DP Strachan, JM Griffiths, ID Johnston and HR Anderson
Department of Public Health Science, St. George's Hospital Medical School, London, United Kingdom.

The impact of past and current asthma on ventilatory function was assessed among young adults born in Britain March 3-9, 1958 who had been followed from birth to ages 7, 11, 16, 23, and 33 yr. We compared 1,060 subjects with a history of asthma, wheezy bronchitis, or wheezing with 275 control subjects with no history of chest illness. Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were measured at 34-35 yr of age before and 20 min after inhalation of 400 micrograms salbutamol, and adjusted for sex, height, and smoking by multiple regression. Among 551 cases reporting no wheeze in the year before examination, ventilatory function after salbutamol did not differ significantly from the controls, except for FEV1 in 192 subjects with transient wheezing before age 7 (p < 0.05). Among 509 cases reporting wheeze in the past year, FEV1 and FEV1/FVC ratio were reduced to a greater extent in those with an earlier age of onset of wheeze (p < 0.001 for trend in each case). These relative reductions were greater if wheezing had persisted through childhood and adolescence, and were only partially reversed by inhalation of salbutamol. Progressive pulmonary changes related to chronic asthma may be an important mechanism underlying the association between childhood chest illnesses and chronic respiratory disease in adult life.

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