Setting and Objective: We assessed the relative effects of age, gender, period of death and birth cohort on asthma mortality rates in Australia from 1907 to 2000.
Design: Asthma mortality data obtained from the Australian Institute of Health and Welfare were adjusted for changes to the International Classification of Diseases and examined for changes over time and age, period and cohort effects.
Results: Age-adjusted period asthma mortality rates indicated epidemics during the mid 1960s and 1980s, predominantly affecting those aged 5-34 years. The main 1960s epidemic coincided with the introduction of high-dose, non-selective beta-sympathomimetic amines. There was a gradual rise in mortality rates in younger age groups, with rates rising from 0.5/100 000 males and 0.9/100 000 females in the 1940s to a peak of 3/100 000 for both sexes in 1966. Fluctuations in mortality rates were influenced by period of death and birth cohort. There was an increased risk of death from asthma with increasing age.
Conclusion: There was no overall trend in asthma mortality rates in any age group. The 1960s epidemic was probably treatment related. Other increases in mortality occurring despite therapeutic advances may reflect increasing prevalence and highlight the need for ongoing surveillance.