The increased incidence and mortality of asthma have been attributed to the “hygiene hypothesis”. Another contributing factor could be related to a lack of recognition of symptoms by patients and providers. Here we report the incidence of asthma in fair attendees who stopped by asthma screening booths.

From July 2000 through July 2003, eight screening sessions were held at both local (Johnson County, IA) and state fairs (Des Moines, IA). During these sessions, volunteers performed spirometry and filled out a questionnaire.

Of 525 volunteers (28 were ≤7 years-old, 122 were 8-14 years-old, and 375 were ≥15 years-old), 112 (21.3%) (Males=40/Females=72) reported that they had been previously diagnosed with asthma. Of these, 17 (15.2%) (Males=10/Females=7) had an FEV1 ≤75% predicted. Of these 17, 13 were treated by a primary care physician, 2 by an allergist, and 2 reported no treating physician. Of the 95 volunteers with asthma history and normal FEV1, 48% were treated by a primary care physician, 36% reported no treating physician, 8% were treated by an allergist, and 5% by a pulmonologist. Of the remaining 413 people who had no previous diagnosis of asthma, 56 (13.6%) (Males=25/Females=31) had an FEV1 ≤75% predicted. We found a total incidence of obstructive airway disease in this population, as defined by an FEV1 <75% predicted, to be 13.9%.

Based on this population of self-reporting fair attendees, a large percentage had potentially undiagnosed asthma as well as asthma that was poorly controlled.