EPIDEMIOLOGY

Physical activity and bronchial hyperresponsiveness: European Community Respiratory Health Survey II

Rafea Shaaban¹, Bénédicte Leynaert¹, David Soussan¹, Josep M Antó², Susan Chinn³, Roberto de Marco⁴, Judith Garcia-Aymerich², Joachim Heinrich⁵, Christer Janson⁶, Deborah Jarvis⁷, Jordi Sunyer², Cecilie Svanes⁸, Matthias Wjst⁶, Peter G Burney⁷, Françoise Neukirch¹, Mahmoud Zureik¹

¹ National Institute of Health and Medical Research (Inserm), Unit 700 Epidemiology, Faculté de Médecine Xavier Bichat, Paris, France
² Institut Municipal d’Investigacio Medica, Universitat Pompeu Fabra, Barcelona, Spain
³ Department of Public Health Sciences, King’s College London, London, UK
⁴ Department of Medicine and Public Health, Division of Epidemiology and Statistics, University of Verona, Verona, Italy
⁵ Institute of Epidemiology, GSF–National Research Center for Environment and Health, Neuherberg, Germany
⁶ Respiratory Medicine and Allergology, University of Uppsala, Uppsala, Sweden
⁷ Respiratory Epidemiology and Public Health Group, National Heart and Lung Institute, London, UK
⁸ Department of Thoracic Medicine, Department of Medicine, Haukeland Hospital, Bergen, Norway

Correspondence to:
Dr Rafea Shaaban
INSERM U700, Epidémiologie des Maladies Respiratoires, Faculté Xavier Bichat, BP 416, 16 rue Henri Huchard, 75018 Paris, France; shaaban{at}bichat.inserm.fr

Background: Identification of the risk factors for bronchial hyperresponsiveness (BHR) would increase the understanding of the causes of asthma. The relationship between physical activity and BHR in men and women aged 28.0–56.5 years randomly selected from 24 centres in 11 countries participating in the European Community Respiratory Health Survey II was investigated.

Methods: 5158 subjects answered questionnaires about physical activity and performed BHR tests. Participants were asked about the frequency and duration of usual weekly exercise resulting in breathlessness or sweating. BHR was defined as a decrease in forced expiratory volume in 1 s of at least 20% of its post-saline value for a maximum methacholine dose of 2 mg.

Results: Both frequency and duration of physical activity were inversely related to BHR. The prevalence of BHR in subjects exercising 1, 2–3 and 4 times a week was 14.5%, 11.6% and 10.9%, respectively (p<0.001). The corresponding odds ratios were 1.00, 0.78 (95% CI 0.62 to 0.99) and 0.69 (95% CI 0.50 to 0.94) after controlling for potential confounding factors. The frequency of BHR in subjects exercising <1 h, 1–3 h and 4 h a week was 15.9%, 10.9% and 10.7%, respectively (p<0.001). The corresponding adjusted odds ratios were 1.00, 0.70 (95% CI 0.57 to 0.87) and 0.67 (95% CI 0.50 to 0.90). Physical activity was associated with BHR in all studied subgroups.

Conclusions: These results suggest that BHR is strongly and independently associated with decreased physical activity. Further studies are needed to determine the mechanisms underlying this association.

Abbreviations: BHR, bronchial hyperresponsiveness; BMI, body mass index; ECRHS II, European Community Respiratory Health Survey II; FEV₁, forced expiratory volume in 1 s; FVC, forced vital capacity

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