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A longitudinal study of risk factors in asthma and chronic bronchitis in childhood
M D Lebowitz1, C J Holberg, F D Martinez
1University of Arizona, College of Medicine, Division of Respiratory Sciences, Tucson 85724.
Insights
Asthma and chronic bronchitis in children and adolescents show high comorbidity. Family history and social factors significantly impact disease course and lung function, influencing future respiratory health.
Area of Science:
- Pediatric Respiratory Medicine
- Epidemiology
- Public Health
Background:
- Asthma and chronic bronchitis are common respiratory conditions in children and adolescents.
- Understanding their longitudinal course, including incidence, persistence, and remission, is crucial for effective management.
- The interplay between these conditions and associated risk factors requires further investigation.
Purpose of the Study:
- To longitudinally assess the prevalence, incidence, persistence, and remission rates of diagnosed asthma and chronic bronchitis in a community sample of children and adolescents over ten years.
- To evaluate the influence of family history of disease and social risk factors on the longitudinal course of these respiratory conditions.
- To examine the relationship between asthma and chronic bronchitis and identify specific associated symptoms.
Main Methods:
- Longitudinal study over ten years in a representative community sample.
- Data collection on diagnosed asthma and chronic bronchitis, including prevalence, incidence, persistence, and remission rates.
- Analysis of the role of family history of lung disease and family social characteristics as risk factors.
- Assessment of symptom associations and remission with continuing symptoms.
Main Results:
- High comorbidity observed between asthma and chronic bronchitis, with approximately half of individuals in each group having the other diagnosis.
- Specific symptoms were associated with each diagnosis.
- Remission of clinical disease did not always equate to symptom resolution, with about half of remitted cases experiencing ongoing symptoms.
- Incidence and remission rates varied over time and were linked to different symptoms and risk factors.
- Family history of lung disease and family social characteristics were significant risk factors influencing disease presence and changes.
- Interactions of risk factors appeared to significantly impact lung function at the start of adult life and potential subsequent disease.
Conclusions:
- Asthma and chronic bronchitis exhibit significant overlap and are influenced by genetic and social factors.
- Family history and social environment play a critical role in the development and progression of these childhood respiratory diseases.
- These factors may mediate the impact of precursors like lower respiratory tract infections and personal habits (e.g., smoking), affecting long-term lung health and adult-onset disease risk.
Abstract:
The prevalence, persistence, incidence and remission rates of reported diagnosed asthma and chronic bronchitis has been studied longitudinally over ten years in a representative community sample of children and adolescents. The objectives are to evaluate the rates of change over time, the role of family history of disease, and the social risk factors in the longitudinal course of disease. The relationship between the two reported diagnoses is very high, about half of each group having the other diagnosis. Each diagnosis has specific symptoms with which it is associated. Remission of clinical disease is associated with continuing symptoms in about half of such cases. The incidence rates and remissions of cases as they have occurred over time were associated with different symptoms and risk factors. A family history of lung disease and family social characteristics are significant risk factors affecting the presence of these diseases, and how they change. Discussion suggests these factors may affect possible precursors, such as lower respiratory tract illnesses, as well as personal habits (such as smoking), which are related to both diagnoses. Further, the interactions of these risk factors appear to significantly influence impairments of lung function at the beginning of adult life, and potential subsequent disease.