Childhood asthma increases respiratory morbidity, but not all-cause mortality in adulthood: The Busselton Health Study. (September 2020)

• Record Type: Journal Article
• Authors: Ng, Christopher A.C.M.; Knuiman, Matthew W.; Murray, Kevin; Divitini, Mark L.; Musk, Arthur W. (Bill); James, Alan L.
• Is Part Of: Respiratory medicine. Volume 171(2020)
• Publication Date: 2020-09
• Subjects: Childhood -- Asthma -- Respiratory diseases -- Morbidity -- Mortality -- Cohort study; COPD chronic obstructive pulmonary disease -- BHS Busselton Health Study -- WA Western Australia -- FEV1 forced expiratory volume in 1 second -- ICD International Classification of Diseases -- HRs hazard ratios -- CI confidence interval; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2020.106095
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Background: Long-term childhood asthma studies that investigate adult outcomes other than lung function are lacking. This study examines the associations of childhood asthma and the occurrence of respiratory events and all-cause mortality in adulthood. Methods: A cohort of 4430 school children (aged to 17 years) who attended the Busselton Health Study between 1967 and 1983 were analysed. Self-reported history of asthma was determined using questionnaires. Participants were followed until 2014 for respiratory disease-related events (hospital admissions or death) and all-cause mortality using the Western Australia Data Linkage System. Cox regression models were used to investigate the impact of childhood asthma on respiratory events and all-cause mortality in adulthood. A subgroup of 2153 participants who re-attended a survey in young adulthood was also analysed. Results: A total of 462 (10%) of the cohort had childhood asthma. During follow-up 791 participants experienced a respiratory event and 140 participants died. Childhood asthma was associated with an increased risk of respiratory events in adulthood (unadjusted HR 1.84, 95% CI 1.52 to 2.23; P < 0.0001). The result remained significant after adjusting for adult-onset asthma, FEV1, body mass index, smoking, dusty job, hay fever, and respiratory symptoms (adjusted HR 1.68, 95% CI 1.07 to 2.64; P = 0.0247). Childhood asthma was not associated with all-cause mortality in adulthood (unadjusted HR 1.08, 95% CI 0.63 to 1.84; P = 0.7821). Conclusion: Childhood asthma is associated with increased risk of respiratory disease-related hospital admissions and death but not all-cause mortality in adulthood. Highlights: Childhood asthma increases respiratory morbidity in adulthood. There is no impact of childhood asthma on all-cause mortality in adulthood. Long term impact of adequately treated childhood asthma should be investigated.