery from the acute illness."

Weiss - J Pediatr 1986 abstract / PubMed

Chlamydia trachomatis infection in children with wheezing simulating asthma. M Bavastrelli, M Midulla, D Rossi, M Salzano. Lancet 1992 May 9;339:1174. Letter. "Our data indicate that wheezing may be another clinical expression of C trachomatis infection and that this organism should be sought as a routine in children who wheeze but have no demonstrable allergy and do not respond to the usual anti-asthmatic medications." No abstract.

Serology of Chlamydia in relation to asthma and bronchial hyperresponsiveness. E Bjornsson, E Hjelm, C Janson, E Fridell, G Boman. Scand J Infect Dis 1996;28(1):63-69. In this study, the highest OR was found for "current or recent C. trachomatis" and "asthma this year," 13.9 (95% CIs 3.0-64.8; p<0.001).

Table III. The propensity for having diagnosed asthma, wheezing or bronchial hyperresponsiveness (BHR) in subjects with serological evidence of chlamydial infection after adjustments for sex, age, smoking and atopy by means of logistic regression. Adjusted odds ratios (95% confidence intervals).

 C. pneumoniae C. trachomatis
 Current or recent Previous Current or recent Previous

Ever asthma 0.7 (0.2-3.9) 0.8 (0.4-1.9) 7.7 (1.8-32.2)** 3.6 (1.4-9.3)**
Asthma this year 1.1 (0.2-4.8) 0.5 (0.2-1.2) 13.9 (3.0-64.8)*** 4.6 (1.7-12.8)**
Wheezing 6.7 (1.3-35.7)* 1.0 (0.5-2.1) 5.3 (1.0-27.7)* 4.2 (1.5-11.8)**
BHR 2.5 (0.7-9.0) 0.7 (0.3-1.5) 3.5 (0.9-13.5) 3.0 (1.2-7.6)*

* p<0.05; ** p<0.01; *** p<0.001

Bjornsson - Scand J Infect Dis 1996 abstract / PubMed

Here's What They're Spending Our Tax Dollars For!

The NIEHS Nurtures Baby Vermin Instead of Young Scientists!

Here's the kind of crap that the National Institute of Environmental Health Sciences puts on its "Kids' Pages," in order to nurture, encourage, and reward children for being the kind of malicious ignoramuses who serve their totalitarian agenda: "Mama didn't know that when I had to go to the hospital, it was because our house was filled with tobacco smoke and I couldn't breathe. It's scary to have asthma. She prayed by my bed all night and just loved me with all her heart" and "Mama didn't know that the chemicals from the smoke in her cigarettes could make our whole family sick. But now she does! Mama quit smoking, and I promised not to ever start." All laced with the anti-smokers' usual favorite insults about smoking "stinking," which is fundamentally a symptom of mental defect in the accuser. This putrid garbage isn't science - it's emotion-manipulating BIBLE CAMP BIBBLE-BABBLE! This agency is entirely dedicated to QUACKERY, specifically the deliberate use of defective studies that ignore the role of infection, in order to promote hysteria over the environmental bogeyman-of-the-day. And the despicable creatures who run this agency are unaccountable to REAL science, due to the political power of the rotten-to-the-core Lasker Lobby that has controlled Congress and the health establishment for six decades! (Mama Didn't Know. The Mama Didn't Know story was created by the KMAC Kids 2000-2001 [Kids Making A Connection] "the Mama Didn't Know book was made possible by funds received from the Tobacco Tax Health Protection Act of 1988, Proposition 99, under Grant Number 99-85267 with the California Department of Health Services, Tobacco Control Section. California Smokers Helpline -800-NO-BUTTS. KMAC activities were originally supported by an NIEHS grant in K-12 environmental health science education, 'Toxrap' Network." "This page was prepared by the NIEHS Office of Management, (919) 541-0395, PO Box 12233, RTP, NC 27709, for the Office of Communications, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS)." 06/08/2005 06:35:50.)

Mama Didn't Know / National Institute of Environmental Health Sciences

Ellen Swallows Richards, the vaunted founder of the smoke-abatement movement, whose 19th century pseudo-science continues to enslave the National Institute of Environmental Health Sciences and its sycophant, the Health Effects Institute, was the aunt of Junius A. Richards, a director of Tobacco and Allied Stocks which took over Philip Morris in the 1950s.

"Tobacco Allergy"

Hypersensitivity to tobacco antigen. CG Becker, T Dubin, HP Wiedeman. PNAS 1976 May;73(5):1712-1716. 12/31 volunteers had skin reactions to a glycoprotein extracted from cured tobacco leaves, which was antigenically cross-reactive to substances found in eggplants,green peppers, potatoes, and tomatoes.

Becker, PNAS 1976 full article / PubMed Central

Tobacco smoke "sensitivity" - is there an immunologic basis? SB Lehrer, F Barbandi, JP Taylor, JE Salvaggio. J Allergy Clin Immunol 1984 Feb;73(2):240-245. A significant number of individuals have reactions to antigens extracted from the whole leaves of tobacco, but these are not found in the smoke. These reactions did not correlate with claimed sensitivity to tobacco smoke. The study was supported by both the Council for Tobacco Research and the National Institutes of Health.

Lehrer - J Allergy Clin Immunol 1984 / tobacco document
Lehrer - J Allergy Clin Immunol 1984 / UCSF (pdf, 6 pp)

Hyperventilation causes asthma and heart symptoms

Hyperventilation syndrome. A brief review. JC Missri, S Alexander. JAMA 1978 Nov 3;240(19):2093-2096. They note that dianosis is often missed, because many patients don't demonstrate classic symptoms. "The ECG changes caused by hyperventilation seem related to alteration of autonomic nervous system tone, both sympathetic and parasympathetic rather than to hemodynamic changes. Less likely, local changes in electrolyte concentration, particularly potassium, may play a role. In the Figure, great downward depression of the ST segment and flattening and inversion of the T waves can be noted. This response is fairly typical, but ST segment depression or T wave changes alone have also been described both in the resting and exercise ECG."

Missri - JAMA 1978 full article / tobacco document
Missri - JAMA 1978 full article / UCSF (pdf, 4 pp)

Hyperventilation syndrome: a diagnosis begging for recognition. GJ Magarian, DA Middaugh, DH Linz. West J Med 1983 May;138(5):733-736. "Hypocapnea and respiratory alkalosis develop rapidly upon onset of hyperventilation and can easily be maintained indefinitely, by nearly imperceptible hyperventilation, such as by taking an occasional deep breath while maintaining a normal respiratory rate. Without knowing this, physicians may directly observe the subtle, chronic form of hyperventilation without recognizing it or, upon considering the diagnosis, inappropriately reject it because the anticipated hyperventilatory respiratory pattern is not present." "Respiratory alkalosis increases the avidity of oxygen binding to hemoglobin such that oxygen becomes less readily released to tissues (the Bohr effect). Hypophosphatemia develops rapidly and persists for the duration of respiratory alkalosis, probably related to intracellular shifts of phosphorus. With persistent hyperventilation, hypophosphatemia would impair generation of 2,3-diphosphoglycerate (2,3-DPG), further reducing oxygen availability for tissue utilization.... Finally, several investigators have shown coronary vasoconstriction induced by hyperventilation in some patients with Prinzmetal's angina and others with fixed coronary occlusive disease." Table 2, hyperventilation can cause general symptoms including weakness, fatigue, and blurred vision; anxiety, depression, phobias, feeling far away, sensations of unreality; numbness and tingling in limbs, lightheadedness, dizziness, fainting, and headaches; a feeling of being unable to take a satisfying deep breath; and musculoskeletal chest wall pain (chest wall syndrome).

Magarian - West J Med 1983 full article / PubMed Central

Hyperventilation is another frequent cause of asthma symptoms: Prevalence of dysfunctional breathing in patients treated for asthma. M Thomas, RK McKinley, E Freeman, C Foy. BMJ 2001 May 5;322(7294):1098. Among 219 adult patients aged 17-65 with diagnosed asthma who were receiving treatment, "About a third of women and a fifth of men had scores suggestive of dysfunctional breathing... Abnormal breathing patterns have been shown to cause breathlessness, chest tightness, chest pain, light-headedness, paraesthesiae, and anxiety. This symptom complex has been described in different clinical situations and has been referred to as the hyperventilation syndrome, behavioural breathlessness, and dysfunctional breathing. It often occurs in association with hyperventilation."

Thomas / BMJ 2001 full article
Thomas - BMJ 2001 full article / PubMed Central

The prevalence of dysfunctional breathing in adults in the community with and without asthma. M Thomas, RK McKinley, E Freeman, C Foy, D Price. Prim Care Respir J 2005 Apr;14(2):78-82. 207 questionnaires. "8% (95% confidence intervals 4-12%) had positive screening scores. Positive screening scores were more common in women (14%, 7-20%) than men (2%, 0-5%, p=0.003). Comparison with the previous survey showed that the prevalence of positive screening scores was higher in those with current asthma than those without (29% vs. 8%, p<0.001)."

Thomas / Prim Care Respir J 2005 full article (pdf, 5 pp)

The Nijmegen Questionnaire

Nijmegen Questionnaire / nhs.uk (pdf, 1 p)

Ear Infections Have Also Increased

Increasing prevalence of recurrent otitis media among children in the United States. BP Lanphear, RS Byrd, P Auinger, CB Hall. Pediatrics 1997 Mar;99(3):E1. "BACKGROUND: The number of visits for otitis media, the most common diagnosis among preschool children, has increased during the past decade. This study was undertaken to determine whether there has been a concurrent increase in the prevalence of recurrent otitis media among children in the United States and to identify risk factors or demographic changes to explain the increase. METHODS: Secondary analyses of cross-sectional data from the Child Health Supplement to the 1981 and 1988 National Health Interview Surveys (n = 5189 [1981] and n = 6209 [1988]) were done to identify temporal changes in the prevalence and any associated risk factors of recurrent otitis media among children <6 years of age. RESULTS: Recurrent otitis among preschool children increased from 18.7% in 1981 to 26% in 1988 (odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.4, 1.7). Although the prevalence of recurrent otitis increased with age, the greatest increase in recurrent otitis media occurred in infants (OR = 1.9, CI = 1.3, 2.9)." "These data indicate that there has been a 44% increase in the prevalence of recurrent otitis media among preschool children in the United States from 1981 to 1988; an excess of 1.8 million children with recurrent otitis media."

Lanphear - Pediatrics 1997 abstract / PubMed
Lanphear / Pediatrics 1997 full article

Trends in otitis media among children in the United States. P Auinger, BP Lanphear, HJ Kalkwarf, ME Mansour. Pediatrics 2003 Sep;112(3 Pt 1):514-520. From the Third National Health and Nutrition Examination Survey, 1988-1991 and 1991-1994. "After controlling for risk factors for OM, the prevalence of OM from phase I to phase II increased from 66.7% to 69.7% (odds ratio [OR] = 1.1; 95% confidence interval [CI] =.99, 1.1), early-onset OM increased from 41.1% to 45.8% (OR = 1.1; 95% CI = 1.03, 1.2), and repeated OM increased from 34.8% to 41.1% (OR = 1.2; 95% CI = 1.1, 1.4). This observed increase corresponds to 561,000 and 720,000 more children having early-onset OM and repeated OM, respectively."

Auinger / Pediatrics 2003 full article

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cast 07-27-14