Large differences in prevalence of asthma have been reported between westernised countries and the former Eastern European countries, and still no consensus about the reasons for the differences exists. The aim of this study was to assess diagnostic labelling of obstructive airway diseases, comparing subjects with respiratory symptoms and the diagnoses obtained in Estonia, Finland, and Sweden. A postal questionnaire was sent to population-based random samples, and 44,483 (76%) answers were obtained from the 58,661 invited in 1996. Among men, current smoking was most common in Estonia, 60%, followed by Finland, 39%, and Sweden, 28%. In all three countries, 30% of women were current smokers. Most respiratory symptoms including wheezing were most common in Estonia, also among non-smokers. The prevalence of asthma was 2.0% and chronic bronchitis 10.7% in Estonia, while the opposite was found in Sweden with an asthma prevalence of 7.8% and a chronic bronchitis prevalence of 3.1%. The pattern in Finland was similar to that of Sweden. The same differences between the three countries were found also among young subjects. The total proportion of diagnosed obstructive lung diseases in subjects with respiratory symptoms was similar, but the diagnosis of asthma was considerably more common in Finland and Sweden. Chronic bronchitis was favoured in Estonia, also among young adults irrespectively of what symptoms were present. In a multivariate model with correction for confounders, the risk (OR) for having a diagnosis of asthma was 5.65 (95% CI: 4.86-6.56) when living in Sweden, and 3.51 (95% CI: 3.00-4.12) in Finland, whereas risk for chronic bronchitis was 0.28 (0.25-0.31) and 0.22 (0.19-0.25), respectively, compared to Estonia. The study indicates differences in diagnostic practices of obstructive lung diseases between the three countries.

We found a surprisingly high prevalence of allergic sensitization among adults in Tallinn. Our results suggest that the cockroach allergen should be included in the investigation panel in order to reach a true prevalence of allergic sensitization in Estonia. Further, the pattern of allergic sensitization in Estonia appears to be different from published data about allergic sensitization in Scandinavia.

Background: Allergies and asthma exhibit a growing health problem in the world. Sparse data are available about the prevalence of allergic sensitization in Estonia and Eastern Europe as well. We studied the prevalence of allergic sensitization, the associations between respiratory symptoms and allergic sensitization, and the influence of age, gender, area of residence, number of siblings and other demographic attributes on allergic sensitization in the population aged 17–69 years. Methods: We conducted a cross-sectional study with 1,346 randomly selected participants distributed in 3 geographically and culturally distinct areas of Estonia. Sensitization to 15 aeroallergens was assessed by skin prick tests. The study also included a structured interview. Results: The total prevalence of allergic sensitization was 33.0%. When estimated in patients aged 20–44 years, the prevalence was 38.5%. The most common sensitizer was cockroach followed by storage mites, while sensitization to cat, dog or pollen (common sensitizers in Scandinavian countries) was low. Allergic sensitization was significantly more common in urban and suburban compared with rural areas. Storage mites were the most common sensitizers in rural areas. Living in urban or suburban areas before the age of 5 significantly increased the risk for positive skin prick tests to several allergens. Conclusions: A higher prevalence of allergic sensitization than previously believed was found. Cockroach and storage mite allergens are suggested to be included in the routine investigation panel in Estonia.

The low prevalence of physician-diagnosed asthma probably reflects a considerable underdiagnosis of asthma in Estonia. Disease criteria for asthma based on symptom combinations together with hyperreactivity yielded a prevalence of 5%-8%, which is similar to the prevalence of asthma among adults in neighboring Western countries.

The low prevalence of physician-diagnosed asthma probably reflects a considerable underdiagnosis of asthma in Estonia. Disease criteria for asthma based on symptom combinations together with hyperreactivity yielded a prevalence of 5%-8%, which is similar to the prevalence of asthma among adults in neighboring Western countries.