Health campaigners have called for an inquiry into death rates from asthma after it emerged that almost twice as many women are dying from the disease as men.
Official figures show there is a widening gap between the number of men and women who are now dying from asthma attacks - a new trend that becomes even more marked among older women.
The latest figures from across the UK show that 916 women died from asthma in 2002 compared to 514 men - the total is equivalent to one asthma death every six hours.
But most of the deaths are among women over 50, raising fears among asthma experts that the National Health Service is failing to care for older sufferers.
The same statistics suggest that the medical advances which have significantly cut the risks of dying from asthma over the past 40 years are failing to be as effective for women as for men.
One of the most reliable methods for assessing death rates - based on numbers of deaths per head of population - shows that the number of men dying from asthma has been cut by half. One set of figures shows it dropped from 31 deaths per million men in 1990 to 15 in 2002.
But for women, the fall has been far less dramatic and now appears to have stopped altogether. Over the same period, the number of deaths for female asthmatics dropped by a third, to about 20 women per million, and has failed to fall any further for the past three years.
Professor Martyn Partridge, the chief scientific adviser for the National Asthma Campaign, said these figures raised questions about whether the disease was being properly diagnosed in older Britons and the quality of medical care they received.
Professor Partridge, one of the keynote speakers at a national conference on asthma to be co-sponsored by The Independent on Sunday later this month, said: "The studies which have been done clearly show that many of these deaths are avoidable. We need a nationally funded inquiry into asthma deaths."
Earlier studies had found that asthmatics with aspirin sensitivity died after being given the painkiller, or were given beta-blockers that interfered with their asthma drugs. In other cases, there were delays in giving life-saving treatment but some asthmatics also failed to use their drugs regularly. Liz Lynch, the mother of one severely asthmatic woman who died in 2002 at the age of 29, said ignorance about the condition was a common experience for her daughter, Bernadette. Staff at their local hospital in Glasgow routinely accused her daughter of failing to take her medicine, even though her notes showed that her body was failing to absorb her steroid drugs.
"Especially in A&E, they always blamed her, saying she hadn't been taking her drugs. She was told once in intensive care that 'one of these days, it could be too late'," said Mrs Lynch, who plans to raise her daughter's experiences at the IoS-sponsored conference.
"The doctors wouldn't take responsibility," she said. "I think they were fed up with her, the amount of times she was in. I think they felt that it was Bernadette's fault."
The NAC admits that very little research has been done into the reason why more adult women die of asthma than men, despite the mounting evidence that women are more likely to be killed by the illness. Most studies have focused on the age, medical histories and lifestyles of asthmatics.
Some theories suggest that hormonal differences could play a part in older women being more prone to asthma.
Recent studies suggest that women on hormone-replacement therapies are 40 to 50 per cent more likely to become severe asthmatics.
However, the latest figures, drawn from official death certificates from 2002, have also raised questions about the accuracy of the certificates.
Professor Peter Burney, an epidemiologist at King's College, London, was cautious about asthma being blamed in all cases, since the older someone became, he said, the less reliable a "cause of death" became.
He suggested that in older women, doctors misdiagnosed asthma when their deaths were due to smoking or other lung diseases, and that the overall diagnoses of asthma in older people could be less accurate than for younger people.
Professor Partridge was more concerned by the figures, however. "We should stress that, mercifully, the number of deaths is small for such a common disease, but proper studies suggest that most of these are preventable. If there are worries about the figures, there's nothing to suggest it is better or worse for asthma than anything else."
'Medicine and Me: Asthma' at the Royal Society of Medicine, 1 Wimpole Street, London on 28 April. Tickets £10. See www.asthma.org.uk for further details.
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