Association between early life history of respiratory disease and morbidity and mortality in adulthood
- 1Department of Social Medicine, University of Bristol, Bristol, UK
- 2Department of Epidemiology and Public Health, The Queen’s University of Belfast, Belfast, UK
- 3Centre for Public Health Research, Massey University, Wellington, New Zealand
- Dr B Galobardes, Department of Social Medicine, University of Bristol, Whiteladies Road, Canynge Hall, Bristol BS8 2PR, UK; bruna.galobardes{at}bristol.ac.uk
- Received 4 July 2007
- Accepted 19 November 2007
- Published Online First 14 February 2008
Abstract
Background: Early life exposure to respiratory diseases is associated with lung impairment in adulthood. The objective of this study was 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 were available (9544 students, 1553 deaths). A 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: A medical history of a respiratory disease (bronchitis, pneumonia and asthma) in early life was associated with a 57% greater risk of overall respiratory disease mortality in adulthood and a more than twofold 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.
Footnotes
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Funding: The authors acknowledge the financial support of the Stroke Association; Chest, Heart and Stroke Scotland; the National Health Service Research and Development Cardiovascular Disease Programme; and the World Cancer Research Fund to carry out the Glasgow University Alumni cohort study. BG is funded by a UK Medical Research Council Fellowship in Health of the Public. PMcC is funded by a career scientist award from the Research and Development Office for Health and Personal Social Services in Northern Ireland. MJ from The Centre for Public Health Research (Massey University, Wellington, New Zealand) is supported by a Programme Grant from the Health Research Council of New Zealand. GDS holds a Robert Wood Johnson Foundation Investigators Award in Health Policy Research. The authors’ work was independent of the funding sources.
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Competing interests: None.
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Ethical approval: yes.
