Factors influencing asthma remission: a longitudinal study from childhood to middle age
- John A Burgess1,
- Melanie C Matheson1,
- Lyle C Gurrin1,
- Graham B Byrnes2,
- Kristie S Adams1,
- Cathryn L Wharton3,
- Graham G Giles1,4,
- Mark A Jenkins1,
- John L Hopper1,
- Michael J Abramson5,
- E Haydn Walters6,
- Shyamali C Dharmage1
- 1Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, The University of Melbourne, Carlton, Victoria, Australia
- 2Biostatistics Group, International Agency for Research on Cancer, Lyon, France
- 3Victorian Cervical Cytology Registry, East Melbourne, Victoria, Australia
- 4Cancer Epidemiology Centre, The Cancer Council Victoria, Carlton, Victoria, Australia
- 5Department of Epidemiology and Preventive Medicine, Monash University, The Alfred, Melbourne, Victoria, Australia
- 6Respiratory Research Group, Menzies Research Institute, The University of Tasmania, Hobart, Tasmania, Australia
- Correspondence to John A Burgess, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, The University of Melbourne, Level 2, 723 Swanston Street, Carlton, Victoria 3053, Australia; jburgess{at}unimelb.edu.au
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Contributors The analysis and interpretation of data was led by JAB with support from LCG, GBB and SCD. Initial drafting of the manuscript was performed by JAB with critical revision of the manuscript for important intellectual content by all authors. JAB is the guarantor. JAB, LCG, GBB and SCD had full access to the data (including statistical reports and tables) in the study. JAB takes responsibility for the integrity of the data and the accuracy of the data analysis.
- Received 15 July 2010
- Accepted 24 February 2011
- Published Online First 30 March 2011
Abstract
Objective To examine asthma remission from childhood to middle age.
Methods This was a population-based cohort study. In 1968 the Tasmanian Longitudinal Health Study enrolled 8583 7-year-old Tasmanian schoolchildren who were re-surveyed in 2004. Those reporting ever having asthma when last surveyed completed another questionnaire in 2007 ascertaining age at last asthma attack and asthma medication use. The main outcome measure was asthma remission, defined as no asthma attack for 2 years and no current asthma medication use, or no self-reported asthma in adult life but with parent-reported childhood asthma.
Results Of 5729 respondents to the 2004 survey, 1238 self-reported asthma. A further 573 denied asthma, but had parent-reported childhood asthma, giving a study sample of 1811. Asthma had remitted in 1177 (65.0%) of whom 649 (55.1%) were male. Childhood (OR 0.38, 95% CI 0.25 to 0.58) and later-onset allergic rhinitis (0.42, 0.29 to 0.63), childhood (0.66, 0.47 to 0.94) and later-onset eczema (0.66, 0.47 to 0.92), maternal asthma (0.66, 0.47 to 0.92) and childhood chronic bronchitis (0.56, 0.41 to 0.76) were negatively associated with remission. There was weaker evidence for a negative association between passive smoking (0.75, 0.54 to 1.04) and lower socio-economic status (p-trend 0.09) and remission. Childhood-onset asthma (3.76, 2.58 to 5.49) was more likely to remit than adult-onset asthma. Adult smoking was positively associated with remission in childhood-onset asthma (1.49, 1.06 to 2.09). Sex did not influence remission.
Conclusion While inherited factors cannot be changed, the effect of allergic rhinitis or eczema on asthma remission might be altered by early, aggressive treatment. Every effort should be made to lessen passive exposure to tobacco smoke.
Footnotes
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Funding The Tasmanian Longitudinal Health Study is supported by grants from the National Health and Medical Research Council (NHMRC) of Australia, the Victorian and Tasmanian Asthma Foundations, the Clifford Craig Medical Research Trust and the Royal Hobart Hospital Research Foundation. MCM, JLH, LCG and SCD are supported by the NHMRC.
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Competing interests None.
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Ethics approval This study was conducted with the approval of the Human Research Ethics Committee, The University of Melbourne.
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Provenance and peer review Not commissioned; externally peer reviewed.
