Document Detail

A reappraisal of the United Kingdom epidemic of fatal asthma. Can general mortality data implicate a therapeutic agent?
MedLine Citation:
PMID:  3827432     Owner:  NLM     Status:  MEDLINE    
The 1960s epidemic of asthma deaths that affected young persons in England and Wales, as well as in other countries, was attributed to the effect of newly available pressurized aerosols containing sympathomimetic bronchodilators. The subsequent decision to ban the nonprescription sale of these agents in the United Kingdom represented a unique use of national and international mortality data. The application of such data for decisions about therapeutic agents has implications for the current rise of asthma deaths in New Zealand, for the recent United States regulatory action regarding the nonprescription sale of aerosolized bronchodilators, and for the appraisal of adverse reactions to other pharmaceutical substances. This article is concerned with the quality of the scientific evidence used to implicate bronchodilators in the 1960s epidemic, and also with the strengths and weaknesses of the ecologic studies on which the implication depended. After concluding that the causal link between asthma deaths and bronchodilators was not supported by satisfactory scientific evidence, we present new data and an alternative diagnostic-exchange hypothesis that may, in part, help explain the original association.
J M Esdaile; A R Feinstein; R I Horwitz
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of internal medicine     Volume:  147     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  1987 Mar 
Date Detail:
Created Date:  1987-04-03     Completed Date:  1987-04-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  543-9     Citation Subset:  AIM; IM    
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MeSH Terms
Aerosols / adverse effects
Asthma / mortality*
Bronchodilator Agents / adverse effects*
Child, Preschool
Epidemiologic Methods / standards*
Great Britain
Statistics as Topic
Reg. No./Substance:
0/Aerosols; 0/Bronchodilator Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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