The relation of adult bronchial responsiveness to serious childhood respiratory illness in the ECRHS

Chinn, Susan; Janson, Christer; Svanes, Cecilie; Dharmage, Shyamali; Jarvis, Deborah

doi:10.1016/j.rmed.2006.09.004

« Previous Next »Respiratory Medicine
Volume 101, Issue 5 , Pages 983-988, May 2007

The relation of adult bronchial responsiveness to serious childhood respiratory illness in the ECRHS

Susan Chinn
- Department Public Health Sciences, King's College London, 5th floor Capital House, 42 Weston Street, London SE1 3QD, UK
- Corresponding author. Tel.: +442073528121x3522; fax: +442073518322.
Christer Janson
- Respiratory Medicine and Allergology, University of Uppsala, 751 85 Uppsala, Sweden
Cecilie Svanes
- Department Thoracic Medicine, 5021 Haukeland Hospital, Bergen, Norway
Shyamali Dharmage
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Level 2, 723 Swanston Street, Carlton, Vic 3053, Australia
Deborah Jarvis
- Respiratory Epidemiology and Public Health Group, NHLI at Imperial College London, Emmanuel Kaye Building, London SW3 6LR, UK

Received 22 May 2006; accepted 5 September 2006. published online 17 October 2006.

Summary

Background

Respiratory symptoms in adulthood have been found to be associated with childhood respiratory infection, but few studies have analyzed adult bronchial responsiveness (BHR) with adequate adjustment for known risk factors.

Objective

To estimate the relation of BHR with serious childhood respiratory infections in a large population study.

Methods

The European Community Respiratory Health Survey (ECRHS) was a cross-sectional population-based survey in 34 centers. Data on serious respiratory infections before the age of 5 years and possible confounders were obtained from a questionnaire administered in the clinic. Blood samples were taken for measurement of total immunoglobulin E (IgE) and specific IgE to four common allergens, and spirometry and bronchial challenge with methacholine were performed. A continuous measure of BHR was analyzed by multiple regression, in 11,282 participants, in relation to serious respiratory infection and other potential risk factors, adjusted for center and major determinants of adult BHR.

Results

Those reporting a serious childhood respiratory infection had greater BHR, by an amount corresponding to approximately 0.23 doubling doses (95% confidence interval 0.02–0.44) of the amount of methacholine causing a 20% fall (PD₂₀) in forced expiratory volume in 1s (FEV₁). All childhood factors explained less than 0.3% of variation in BHR in addition to over 20% by factors measured in adulthood. The relation of BHR to BMI was confined to smokers.

Conclusions

We found an effect of serious childhood respiratory infection on adult BHR, but this was small in comparison to relations of BHR to IgE-sensitization and airway caliber.

Keywords: Bronchial responsiveness, Respiratory infection, Atopy, Spirometry, Smoking, Body mass index