Who’s Lying Now?

1. Who’s Lying Now?

2. From CTVWed. Nov. 17, 2010 “Changes in diagnostic patters.” Remember this. It’s going to be important later on. Yay! Nice to hear after years of asthma cases inexplicably rising. A what? A “plateau”? Is there a limit to how many people can have a given disease? And if so, why wasn’t this “plateau” reached back at 13%? • OTTAWA — Asthma cases have dropped among two- to seven-year-olds to their lowest level in more than a decade, Statistics Canada reported Wednesday. • One factor that may have contributed to the decline is the hand-in-hand drop in smoking rates across the country, along with changes in diagnosis patterns, experts say. • The percentage of kids with asthma rose from 11 per cent to 13 per cent from 1994 to 2001, but by last year, the figure had fallen to 10 per cent. • Since the turn of the century, the percentage of kids with asthma has fallen in the Atlantic provinces, Ontario and Quebec, but remained fairly stable in the Prairie provinces and British Columbia, the study showed.Dr. Allan Becker, a pediatric allergist, said the overall findings don't surprise him. • "There are two things that I think are probably going on. One is that we may actually be seeing a real plateau in asthma prevalence, and that's entirely possible," he said from Winnipeg, where he is head of the section of Allergy and Clinical Immunology in the department of pediatrics and child health at the University of Manitoba.

3. Here’s the “change in diagnostic pattern mentioned previously. What he’s saying is that they used to diagnose any kind of wheezing among children as “ashtma,” but now they’re not. From CTVWed. Nov. 17, 2010 • "And secondly that there is that diagnostic perception now that not all that wheezes is asthma. That's an aphorism that we've heard from our professors many, many, many years ago, mostly speaking about adults. But now that's equally true in terms of children." • The study found that a significantly higher percentage of boys than girls had been diagnosed with asthma over the 14-year period. The upturn in asthma prevalence to 2000 and the decline that followed was seen in all age groups.

4. From CTVWed. Nov. 17, 2010 To paraphrase – smoking has nothing to do with asthma rates, but misdiagnosis does. So, just to be clear, now that they’re no longer diagnosing every cough as “asthma,” the asthma rates have gone down. No question a “change in diagnostic patterns” helps, too! • Becker said "there's no question" that a decline in smoking rates helps. • "Children of parents who smoke have a much higher frequency of colds, of respiratory infections, and among those children, the viral illnesses are the major causes of these wheezing illnesses," he said. • "And that would suggest, then, a diagnosis of asthma. So with fewer -- especially young parents -- smoking, it really does make a difference in the likelihood that these children will have wheezy episodes with their colds.“

5. But where are the smoking stats? • While the article makes much of the lower smoking rate, neither it nor the good doctor actually give any figures. • We shall correct that oversight now.

6. The percentage of kids with asthma rose from 11 per cent to 13 per cent from 1994 to 2001 But the smoking rate has been steadily declining since the early 1970s. Smoking trends in the United States (per capita) 1900 - 1998. Source: US Department of Agriculture

7. And while we’re at it... • Another item of interest left out of the “report” was any mention of asthma rates prior to 1994. • Again, we shall correct this oversight.

8. So as smoking rates have gone down, asthma rates have gone up – except for the past decade, when they decided to stop diagnosing all “wheezes” as asthma. Wouldn’t it be interesting if this same inverse correlation could be found between asthma and other pollutants? Now let’s add in some asthma rates, just for, you know – fun. • Same chart as last slide with overlay chart showing asthma trends (lower right hand corner). Overlap begins in 1971. Asthma chart from Public Health Agency of Canada. “Asthma Hospitalizations, ages 0-19, Canada, 1971-1995.” (Solid line ages 0-4, dashed line ages 5-19.) Now let’s add asthma rates. WTF! These stats start from 1971. I’ve lined the chart up so we can compare with the smoking rates from that period on. Now let’s add some asthma rates, just for, you know – fun. This is the same chart as before, showing the smoking rate over the course of seven decades. Now let’s add in some asthma rates – just for, you know, fun.

9. "Asthma in California," California Department of Health Services. Points of Interest No. 9, May 2003. http//www.ehib.org/oma/papers/brfss_poi_asthma.pdf. California Air Resources Board. 2003 Air Pollution Data CD: available at http:www.arb.ca.gov/aqd/aqdcd/aqdcd.htm

10. At least you can trust the education system