Related Experiment Video
Updated: Mar 8, 2026
Generation of a Chronic Obstructive Pulmonary Disease Model in Mice by Repeated Ozone Exposure
Published on: August 25, 2017
Childhood Lung Function Predicts Adult Chronic Obstructive Pulmonary Disease and Asthma-Chronic Obstructive Pulmonary
Dinh S Bui1, John A Burgess1, Adrian J Lowe1
11 Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Victoria, Australia.
Insights
Childhood lung function, specifically low FEV1/FVC ratio at age 7, is linked to developing chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome (ACOS) by middle age.
Area of Science:
- Pulmonary Medicine
- Pediatric Respiratory Health
- Epidemiology
Background:
- Chronic obstructive pulmonary disease (COPD) poses a growing global health burden.
- Limited data exist on early-life risk factors contributing to COPD development.
- Understanding childhood predictors is crucial for early intervention strategies.
Purpose of the Study:
- To examine the association between childhood lung function and adult COPD phenotypes.
- To investigate the role of early lung function in the development of asthma-COPD overlap syndrome (ACOS).
Main Methods:
- Longitudinal cohort study of 8,583 Tasmanian children followed from age 7 to 45 years.
- Spirometry used to assess lung function in childhood and adulthood.
- COPD defined by post-bronchodilator FEV1/FVC < lower limit of normal; ACOS defined by coexisting COPD and current asthma.
Main Results:
- Lowest quartile of FEV1 at age 7 was associated with ACOS (OR 2.93).
- Lowest quartile of FEV1/FVC ratio at age 7 was associated with ACOS (OR 16.3) and COPD (OR 5.76).
- Neither FEV1 nor FEV1/FVC in childhood predicted asthma alone.
Conclusions:
- Impaired lung function in childhood is a significant risk factor for developing COPD and ACOS in adulthood.
- School-age lung function screening can identify high-risk individuals for targeted interventions.
- Further research is needed to explore modifiers and develop effective interventions for children with poor lung function.
Rationale:
The burden of chronic obstructive pulmonary disease (COPD) is increasing, yet there are limited data on early life risk factors.
Objectives:
To investigate the role of childhood lung function in adult COPD phenotypes.
Methods:
Prebronchodilator spirometry was performed for a cohort of 7-year-old Tasmanian children (n = 8,583) in 1968 who were resurveyed at 45 years, and a selected subsample (n = 1,389) underwent prebronchodilator and post-bronchodilator spirometry. For this analysis, COPD was spirometrically defined as a post-bronchodilator FEV1/FVC less than the lower limit of normal. Asthma-COPD overlap syndrome (ACOS) was defined as the coexistence of both COPD and current asthma. Associations between childhood lung function and asthma/COPD/ACOS were examined using multinomial regression.
Measurements And Main Results:
At 45 years, 959 participants had neither current asthma nor COPD (unaffected), 269 had current asthma alone, 59 had COPD alone, and 68 had ACOS. The reweighted prevalence of asthma alone was 13.5%, COPD alone 4.1%, and ACOS 2.9%. The lowest quartile of FEV1 at 7 years was associated with ACOS (odds ratio, 2.93; 95% confidence interval, 1.32-6.52), but not COPD or asthma alone. The lowest quartile of FEV1/FVC ratio at 7 years was associated with ACOS (odds ratio, 16.3; 95% confidence interval, 4.7-55.9) and COPD (odds ratio, 5.76; 95% confidence interval, 1.9-17.4), but not asthma alone.
Conclusions:
Being in the lowest quartile for lung function at age 7 may have long-term consequences for the development of COPD and ACOS by middle age. Screening of lung function in school age children may identify a high-risk group that could be targeted for intervention. Further research is needed to understand possible modifiers of these associations and develop interventions for children with impaired lung function.
Related Concept Videos
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
01:24Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
01:20Chronic Obstructive Pulmonary Disease-II: Pathophysiology
Chronic Inflammation
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD: