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Effects of childhood and adolescence-adulthood respiratory infections in a general population
P Paoletti1, R Prediletto, L Carrozzi
1CNR Institute of Clinical Physiology, Italy.
Insights
Childhood respiratory infections (CRI) and adolescent-adult infections (ARI) increase respiratory symptoms and lower lung function. Combined CRI and ARI history shows the most severe respiratory issues and poorest lung health, irrespective of smoking.
Area of Science:
- Pulmonology
- Epidemiology
- Public Health
Background:
- Childhood respiratory infections (CRI) are common but their long-term impact on respiratory health, including obstructive airways disease (OAD), is not fully understood.
- Previous studies have focused on specific infections or adult-onset diseases, leaving a gap in understanding the cumulative effect of early-life and later respiratory infections.
Purpose of the Study:
- To investigate the association between childhood respiratory infections (CRI) and adolescent-adult respiratory infections (ARI) with respiratory symptoms, diseases, and lung function in a general population.
- To assess the combined impact of CRI and ARI on respiratory health outcomes, considering smoking as a potential modifying factor.
Main Methods:
- A general population sample (n=3,289) in unpolluted Northern Italy was surveyed using a standardized questionnaire for respiratory symptoms, diseases, and risk factors.
- Lung function was assessed using spirometry (forced vital capacity, expiratory flows) and single-breath diffusing capacity.
- Subjects were categorized based on history of pertussis (PT), other childhood respiratory infections (CRI), or no childhood respiratory infections (NOCRI), and history of adolescent-adult respiratory infections (ARI).
Main Results:
- Prevalence of respiratory symptoms and diseases was higher in subjects with CRI and ARI, particularly those with a history of both.
- Subjects with CRI exhibited significantly lower lung function parameters (forced vital capacity, expiratory flows, diffusing capacity) compared to NOCRI subjects, even after adjusting for age, sex, and smoking.
- A history of ARI was associated with increased respiratory symptoms and diseases in both smokers and non-smokers.
- Subjects with both CRI and ARI had the highest prevalence of respiratory symptoms and diseases and the lowest lung function values, irrespective of smoking status.
Conclusions:
- Childhood respiratory infections (CRI) have a lasting negative impact on respiratory health and lung function into adulthood.
- Adolescent-adult respiratory infections (ARI) further exacerbate respiratory symptoms and diseases.
- The combination of childhood and later respiratory infections poses the greatest risk for severe respiratory morbidity and impaired lung function, highlighting the importance of preventing early-life infections.
Abstract:
The role of childhood respiratory infections before 12 yrs of age (CRI) and during adolescence-adulthood (ARI) was studied in a general population sample (n = 3,289), living in an unpolluted area of Northern Italy. The presence of respiratory symptoms and diseases, as well as risk factors for obstructive airways disease (OAD), was assessed by a standardized questionnaire. Forced vital capacity and derived expiratory flows, and single-breath diffusing capacity were measured using computerized instrumentation. There were 1,185 (36.2%) subjects who reported pertussis (PT), 374 (11.4%) recurrent chest colds, pneumonia and croup, singly or in combination, with or without pertussis (CRI), and 1,718 (52.4%) reported no respiratory infections in childhood (NOCRI). Prevalence rates of respiratory symptoms and diseases were significantly higher in subjects of the CRI group in all ages, and in older smokers. Wheeze and attacks of shortness of breath with wheeze were significantly higher in younger nonsmoking subjects with a history of CRI. Respiratory symptoms and diseases were not more prevalent in subjects of the PT group. Prevalence rates of respiratory symptoms and diseases were significantly higher in subjects with a history of ARI, both in smokers and nonsmokers. Lung function parameters adjusted for sex, age and smoking were significantly lower in CRI subjects; PT subjects showed lower values than NOCRI subjects. A significantly higher prevalence rate of ARI was present in subjects who reported CRI, both in smokers and nonsmokers. Subjects with both CRI and ARI showed the highest prevalence of respiratory symptoms and diseases. In addition, they had the lowest lung function values regardless of smoking habit.