Am. J. Respir. Crit. Care Med., Volume 156, Number 6, December 1997, 1863-1869

Cold Air Challenge at Age 6 and Subsequent Incidence of Asthma
A Longitudinal Study

ENRICO LOMBARDI, WAYNE J. MORGAN, ANNE L. WRIGHT, RENATO T. STEIN, CATHARINE J. HOLBERG, and FERNANDO D. MARTINEZ

Respiratory Sciences Center, University of Arizona, Tucson, Arizona

The aim of this study was to assess the relation between bronchial hyperresponsiveness to dry, cold air at age 6 and the subsequent incidence of asthma. The cumulative incidence of newly diagnosed asthma between ages 6 and 11 among 360 children included in this study was 12.0%. Survival analysis showed that hyperresponsiveness to cold air at age 6 was associated with an increased risk of developing subsequent asthma (hazard ratio = 2.6, 95% CI = 1.2-5.4; p = 0.01). However, after adjusting for potential confounders, only mild wheezing at age 6 (adjusted hazard ratio = 7.5, 95% CI = 3.6- 15.9; p < 0.001) and skin test reactivity to allergens at age 6 (adjusted hazard ratio = 3.6, 95% CI = 1.5-8.5; p < 0.01), but not hyperresponsiveness to cold air (adjusted hazard ratio = 0.9, 95% CI = 0.4  -2.2; p = 0.8), remained significant predictors of subsequent development of asthma. These findings were substantially confirmed after stratifying for wheezing illnesses before age 3. We conclude that hyperresponsiveness to cold air at age 6 was associated with subsequent development of a diagnosis of asthma but this effect was not independent of atopy and mild wheezing at age 6. 

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