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Childhood Chest Illness and the Rate of Decline of Adult Lung Function between Ages 35 and 45 Years

¹ Division of Community Health Sciences, St. George's, University of London, London, United Kingdom

Correspondence and requests for reprints should be addressed to David P. Strachan, M.D., Professor of Epidemiology, Division of Community Health Sciences, St. George's, University of London, Cranmer Terrace, London SW17 0RE, UK. E-mail: d.strachan{at}sgul.ac.uk

Rationale: There is an association between childhood chest illness and impairment of adult ventilatory function. It has not yet been established whether respiratory illness in childhood predisposes to chronic obstructive pulmonary disease by accelerating the decline in adult lung function.

Objectives: To determine the effects of childhood chest illness and smoking on the rate of decline of adult ventilatory function from the age of 35 to 45 yr in a large, nationally representative sample of British adults.

Methods: Spirometry measurements were compared at 35 and 45 yr of age in 1,158 adults participating in the British 1958 Birth Cohort. Multiple regression analysis was used to measure the association between childhood chest illness and within-person change in spirometric volumes between age 35 and 45 yr, adjusting for potential confounding factors.

Measurements and Main Results: The mean reduction in FEV₁ between ages 35 and 45 yr was 35 ml/yr. Compared with subjects without the relevant respiratory history, the rate of decline was not significantly associated with pneumonia (mean difference, –0.2; 95% confidence interval, –6.1 to +5.8 ml/yr), whooping cough (0.7, –5.1 to +6.5 ml/yr), wheeze by age 7 yr (0.4, –5 to +5.9 ml/yr), or wheeze onset by age 8 to 16 yr (–3.4, –10.5 to +3.6 ml/yr). A similar pattern emerged for forced vital capacity.

Conclusions: Childhood chest illness does not adversely affect the rate of decline of lung function in mid-adult life.

Key Words: asthma • chronic obstructive pulmonary disease • pneumonia • ventilatory function • whooping cough

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject There is an association between childhood chest illness and impairment of adult ventilatory function. It has not been established whether such illness predisposes to chronic obstructive pulmonary disease by accelerating the decline in adult lung function. What This Study Adds to the Field Childhood chest illness does not adversely affect the rate of decline of lung function in mid-adult life.

 

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