Medical history of respiratory disease in early life relates to morbidity and mortality in adulthood

Bruna Galobardes ^1*, Peter McCarron ², Mona Jeffreys ³ and George Davey-Smith ⁴

¹ University of Bristol, United Kingdom
² Queen's University Belfast, United Kingdom
³ Massey University, New Zealand
⁴ Unversity of Bristol, United Kingdom

^* To whom correspondence should be addressed. E-mail: bruna.galobardes{at}bristol.ac.uk.

Accepted 19 November 2007

Abstract

Background: Early life exposure to respiratory diseases is associated with lung impairment in adulthood. The objective of this study is to investigate morbidity, and respiratory and other cause-specific mortality among people who reported a medical history of bronchitis, pneumonia and asthma early in life.

Methods: We studied an historical cohort of male students who attended Glasgow University between 1948 and 1968 and for whom long-term follow-up and cause-specific mortality are available (9544 students, 1553 deaths). Medical history of respiratory diseases, including bronchitis, pneumonia and asthma, along with other disease risk factors and socioeconomic conditions, were collected during university health examinations. A subsample responded to a postal follow-up in adulthood (n=4044), which included respiratory and other chronic disease questions.

Results: Medical history of a respiratory disease (bronchitis, pneumonia and asthma) in early life was associated with a 57% higher risk of overall respiratory disease mortality in adulthood and a more than 2-fold increase in chronic obstructive pulmonary disease mortality (fully adjusted hazard ratio (HR): 2.37, 95% CI: 1.16, 4.83). In addition, students reporting a history of bronchitis had a 38% higher risk of cardiovascular disease mortality (95% CI: 1.06, 1.80). Respiratory disease in early life was also associated with a higher risk in adulthood of chronic phlegm, dyspnoea and doctor's diagnosis of asthma, bronchitis and emphysema (adjusted odds ratios ranging from 1.40 to 6.95 for these outcomes).

Conclusion: An early life history of respiratory diseases is associated with higher mortality and morbidity risk in adulthood in men, the associations being seen particularly for respiratory-related and cardiovascular deaths among those with a history of bronchitis. All early life respiratory diseases appeared to be negatively associated with later adult respiratory health.

Keywords: cause-specific mortality, early life, respiratory diseases, respiratory morbidity, respiratory mortality

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