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American Journal of Respiratory and Critical Care Medicine Vol 166. pp. 166-172, (2002)
© 2002 American Thoracic Society

Original Article

Early Life Factors Contribute to the Decrease in Lung Function between Ages 18 and 40

The Coronary Artery Risk Development in Young Adults Study

George G. Apostol, David R. Jacobs, Jr., Albert W. Tsai, Richard S. Crow, O. Dale Williams, Mary C. Townsend and William S. Beckett

Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota; Institute for Nutrition Research, University of Oslo, Oslo, Norway; Ingenix Pharmaceutical Services, Eden Prairie, Minnesota; Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; M.C. Townsend Associates, Pittsburgh, Pennsylvania; and Department of Environmental Medicine/Occupational Medicine Division, University of Rochester School of Medicine, Rochester, New York

Correspondence and requests for reprints should be addressed to David R. Jacobs Jr., Ph.D., Division of Epidemiology, School of Public Health, University of Minnesota, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454. E-mail: jacobs{at}epi.umn.edu

Early life factors may influence pulmonary function. We measured forced expiratory volume in 1 second (FEV1) in 1985–1986 and 2, 5, and 10 years later in approximately 4,000 black and white men and women initially aged 18–30 years. We estimated the age pattern of FEV1 according to family smoking status, early diagnosis of asthma, early smoking initiation, adult asthma, and cigarette smoking. FEV1 followed a quadratic pattern from age of peak through age 40. The pattern varied by race and sex. Early smoking initiation was associated with a faster decrease in FEV1. Smoking by family members was related to early life asthma and may have contributed to faster FEV1 decrease by encouraging behaviors such as heavier smoking or earlier smoking initiation. Prevalence of smoking was 28% when no family member smoked, compared with 59% when four or more members smoked. The FEV1 decline was 8.5% in never-smokers without asthma; 10.1% in nonsmoking individuals diagnosed with asthma; and 11.1% in baseline smokers who smoked 15 or more cigarettes per day. The combination of asthma and heavier smoking was synergistic (17.8% decline). This study delineates an increased rate of decline in those with asthma or in those who smoke cigarettes and implicates early life exposures as contributing to the faster rate of FEV1 decline.

Key Words: lung development • family smoking • smoking • asthma




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