Study Paints Grim Picture of Puffer Use

asthma reliever medication

Australian asthmatics are overusing reliever medication, according to new research that strongly suggests many are failing to manage their condition.

A study from the Woolcock Institute of Medical Research and the University of Sydney reveals for the first-time details surrounding a hidden population of people who buy their reliever puffer over the counter, with concerning results.

More than two thirds of those surveyed overused their reliever, while in contrast a similar number did not use a preventer puffer regularly. Alarmingly, almost 20 per cent of people who bought their reliever without a prescription reported that they had not been diagnosed with asthma. The study is published in the prestigious international journal BMJ Open.

“Results show our concerns about asthma management are real,” says Professor Sinthia Bosnic-Anticevich, senior author and head of the Woolcock’s Quality Use of Respiratory Medicines Group, which is an affiliate of the University of Sydney. The high proportion of reliever overuse and the low proportion of regular preventer use is in complete contrast to what we would hope to see.”

She adds: “It’s well established that one of the key signs of poor asthma symptom control is the need for frequent reliever use. This research indicates that this is common, yet patients don’t seem to be complaining.”

Two million Australians - about one in ten - have asthma, a chronic lung condition that inflames and narrows the airways, causing wheezing, shortness of breath, chest tightness and coughing. The causes are still not well understood, but triggers are known to include viral infections, exercise, and exposure to allergens and irritants.

Adherence to medications is poor, with many patients failing to use their preventer inhalers regularly, instead relying on reliever medication, the “ambulance-at-the-bottom-of-the-cliff” solution. Global asthma experts recently moved to officially condemn reliever-only use as a practice associated with high risk.

Australia is one of the few countries to make asthma relievers available through pharmacies without a prescription, which provides us with a unique opportunity to understand how patients truly use their relievers, with more than 60 per cent of people getting the medication this way. Researchers from the Woolcock and University of Sydney investigated the real-life purchase of short-acting beta agonists (SABA) in NSW pharmacies. The team examined questionnaires completed by 412 people buying SABA over the counter. Results showed 70 per cent of participants reported so-called “overuse” of SABA, that is more than the recommended maximum of twice a week within the last four weeks.

“SABA overuse is very high, while preventer medication use remains low, a habit which can lead to poor outcomes and likely explains why only a quarter of over-the-counter purchasers reported well-controlled asthma,” Professor Bosnic-Anticevich says. “When you consider that there are potentially tens of thousands of people using their medication like this, it suggests that a considerable proportion of Australians are experiencing wheezing, chest tightness and, worse still, asthma flare ups, due to uncontrolled disease.”

The Woolcock expert explains that SABA therapy should be carefully restricted to ‘as needed’ usage only. “We know that using your reliever too much is linked to poor asthma control, increased airway hyper-responsiveness, more asthma-related hospital admissions and, in extreme cases, death,” Professor Bosnic-Anticevich says. “What we really need to understand is why this is happening.”

“We absolutely don’t want to ask patients to withhold using their SABA if they need it, but we do need to solve the problem of why they need it or feel they need it,” she says. “It is critical that we support patients and work with them and their doctors to ensure that asthma flare ups are prevented, and overuse of SABA is not the answer.”

The researchers are calling for more work to explore ways in which community pharmacists can identify these uncontrolled asthma patients and refer them onto treatment plans that improve asthma outcomes.

The paper, entitled Understanding reliever overuse in patients purchasing over-the-counter short-acting beta2 agonists: An Australian community pharmacy- based survey, was a collaboration involving the Woolcock Institute of Medical Research, Sydney Local Health District and University of Aberdeen, United Kingdom.

GP Seminar: Sleep in theory and practice


The Woolcock Institute of Medical Research invites you to come along to a evening GP seminar.

We will discuss the assessment of obstructive sleep apnea, adult and paediatric sleep disorders, and associated mental disorders. Come along to hear the latest research, discuss relevant issues and identify alternative assessments and treatments that may assist your practice.

Date & Time

6pm, 12 September 2019


6.00pm: Registration and light refreshments

6.30pm: Welcome and introduction

6.40pm: What’s new in sleep apnea diagnosis by Professor Ron Grunstein

7.10pm: Sleep problems in children by Dr Geshani Jayasuriya

7.30pm: Sleep and mood - recognising and treating both at the same time by Dr Chris Blackwell

7.50pm: Questions and answers

About this course

An application will be submitted to the RACGP for this activity to be accredited for 3 Category 2 points, as part of the RACGP QI&CPD Program in the 2017-19 Triennium. Activity number to be allocated.


Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe NSW 2037

Asthma Specialist Wins Prestigious Medal

Professor Helen Reddel with Professor Bruce Thompson, TSANZ President.

Professor Helen Reddel with Professor Bruce Thompson, TSANZ President.

Woolcock respiratory researcher Professor Helen Reddel has been honoured for her outstanding contribution to thoracic medicine.

The Sydney respiratory physician is the recipient of the 2019 Society Medal bestowed by the Thoracic Society of Australia and New Zealand (TSANZ). The prestigious award was presented at the TSANZ annual conference on the Gold Coast on April 2.

Professor Reddel is a widely-published researcher specializing in practical evidence-based strategies to improve care for Australians living with asthma and chronic obstructive pulmonary disease (COPD). Her work involves collaborations with GPs, pharmacists and nurses, and has a strong focus on improving clinical guidelines and communication between patients and health professionals.

A Research Leader at the Woolcock Institute of Medical Research, and Clinical Adviser to the Australian Centre for Airways disease Monitoring, Professor Reddel is also the Chair of the Science Committee of the Global Initiative for Asthma (GINA), and a member of the National Asthma Council (NAC) Guidelines Committee. She has contributed her expertise to organisations such as the Lung Foundation of Australia (LFA), National Prescribing Service (NPS) and Asthma Australia.

She has published over 170 peer-reviewed articles, including two that were recently published in the prestigious New England Journal of Medicine, both identified by the journal editor as being of “significant importance to the field of respiratory medicine”. The 2009 report of an international Task Force on asthma outcomes that Professor Reddel co-chaired was recently described as the 18th most influential asthma publication since 1960. Professor Reddel also regularly presents at international respiratory conferences on the challenges of diagnosis and management for asthma and COPD. She continues to lead ground-breaking research, currently co-chairing a multinational study of over 12,000 patients that is investigating mechanisms underlying asthma and COPD.

Professor Reddel is the second female to receive this award, following Prof Ann Woolcock in 1998 who supervised Prof Reddel’s PhD studies.

The TSANZ Society Medal was conceived as an acknowledgment of excellence in the advancement of the practice of thoracic medicine in Australia and New Zealand. The inaugural Society Medal was presented in 1992 to Dr Maurice Joseph, who ably embodied the qualities envisaged by this senior prestigious award.

Why You Shouldn’t Mess With Your Body Clock: Expert

Next time you consider pulling an all-nighter, spare a thought for your poor body clock.

A world-leading sleep scientist will reveal the inner workings of our sleep cycle at a free public lecture to be held in central Sydney this week.

Professor Derk-Jan Dijk is an internationally-renown sleep expert with intimate knowledge of circadian rhythms, the internal biological mechanism that controls how our body and brain behave at particular times of the day.

“The best advice I can offer is don’t mess with your body clock,” says Professor Dijk, ahead of Wednesday’s address at the Woolcock Institute of Medical Research in Glebe. “Take an all-nighter or a big weekend sleep-in, for instance. It might suit your lifestyle but that’s going to cause some real internal chaos that can have a devastating effect on your mental and physical health. The more you understand how your body clock works, the better.”

Professor Dijk, Director of the Surrey Sleep Research Centre at the University of Surrey, United Kingdom, is an international authority on the body clock, having studied circadian rhythms and sleep in humans for 35 years. The public lecture will cover the basics: what they are, where they’re located and what they regulate.

He’ll also go through the role of busy social lives and frantic work schedules on this internal biological clock, and how confusing it can damage your mood and make you more susceptible to disease.

“Your body clock also changes as you age, posing some mental health challenges, but there’s good news. We’re discovering new interventions that can reverse some of these changes and get your body clock back into line,” the scientist explains.

Professor Dijk will also reveal the latest on new genetic biomarkers for insufficient sleep and circadian disruption that hold promise for future discoveries.  

The talk is this year’s Ann Woolcock Lecture, a series of annual addresses to honour the Woolcock’s esteemed founder. To celebrate Professor Woolocock’s legacy, invited researchers share their ideas with industry, policy makers, doctors, specialists and patients with a view to prompting new collaborations to improve respiratory and sleep health.

The free lecture, Chaos In Our Body Clocks – A Pathway To Disease, will be held on Wednesday, 8 August at 5.30pm, at the Woolcock Institute of Medical Research headquarters in Glebe, Sydney. Bookings are essential, please email



Pharmacy-Driven Service Set to Transform Asthma Landscape

asthma treatment

Pharmacists are leading an innovative new push to relieve Australians from the heavy burden of uncontrolled asthma.

Under the Sixth Community Pharmacy Agreement, the Australian Government is providing $50 million over five years for the Pharmacy Trial Program (PTP) to trial new approaches for pharmacy services. This program is funding several trials to improve patient outcomes and seeks to expand the role of pharmacists in delivering a wider range of primary health care services through community pharmacy.

The Woolcock Institute of Medical Research in Sydney is heading up one of these trials involving a pharmacist-delivered asthma service, in which pharmacists can assess and, if necessary, refer asthma patients with complex issues to a GP.

Researchers are looking to recruit 80 pharmacists and 20 GPs from across New South Wales, Western Australia and Tasmania to take part in the trial. Health professionals involved will be remunerated for time spent on the service.

“We have a very exciting opportunity for pharmacists across three states to get involved in a totally new concept in asthma management for Australia,” says Professor Carol Armour, executive director of the Woolcock Institute of Medical Research. “If it works as hoped it will relieve the substantial burden that many patients and their families experience as a result of sub-optimally controlled asthma.”

Asthma affects approximately 10 per cent of the Australian population and when assessed, half of these people have poorly controlled asthma.

Called the Pharmacy Trial Program – Asthma and Rhinitis Control, or The PTP – ARC, the project addresses the need to improve clinical outcomes for the Australian population at risk of uncontrolled asthma. It does this by extending the role of pharmacists in the delivery of primary health care services through community pharmacies.

The service is based on pharmacists:

  • Identifying patients with poorly controlled asthma using the Asthma Control Questionnaire (ACQ);
  • Assessing possible causes of poor control; and
  • Referring patients with unknown causes/complex issues to their GP.

“The proposed intervention involves an evidence-based pharmacist-delivered service for patients with uncontrolled asthma, which can easily be integrated into pharmacists’ workflow,” the specialist explains.

This intervention targets three key factors associated with uncontrolled asthma. These are: Poor adherence - characterised by underuse of preventer medication and/or overuse of reliever medication, suboptimal inhaler technique, and/or uncontrolled allergic rhinitis.

The randomized controlled trial starts in July and will recruit 840 Australians with poorly controlled asthma.

Pharmacies will be asked to submit an expression of interest in the project once the software and training plan is complete.

“Should the service prove to be cost-effective and acceptable to patients, we could see pharmacists delivering the service more widely,” Professor Armour says. “This is your chance to be involved in an exciting new direction for asthma management in Australia.”

The project is a collaboration between the Woolcock, University of Sydney, Curtin University, University of Tasmania, Pharmaceutical Society of Australia, The Pharmacy Guild of Australia, National Asthma Council Australia and The George Institute for Global Health.

The call for pharmacists to submit an expression of interest has started in NSW and WA (2 July). The call in Tas will occur shortly afterwards. Please watch the Pharmacy Guild and PSA websites.

Lung Cancer Centre Sets Sights on Cure

A cure for Australia’s deadliest cancer is closer than ever with the launch of a dedicated lung cancer research centre charged with boosting survival rates and treatment options for the killer disease.  

The Centre for Lung Cancer Research opened its doors in Sydney today, ushering in a new era of innovation and collaboration to find a cure for a disease affecting 10,000 Australians each year.

Working across the areas of genetics, drug discovery, delivery of medications and patient care, the Centre, unveiled by NSW Health Minister Brad Hazzard, will transform today’s lung cancer research landscape and ensure lab discoveries are swiftly implemented in cancer clinics.

“Lung cancer has an appalling survival rate, very few effective treatment options and a bad reputation which has made it difficult to secure the funding needed to make research breakthroughs,” says Professor Carol Armour, Director of Sydney’s Woolcock Institute of Medical Research, where the Centre is based.

“We’re changing that forever, with a purpose-built lung cancer research facility dedicated exclusively to finding a cure for this killer condition. With the innovations inside these walls and among our broad network of leading researchers, lung cancer will no longer be the dreaded diagnosis that it is today.”

Lung cancer facts make grim reading. More Australians die every year from this disease than breast and prostate cancer combined. Despite this, lung cancer receives only a small fraction of the funding of other cancers, largely due to its negative links to smoking, Professor Armour says. “What people don’t realise is that many sufferers have never smoked, and of those who have, many started young before cancer links were well understood, so the stigma is really quite undeserved,” Professor Armour says.

The Centre aims to lift the profile of lung cancer by supporting large translational research programs to be run from its high-tech purpose-built Glebe facilities. It includes the Lung Cancer Research Network, a team of world-class researchers from over 20 hospitals, research centres, universities and organisations who are united in the goal to better understand, treat and prevent the disease.

“The facility acts as a hub for researchers, clinicians, respiratory physicians, oncologists, radiologists, thoracic surgeons, advocates for lung cancer, basically all those who are passionate and motivated to fast track a cure for lung cancer,” says respiratory specialist Associate Professor Lucy Morgan, a member of the network supported by the new Centre. Collaboration in our network will connect discovery and implementation more quickly than ever before.

”The work has already begun, with the network establishing core research projects through the Centre to develop non-invasive diagnosis, innovative drug delivery and 3D-printed airway stents for patients with breathing difficulties,” Associate Professor Morgan says.

The Centre’s database and bio-bank give lung cancer researchers access to unprecedented quantities of valuable cells, de-identified patient information and fresh experimental results in the areas of molecular biology and drug discovery. The state-of-the-art laboratory will be available to researchers and provide tissue and cell analysis.

The innovation has been welcomed by Lillian Leigh, a Sydney lawyer and mother who was diagnosed with stage four lung cancer three years ago, aged 37. “We desperately need better treatments and far better outcomes for people diagnosed with this disease,” says Ms Leigh, who will speak at the launch.

“The Centre and the Network have a very exciting opportunity here to build a robust, energised lung cancer research field. That gives myself and others hope for a brighter future where survival rates climb and we get the chance to see our children grow up.”

The Centre for Lung Cancer Research will be opened by NSW Health Minister Brad Hazzard at 9.30am on Wednesday, April 18 at the Woolcock Institute of Medical Research in Glebe, Sydney.

Lung Cancer: The Facts

  • Lung cancer is the 4th most common cancer in Australia and has the highest mortality rate
  • More than 10,000 Australians are diagnosed with it each year
  • It kills more women than breast, uterine, and ovarian cancer combined
  • Unlike breast or prostate cancer, lung cancer has no diagnostic tests for early detection
  • It is the leading cause of cancer in the Aboriginal population
  • Just 15% of those diagnosed with lung cancer are still alive five years later

Ensuring Clean Energy isn’t the New Cane Toad

Renewable energy is touted as the great hope for our planet’s future, but is it as clean as it’s cracked up to be?

Australia’s top pollution researchers are reviewing the benefits and pitfalls of solar, wind, hydro and other renewable energy options to ensure they’re adopted as effectively and safely as possible.

The expert group, called the Centre for Air pollution, energy and health Research (CAR), will be the first in Australia to investigate how these popular new forms of energy will impact on our health.

“There is a lot of enthusiasm to do away with fossil fuels and embrace renewables, and rightly so,” says Head of CAR, Professor Guy Marks. “The problem is there are a lot of assumptions that clean energy is going to help us live healthier lives. Certainly, we’d love to think that’s the case, but we need to make sure there are no unforeseen side-effects.”

CAR is a NHMRC Centre of Research Excellence bringing together researchers who investigate how environmental pollutants affect our health. The issue is a critical one, with pollution now regarded as the world’s largest single environmental health risk, according to the World Health Organization. Air pollution alone has been linked to more than a quarter of all deaths from lung cancer, stroke and heart disease. Pollutants in the air, water and soil were responsible for nine million deaths globally in 2015, the Lancet Commission recently reported. The economic toll is also high, with pollution costing the planet $4.6 trillion a year.

Launched in 2013, CAR has been re-funded a further five years to continue its work investigating how pollution from fossil fuels, coal and bushfires affect the health of Australians. Excitingly, the group of 30 eminent researchers has extended its focus to include renewable energy options and how to adopt them to maximize health benefits.

Professor Marks, from the Woolcock Institute of Medical Research and the University of NSW, says most people firmly agree that to tackle climate change we need to move away from traditional fossil fuels and towards renewable forms of energy. “But a key question remains: What is the best way to achieve this transition? That is, how can we transition to renewables in the cheapest, most efficient way and with the least economic, social and health impacts? Our role is to make sure that health impacts are considered.”

Logic suggests that burning of fossil fuels contributes significantly to air pollution, greenhouse gases and health problems so switching to renewables is likely to reduce pollution and improve health, Professor Marks explains. Indeed, international studies comparing fossil fuels with clean energy show huge reductions in both pollutants and premature deaths.

“However, the reality may be more complicated because this type of analysis focuses only on the benefits of renewables and assumes there are no adverse health consequences arising from their use,” the expert says. “This may not be a valid assumption, particularly when you consider the manufacture, transport and disposal of renewable energy sources, all of which may generate environmental impacts with adverse health consequences.”

CAR researchers propose a new model to evaluate health implications, both positive and negative, of renewable energy projects or technologies. This assessment is carried out at each stage of a project’s life, allowing policy makers to mitigate any health risks. “After all, as Australians have learnt to our great cost through our cane toad experience, what appears like a great solution to a problem may not be as rosy as first thought.”

To mark its re-launch, CAR will hold an official launch of the Centre, followed by an Energy Transitions Forum at the Melbourne Town Hall on 23 March. The event, from 10am-4pm, brings together policy makers, researchers and members of the community to tackle the issue of renewables and their impact on health. Six experts will speak followed by a Q&A. For further information, email

About CAR

The Centre for Air pollution, energy and health Research (CAR) brings together more than 30 researchers at the cutting edge of their fields to study how environmental pollutants affect our health. CAR is an NHMRC Centre of Research Excellence (CRE). As a CRE, CAR does not direct research projects but instead supports teams of researchers to pursue collaborative projects and to develop their capacity.

Our vision is for a healthier community through cleaner air and cleaner energy sources.

Interview with Dr Tracy Smith about Breathlessness

Interview with Dr Tracy Smith, respiratory physician, Woolcock Institute of Medical Research.


Dr Tracy Smith expounds on the various factors that cause breathlessness. Breathlessness can be confusing for doctors. Woolcock Institute of Medical Research in Sydney has launched a Breathlessness Clinic to fast track diagnosis and treatment for the many people suffering from this worrying, anxiety-inducing complaint. 

Would you like to find out more about the Woolcock Breathlessness Clinic, please visit:

Blue Illusion Fashion Parade 2017

Thanks to model / supporter extraordinaire Mrs Lynette De Michiel, who championed the event on behalf of the Woolcock once more on Saturday, 4 November 2017 at Blue Illusion Miranda, we raised over $1,000. 

Are you looking for ways to support the Woolcock? Ask for donations instead of gifts, hold a musical concert, bake cakes or put on a fashion parade. Talk to us for more information or ideas on 02 9114 0414.

Lung Disease Testing in Pharmacies a Winner: Research


A pharmacy-run service to test for the lung condition COPD would benefit hundreds of Australians, especially those in rural areas, new research suggests.

The Woolcock Institute of Medical Research in Sydney ran a six-month service across 21 community pharmacies in NSW to check the feasibility of screening for chronic obstructive pulmonary disease, or COPD, using microspirometry.

The results, published in the International Journal of Chronic Obstructive Pulmonary Disease, show 10 per cent of those tested in pharmacies were given a diagnosis of COPD after a doctor’s referral. A further five per cent were diagnosed with another medical condition.

Although only half of all screened patients live in regional areas, 93 per cent of those diagnosed with COPD were from regional areas, suggesting those living rurally would benefit most from the service. The study was carried out by a PhD student working at the Woolcock, Mariam Fathima.

Woolcock Executive Director, Professor Carol Armour, said rolling the service out across pharmacies nationwide would allow hundreds of people to benefit from COPD diagnosis and treatment. “COPD sufferers are often troubled by shortness of breath and a troublesome cough, but numerous treatments are available to help make life more bearable,” Professor Armour explains. “Getting that diagnosis is vital so we can get these patients onto treatment sooner, and start boosting their quality of life.  We’ve proven a pharmacy-run service would be a very effective means of making that happen.”

The study involved pharmacists trained in COPD case finding, including lung function testing, who invited patients aged 35 years and over with a history of smoking and/or respiratory symptoms to participate. High-risk patients were identified via a COPD risk assessment questionnaire. Those with concerning lung function were referred to their GP for further assessment and diagnosis.

In all, 157 patients did the lung function test and 61 (39 per cent) were referred to their GP.  A total of 15 (10 per cent) patients were diagnosed with COPD. Another eight (5 per cent) patients were diagnosed with other medical conditions and 87 per cent of these were started on treatment.

COPD is a lung illness most commonly triggered by smoking. The disease causes lung damage which then makes it difficult to breathe. 

COPD in Australia

  • COPD affects one in 13 Australians aged 40 and over. Rates are higher in men
  • Sufferers struggle to breathe deeply and have a persistent mucousy cough
  • Smoking is the primary cause but other triggers include tuberculosis, air pollution and occupational exposure in workplaces such as mines
  • COPD is responsible for about 60,000 hospitalisations annually 
  • The condition costs Australia about $950m in direct health costs each year, accounting for 1.3 per cent of all healthcare expenditure
  • A Woolcock feasibility study confirms COPD can be effectively tested in a pharmacy setting. Of those tested by pharmacists, 15 per cent went on to get a diagnosis of COPD or another medical condition by their doctor

Please click here to view the full publication. 

Do you have insomnia?

The Bellberry Human Research Ethics Committee has reviewed and approved this study (Protocol number 2016-02-104) in accordance with the National Statement on Ethical Conduct in Human Research (2007) incorporating all updates. Australia and New Zealand Clinical Trials Registry number 12614001293651.

The Bellberry Human Research Ethics Committee has reviewed and approved this study (Protocol number 2016-02-104) in accordance with the National Statement on Ethical Conduct in Human Research (2007) incorporating all updates. Australia and New Zealand Clinical Trials Registry number 12614001293651.

Do you want better sleep at night and better concentration during the day?

At the Woolcock we are trialling a combination of a behavioural intervention with a short script of a new medication that we hope will improve sleep and daytime performance.

This study requires two visits to the Woolcock Institute of Medical Research in Sydney, Glebe, NSW.

If you would like to find out more about this study, please follow this link to register your interest. 

Aussie Asthmatics No Better Off On More Costly Drug: Study

Australians are relying on expensive asthma medication despite new research showing many New Zealanders with asthma fare just the same on a more affordable inhaler.

Important new research from the Woolcock Institute of Medical Research in Sydney has confirmed high rates of poor asthma control in Australia and across the ditch. The study, published today in the international journal Respirology, shows 45 per cent of Australians and 41 per cent New Zealanders live with poorly controlled asthma symptoms. Further, almost 30 per cent of people with asthma in both countries required urgent health care for asthma in the past year.

“Interestingly we found that most Australians with asthma are prescribed a combination preventer medication while New Zealand achieved the same asthma results overall with more use of a basic preventer inhaler that, in Australia, is more affordable for patients,” says lead researcher and asthma specialist Professor Helen Reddel. “This suggests that for some Australian patients, their extra spending may not be paying off.” 

More than two million Australians have asthma, a chronic lung condition that inflames and narrows the airways, causing wheezing, shortness of breath, chest tightness and coughing. The causes are still not well understood, but in patients with asthma, the triggers for symptoms are known to include viral infections, exercise, and exposure to allergens and irritants. Preventer inhalers markedly reduce the risk and symptoms of asthma if they are taken regularly, but many patients fail to use them regularly, instead relying on a quick-relief inhaler that doesn’t treat the asthma itself, the ambulance-at-the-bottom-of-the-cliff solution.

Professor Reddel and her colleagues from Melbourne, Christchurch and Wellington set out to investigate whether use of the combination preventer medication was linked to better asthma results for patients. The study involved more than 3000 randomly-selected Australians and New Zealanders with asthma who completed an online survey focused on asthma symptom control, medication use, and doctors’ visits over the period of one year. 

“Guidelines in both countries recommend that most people with asthma should be taking a simple daily asthma preventer inhaler to reduce symptoms and reduce the risk of serious flare-ups,” Professor Reddel says. “However, we discovered that in both countries, almost half of the people prescribed any type of preventer medications are not taking them regularly.”

Guidelines in both countries also recommend that asthma treatment should start with a basic preventer inhaler, with the combination inhalers prescribed if asthma is still not well-controlled despite the medication being taken correctly and regularly. In Australia, the simple preventer inhaler is more affordable for patients than the combination preventer, but in New Zealand, the cost to patients is the same.

Despite this, out of those using a preventer in Australia, 82 per cent were taking a combination preventer inhaler, compared with just 44 per cent in New Zealand. Kiwis were more likely to use a basic (single medication) preventer inhaler. The story becomes even more interesting when we look at how often patients said they were taking their preventer inhaler - in both countries combined, the combination inhalers were more likely to be taken regularly than simple preventer inhalers (61 per cent vs 47 per cent), but more New Zealanders than Australians were taking a preventer inhaler regularly (43 per cent vs 34 per cent).

The most important statistic – rates of uncontrolled asthma that leave patients at risk of asthma attacks – were equally poor in both countries. “Despite the greater use of combination inhalers in Australia, Australia’s results are no better,” Professor Reddel says. “This suggests that some Australian patients could be better off if they considered moving to the more affordable basic preventer therapy, as long as they made sure to take it every day.”

Explaining the trans-Tasman differences, Professor Reddel says New Zealanders pay less for their asthma medication than Australians, but until recently, access to combination therapies (which are more expensive for government) was more tightly regulated in New Zealand than Australia. “Also, in Australia, reliever inhalers are available over-the-counter without a prescription, so many patients with uncontrolled asthma in Australia rely on quick relief medications that don’t actually treat their asthma, without seeing their GP.”

She called on doctors and pharmacists to make patients aware that choices are available for preventer medications. “In Australia, almost all of the basic asthma preventer inhalers are more affordable for patients than are combination inhalers, but there is little awareness of this,” the specialist says. “Since cost is often an important factor for patient decisions about medications, it would be good to make patients and doctors in Australia aware that there are more affordable options available, that for many patients would work just as well.”

Given the high rates of poorly-controlled asthma in both countries, urgent work is also needed to boost use of preventer medications in general, she says. “Used daily and used correctly, a preventer inhaler is the very best tool a person with asthma has to ensure their condition is well controlled and reduce their risk of a flare-up,” Professor Reddel says. “Most people only need a low dose to get the full benefit, and yet so many people aren’t taking it regularly.”

“My advice is please use your preventer inhaler, and have someone check that you are using it correctly. It will help protect you, keep you out of hospital and it may even save your life.”

Wind Turbine Truth: Is Clean Energy Making You Sick?

As seen on SBS news:

In a world first, the controversial theory that the inaudible noise generated by wind farms can harm health is being put to the test in a Sydney sleep lab.

Starting tomorrow, researchers at Woolcock Institute of Medical Research will be exposing Sydneysiders to silent sound waves from wind turbines while they sleep to find out if the clean energy source could be making them sick.

“This is a contentious issue, with some residents living near wind farms certain that their health is being harmed and others seemingly unaffected,” says the study’s principal investigator, Associate Professor Nathaniel Marshall. “The science is murky on the topic so the sooner we can get some conclusive results the better.”

Australia is home to more than 75 wind farms housing about 2000 turbines. As the cheapest source of large-scale renewable energy, wind power use is rapidly expanding nationwide, with multiple new projects in the pipeline.

But with the growth has come a rise in complaints from residents living near wind farms who report experiencing headaches, dizziness and sleep disturbances which they attribute to the turbines. The symptoms, which some sufferers also say include nausea, tinnitus and irritability, are referred to collectively as wind turbine syndrome (WTS), which they link to infrasound, the inaudible sound that emanates from each generator.

The Woolcock will enlist 40 people, who report some sensitivity to audible sound and expose them to traffic noise, inaudible sound known as infrasound, or quiet over three weekend three-night visits to the institute’s purpose-built sound-isolated laboratory.

“As infrasound is inaudible and the order of the exposures is randomised and concealed from the participants, they won’t know which they have been exposed to,” Associate Professor Marshall explains.

The research team will run multiple tests to confirm each participant’s sleep quality, blood pressure, heart rate, neurocognitive functioning and symptoms related to WTS. Their levels of stress and anxiety will also be monitored. “We hope to find out whether wind turbine syndrome is real or whether the symptoms people experience are the result of so-called ‘nocebo effect’, where a person becomes convinced something harmless is making them ill,” Associate Professor Marshall says.

The study is one of two comprehensive trials funded at the Woolcock by the NHMRC over five years to bring some hard science to the wind turbine syndrome argument. The second project involves a group of residents in NSW’s Southern Highlands who will be randomly exposed to either infrasound or nothing for six months through a purpose-built device installed in their bedroom. These participants will also be “blinded” as to which exposure they are receiving.

The studies’ results will be available in 2-4 years and will be used by policymakers to inform public health and manage future growth of the clean energy source.

The Woolcock is seeking volunteers for the laboratory study. Participants cannot be shift workers, pregnant or breastfeeding, and must be willing to go without caffeine, alcohol, and tobacco for the three study weekends. To enquire, please go to

Wind Turbine Syndrome

Some people who live near wind farms complain of dizziness, sleep disturbance and other symptoms referred to collectively as wind turbine syndrome. Sufferers argue WTS is caused by infrasound generated by wind turbines. This is controversial however, with many academics and others claiming the illness is purely psychological.

The Woolcock Wind Farm Trials

The NHMRC has awarded Woolcock Institute of Medical Research $1.94m over five years to bring some hard science to the argument. It is running two trials, one lab-based and one in people’s homes, to test conclusively whether infrasound from wind turbines has any effect on health.

About the Woolcock

The Woolcock Institute of Medical Research is one of the world's leading respiratory and sleep research organisations. It has over 200 medical researchers working to uncover the causes of disease, find better treatments and translate these into practice.

Please click here if you would like to participate in this study.

The Big Idea Challenge

Congratulations to Jesse Xu, who has been listed as one of the six finalists after presenting at the Big Idea Challenge on "next generation printed personalised airway stents in the lung". 

Jesse was one of the 33 applicants from Sydney Research (Central Sydney health district, MRIs and University of Sydney). The six finalists will now go into a program which will mentor their development skills.

They presented the following ideas:

  1. New stretchable fibres made of polyurethane to be woven into fabric to sense heart attack risk
  2. Next generation printed personalised airway stents in the lung
  3. A lifelike birthing simulator that mimics the pathway a baby actually follows to be born with the associated physics involved rather than assuming the baby slides down a straight tube
  4. A new specific immunosuppressive based on dendritic cells for inflammation and organ transplant
  5. A biopen which delivers special ink to the surface of the eye to seal a break or tear
  6. A miR blood test for diagnosing coronary artery disease (at $20 rather than angiography which costs lots more)

Bedroom Vigilantes Needed to Get Teens Snoozing: Experts

Teen sleep

Parents need to stop tip-toeing around their sleep-deprived teens and take firm steps to get adolescents sleeping soundly, experts warn.

Sleep specialists at the Woolcock Institute of Medical Research in Sydney are calling on parents to step up and act as bedroom vigilantes to curb rising rates of sleep deprivation among Australian high school students.

“Mums and dads have the power to dramatically improve their children’s sleep but sadly many are failing to take action because they fear the fights it will trigger,” explains Woolcock Adolescent Sleep Physician Dr Chris Seton. “What they don’t realise is that the cost of this inaction is huge. Their children are so sleep deprived that all the efforts parents make to provide a good education are often wasted. Kids are not learning anything when they’re tired.”

Help is at hand however, with Woolcock specialists hosting a Sleep Education Seminar designed to empower parents and leave teens feeling well slept and clear headed.

Research shows that teenagers need about 9.5 hours of sleep each night, but most – about 70 per cent - only average 7 hours. “That means that young people are in 10-15 hours of sleep debt by the end of the 5-day school-week, so it makes sense that many sleep in on weekends or nap to catch up,” Dr Seton says. “Unfortunately though, over-sleeping on weekends actually continues the cycle of poor sleep and ultimately makes things worse.”

This habit develops at the same time many parents hand over sleep responsibility to their youngsters. “Parents often wash their hands of the sleep issue because they worry about arguments and because there’s this feeling that ‘everyone else is doing it’. They may also think their child is old enough now to take responsibility for their own sleep. “Sadly this is not the case. Kids are poor sleep managers. They’re addicted to screens, place no value on sleep, and have serious FOMO that keeps them up on social media late at night. Parents must act as bedroom vigilantes and take action.”

The Woolcock has enacted a 4-step plan to help parents get their kids sleeping well. First up, chat to your teen about the benefits of sleep and broker an agreement on a sensible, regular, weeknight bedtime. “Work out bedtime by counting back from wake up time,” Dr Seton suggests. “If a child needs to be up at 7am then they need to be in bed by 9.15 pm so they’re asleep by 9.30pm in order to get that crucial 9.5 hours sleep.”

Next up, help your child set up a pre-bed routine of relaxing activities, like a hot bath, warm drink or soothing music, to help “tell” the brain sleep is coming. Step 3 is simple: Ensure that bedtime and lights out occur in tandem so the teen’s brain associates the bed with sleep only.

Step 4 requires parents draw up a digital contract with their youngster to restrict screen use at night. Managing screen use requires parents to physically remove phones and laptops from bedrooms at night, ban desktop computers from rooms altogether, or disable all technology through the family modem. “This is not likely to be popular but it needs to happen. Screens are the single biggest sleep disrupter in the modern word. Managing their use is key to solving sleep problems.”

Woolcock Sleep Psychologist Dr Amanda Gamble has a few other important pieces of advice to impart. “Start this conversation early! It’s far easier to talk about the importance of sleep with a 12 year old than it is with a 16 year old. Changing habits early will help set your child up with better habits later.”

Dr Gamble says it’s important that parents lead by example. “Be careful what you’re modelling for your kids. Limit your own use of devices in the hour before bed to show that you take device use seriously and also value sleep.”

Parents should also be aware of the biggest teen sleep myth. “There’s a real misconception out there that teenagers sleep in because they are lazy,” she says. “They’re not lazy at all, just chronically sleep deprived. They sleep in as a means of trying to catch up but this only makes matters worse. That’s why your tired youngster desperately needs you to step in and help them get more sleep every night.”

When teenagers are very resistant to change it’s worth considering that a teenager’s use of devices at night may be a symptom of a much larger problem, like feelings of stress, sadness or frustration.

Parents are invited to attend a Woolcock Sleep Education Seminar that teaches all you need to know about adolescent sleep, as well as showing you how to detect problems and implement practical assistance for your sleepy teenager.


Learn about respiratory and sleep

Do you have insomnia?

The Bellberry Human Research Ethics Committee has reviewed and approved this study (Protocol number 2016-02-104) in accordance with the National Statement on Ethical Conduct in Human Research (2007) incorporating all updates. Australia and New Zealand Clinical Trials Registry number 12614001293651.

The Bellberry Human Research Ethics Committee has reviewed and approved this study (Protocol number 2016-02-104) in accordance with the National Statement on Ethical Conduct in Human Research (2007) incorporating all updates. Australia and New Zealand Clinical Trials Registry number 12614001293651.

Do you want better sleep at night and better concentration during the day?

At the Woolcock we are trialling a combination of a behavioural intervention with a short script of a new medication that we hope will improve sleep and daytime performance.

If you would like to find out more about this study, please follow this link to register your interest. 



Blue Illusion Fashion Parade 2017

Thanks to model / supporter extraordinaire Mrs Lynette De Michiel, who championed the event on behalf of the Woolcock once more on Saturday, 25 February 2017 at Blue Illusion Miranda, we raised over $1100 on the day of the parade! 

Are you looking for ways to support the Woolcock? Ask for donations instead of gifts, hold a musical concert, bake cakes or put on a fashion parade. Talk to us for more information or ideas on 02 9114 0414.

Are you a smoker aged between 25 and 55 years? You may be eligible for our study


Are you a smoker aged between 25 and 55 years?

Would you like to participate in a clinical trial to try and find out if it is possible to reduce the effects of smoking on your lungs?

We are enrolling volunteers now.

If you have been a smoker for 10 years or more, we are keen to study you!

If you are eligible to participate, you will be seen regularly by a study doctor and receive study-related testing and study medication at no cost.

For more information, please contact:

Name: Tanya Badal
Phone number: (02) 9114 0400
E-mail address:

Institutions: Woolcock Institute of Medical Research (Glebe), Royal North Shore Hospital, Concord Hospital & Campbelltown Hospital

This study has been approved by the Northern Sydney Local Health District Human Research Ethics Committee, reference HREC/15/HAWKE/489

Asthmatics Miss Out on Crucial Lung Tests: Report

Most Australians with asthma and other lung conditions are missing out on lung tests needed to properly diagnose their condition, a new report reveals.

Spirometry lung function tests are recommended to ensure the millions of Australians with breathing disorders are correctly diagnosed around the time they start medication. However, a report produced by the Australian Centre for Airways disease Monitoring (ACAM) at the Woolcock Institute of Medical Research shows these tests are rarely performed.

We discovered that 82 per cent of people on medication to treat chronic airways disease, including asthma and chronic obstructive pulmonary disease (COPD), did not have their lung function tested within 12 months before or after their initial prescription,” says Woolcock respiratory physician Professor Helen Reddel. “That is very concerning given research shows these tests are needed to ensure people are correctly diagnosed.

The report is a collaboration of ACAM and the Australian Institute of Health and Welfare supporting the national monitoring of chronic respiratory conditions. It analyses data collected as part of the Sax Institute’s 45 and Up Study of more than 250,000 NSW residents.

The work investigates the use of spirometry, a type of lung function test that assesses how well the lungs are working, which is regarded an essential part of diagnosing and managing chronic airways disease.

As Professor Reddel explains, guidelines for asthma and COPD recommend that spirometry be performed to confirm the diagnosis before treatment is started, or soon after. “Unfortunately, in most cases this is not happening,” she says.

For asthma in particular, once the disease is diagnosed it’s recommended that lung function be measured again periodically, every 1–2 years for most patients. “But we found that lung function testing was performed for only about one-quarter of asthma patients in a three-year period, and 12 per cent had only one lung function test during that time,” the physician says. “There are serious concerns the lack of testing may be contributing to inaccurate diagnosis and inappropriate use of medicines.

Researchers believe the findings may reflect difficulties for the medical community in carrying out spirometry tests in primary care, including insufficient Medicare reimbursements, the need for careful staff training, and on-the-job time constraints.

The results support findings from the recent Medicare Benefits Schedule Review, for which the Thoracic Medicine Clinical Committee noted underuse of lung function testing in primary care and recommended changes in order to increase its use for diagnosis and management of asthma and COPD.

The report, The use of lung function testing for the diagnosis and management of chronic airways disease: Demonstration data linkage project using the 45 and Up Study 2001–2014, can be found by clicking this link: