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Published ahead of print on October 14, 2004, doi:10.1164/rccm.200402-230OC

Am. J. Respir. Crit. Care Med., Volume 171, Number 2, January 2005, 109-114

A more recent version of this article appeared on January 15, 2005
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Submitted on February 23, 2004
Accepted on October 14, 2004

Decline in Lung Function in the Busselton Health Study: the Effects of Asthma and Cigarette Smoking

Alan L James1*, Lyle J Palmer2, Elizabeth Kicic3, Peta S Maxwell3, Sharon E Lagan3, Gerard F Ryan4, and A. William Musk4

1 West Australia Sleep Disorders Research Institute, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia; School of Medicine and Pharmacology, University of Western Australia, Nedlands, Western Australia, Australia, 2 Western Australian Institute for Medical Research, UWA Centre for Medical Research, University of Western Australia and Laboratory for Genetic Epidemiology, Nedlands, Western Australia, Australia, 3 West Australia Sleep Disorders Research Institute, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia, 4 Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia

* To whom correspondence should be addressed. E-mail: ajames{at}it.net.au.

Asthma in adults may be associated with chronic airflow obstruction, possibly resulting from airway disease in early life and/or a greater rate of decline in lung function in adult life, compared with non-asthmatics. Treatment and cigarette smoking may also influence the rate of decline of lung function. The aim of the present analysis was to examine the level and rate of decline in lung function in relation to asthma and cigarette smoking in adults. Subjects (n=9,317) had participated as adults (>18 years) in one or more of the cross-sectional Busselton Health Surveys between 1966 and 1981 or in the follow-up study of 1994/5. The effects of sex, doctor-diagnosed asthma, smoking status and anthropometric data on the level and rate of decline in FEV1 were examined in a linear mixed effects model. At age 19, FEV1 was reduced in subjects with asthma but was similar in smokers and nonsmokers. Males, taller subjects, smokers and subjects with asthma had greater declines in FEV1 with age. Smoking and asthma had additive but not multiplicative effects on decline. Thus asthma is associated with reduced lung function at the beginning of adult life as well as an increased rate of decline during adult life.
Key words: epidemiology, asthma, smoking, lung function tests.




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