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Aim: To identify the level of non-pharmacological care received by middle-aged adults with current asthma in Australia and to identify its association with clinical measures. Methods: The Tasmanian Longitudinal Health Study (TAHS) is a population-based cohort first studied in 1968 (n = 8583). In 2010, when participants were aged 49 years, a stratified sample enriched for asthma and bronchitis underwent clinical assessments including respiratory questionnaires and lung function testing (n = 836). Current asthma was defined as self-reported asthma symptoms and/or healthcare utilization in the last 12 months. Multivariable linear regression and log-binomial models were used to assess the relevant associations. Results: Of the entire TAHS cohort, 15.6% (95% CI 13.4–18.2%) had current asthma. Of these, 37.9% (95% CI 30.5–45.9%) had seen a general practitioner for their asthma and 16.5% (95% CI 11.5–23.1%) had discussed their asthma with a pharmacist in the last 12 months. Written asthma action plans (AAPs) were reported by 17.9% (95% CI 12.9–23.2%), verbal AAPs by 53.8% (95% CI 45.9–61.6%) and doctor-assessments of inhaler technique by 42.7% (95% CI 35.2–50.5%). Adults with asthma of greater severity were more likely to have received verbal AAPs (p-trend =0.02). In contrast, adults with lower spirometry were more likely to have received verbal AAPs (p = 0.04), written AAPs (p = 0.001) and education on inhaler technique (p = 0.04). Conclusion: Despite an established evidence base and recommendations in local and international guidelines, non-pharmacological asthma management remains sub-optimal in the middle-aged adult asthma population. [ABSTRACT FROM AUTHOR]

Particulate matter (PM) has been widely associated with adverse effects on respiratory health, both overseas and in Australia. This study aimed to investigate the impacts of ambient particles of <2.5 μm diameter (PM2.5) in Melbourne on adverse respiratory symptoms. Two cohorts of adults were recruited in 1992-1998, and completed detailed respiratory questionnaires in 1998-1999 and 2004-2005. The mean age at baseline was 37.2 years, 55% were female, and the mean time lapsed between the baseline and follow-up questionnaires was 5.2 years. PM2.5 exposure was assessed from gravimetric data and routine nephelometry at monitoring stations located centrally with respect to the residence of most participants. Daily exposures to PM2.5 were averaged over the previous 12 months and mean daily exposure was 6.8 μg/m3. Logistic regression models were used to examine associations between PM2.5 exposure and adverse respiratory symptoms. Adjustment was made for age, gender, current smoking status, and medication use, but further adjustment for atopy did not alter the results. There was insufficient variability in PM2.5 exposure among participants over the study period to provide convincing evidence for or against associations between PM2.5 and adverse respiratory symptoms. [ABSTRACT FROM AUTHOR]