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Current asthma contributes as much as smoking to chronic bronchitis in middle age: a prospective population-based study.
- Source :
-
International journal of chronic obstructive pulmonary disease [Int J Chron Obstruct Pulmon Dis] 2016 Aug 16; Vol. 11, pp. 1911-20. Date of Electronic Publication: 2016 Aug 16 (Print Publication: 2016). - Publication Year :
- 2016
-
Abstract
- Background and Objective: Personal smoking is widely regarded to be the primary cause of chronic bronchitis (CB) in adults, but with limited knowledge of contributions by other factors, including current asthma. We aimed to estimate the independent and relative contributions to adult CB from other potential influences spanning childhood to middle age.<br />Methods: The population-based Tasmanian Longitudinal Health Study cohort, people born in 1961, completed respiratory questionnaires and spirometry in 1968 (n=8,583). Thirty-seven years later, in 2004, two-thirds responded to a detailed postal survey (n=5,729), from which the presence of CB was established in middle age. A subsample (n=1,389) underwent postbronchodilator spirometry between 2006 and 2008 for the assessment of chronic airflow limitation, from which nonobstructive and obstructive CB were defined. Multivariable and multinomial logistic regression models were used to estimate relevant associations.<br />Results: The prevalence of CB in middle age was 6.1% (95% confidence interval [CI]: 5.5, 6.8). Current asthma and/or wheezy breathing in middle age was independently associated with adult CB (odds ratio [OR]: 6.2 [95% CI: 4.6, 8.4]), and this estimate was significantly higher than for current smokers of at least 20 pack-years (OR: 3.0 [95% CI: 2.1, 4.3]). Current asthma and smoking in middle age were similarly associated with obstructive CB, in contrast to the association between allergy and nonobstructive CB. Childhood predictors included allergic history (OR: 1.3 [95% CI: 1.1, 1.7]), current asthma (OR: 1.8 [95% CI: 1.3, 2.7]), "episodic" childhood asthma (OR: 2.3 [95% CI: 1.4, 3.9]), and parental bronchitis symptoms (OR: 2.5 [95% CI: 1.6, 4.1]).<br />Conclusion: The strong independent association between current asthma and CB in middle age suggests that this condition may be even more influential than personal smoking in a general population. The independent associations of childhood allergy and asthma, though not childhood bronchitis, as clinical predictors of adult CB raise the possibility of some of this burden having originated in childhood.
- Subjects :
- Adult
Age Factors
Age of Onset
Asthma diagnosis
Asthma physiopathology
Bronchitis, Chronic diagnosis
Bronchitis, Chronic physiopathology
Child
Female
Follow-Up Studies
Humans
Logistic Models
Longitudinal Studies
Male
Multivariate Analysis
Odds Ratio
Prevalence
Prognosis
Prospective Studies
Respiratory Sounds
Risk Factors
Smoking epidemiology
Smoking physiopathology
Spirometry
Surveys and Questionnaires
Tasmania epidemiology
Time Factors
Asthma epidemiology
Bronchitis, Chronic epidemiology
Lung physiopathology
Smoking adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1178-2005
- Volume :
- 11
- Database :
- MEDLINE
- Journal :
- International journal of chronic obstructive pulmonary disease
- Publication Type :
- Academic Journal
- Accession number :
- 27574415
- Full Text :
- https://doi.org/10.2147/COPD.S103908