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Early-life risk factors for reversible and irreversible airflow limitation in young adults: findings from the BAMSE birth cohort
  1. Gang Wang1,2,3,
  2. Inger Kull2,3,4,
  3. Anna Bergström2,5,
  4. Jenny Hallberg3,4,
  5. Petra Um Bergström3,4,
  6. Stefano Guerra6,7,
  7. Goran Pershagen2,5,
  8. Olena Gruzieva2,5,
  9. Marianne van Hage8,
  10. Antonios Georgelis2,5,
  11. Christer Janson9,
  12. Anders Lindén2,10,
  13. Erik Melén2,3,4
  1. 1Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
  2. 2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  3. 3Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
  4. 4Sachs' Children's Hospital, Stockholm, Sweden
  5. 5Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
  6. 6Asthma and Airway Disease Research Center, The University of Arizona, Tucson, Arizona, USA
  7. 7ISGLOBAL, Barcelona, Spain
  8. 8Medicine Solna, Division of Immunology and Allergy, Karolinska Institutet, Stockholm, Sweden
  9. 9Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
  10. 10Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
  1. Correspondence to Dr Erik Melén, Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm 118 83, Sweden; erik.melen{at}


We aimed to determine prevalence and early-life risk factors for reversible and irreversible airflow limitation in young adults from the general population. Among young adults in their 20s, the prevalence was 5.3% for reversible airflow limitation and 2.0% for irreversible airflow limitation. While parental asthma was the only risk factor for development of reversible airflow limitation, the risk factors for development of irreversible airflow limitation were current asthma, childhood respiratory tract infections and asthma, and exposure to air pollution.

  • COPD epidemiology

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  • Contributors JH, AL and EM designed the study and outlined the contents of the manuscript. GW was responsible for the practical conduct of the study, including the planning, coordination and analyzes of the data, and the writing the manuscript under the supervision by EM. JH had overall responsibility for the lung function measurements at 24 years of age. GP and OG had overall responsibility for the air pollution data. PUB, CJ, MvH, AG, AB, SG and IK revised the work critically for the content. All authors contributed to the interpretation of the data and approved the final manuscript prior to its submission.

  • Funding This study was supported by grants from the Swedish Research Council, the Swedish Research Council for Health, Working Life and Welfare, Formas, the Swedish Heart-Lung Foundation, the European Research Council (TRIBAL, grant agreement 757919), Strategic Research Area (SFO) Epidemiology, Karolinska Institutet and Region Stockholm (ALF project, and for cohort and database maintenance), Swedish Asthma and Allergy Association’s Research Foundation. The Cancer and Allergy Foundation and the Swedish Association for Allergology (through the Major research grant sponsored by Novartis, Sanofi, Mylan, GSK, Astra Zeneca). The King Gustaf V 80th Birthday Foundation. The Hesselman Foundation. Thermo Fisher Scientific (Uppsala, Sweden) provided reagents for IgE analyses. GW is sponsored by the China Scholarship Council (CSC, File No. 201906240227).

  • Disclaimer The funders had no role in designing the project or interpretation of data.

  • Competing interests EM reports personal fees from Sanofi, Chiesi and AstraZeneca, outside the submitted work.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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