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Childhood asthma increases respiratory morbidity, but not all-cause mortality in adulthood: The Busselton Health
Christopher A C M Ng1, Matthew W Knuiman2, Kevin Murray2
1Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia.
Insights
Childhood asthma increases the risk of adult respiratory events, including hospitalizations and death. However, this study found no link between childhood asthma and overall mortality in adulthood.
Area of Science:
- Epidemiology
- Respiratory Medicine
- Public Health
Background:
- Longitudinal studies on childhood asthma's long-term adult outcomes beyond lung function are scarce.
- This research addresses the gap by examining adult respiratory events and mortality following childhood asthma.
Purpose of the Study:
- To investigate the association between childhood asthma and the incidence of respiratory disease-related events in adulthood.
- To determine if childhood asthma impacts all-cause mortality in later life.
Main Methods:
- Analysis of a cohort of 4430 individuals from the Busselton Health Study (1967-1983).
- Self-reported childhood asthma data collected via questionnaires.
- Long-term follow-up until 2014 for respiratory events and mortality using the Western Australia Data Linkage System.
- Cox regression models employed to assess the impact of childhood asthma.
Main Results:
- Childhood asthma (10% of cohort) was linked to a significantly increased risk of adult respiratory events (adjusted HR 1.68, P=0.0247).
- This association persisted after adjusting for factors like adult asthma, lung function, BMI, smoking, and allergies.
- No significant association was found between childhood asthma and all-cause mortality in adulthood (unadjusted HR 1.08, P=0.7821).
Conclusions:
- Childhood asthma is a significant risk factor for adult respiratory disease-related hospital admissions and mortality.
- The findings highlight the importance of long-term respiratory health monitoring for individuals with a history of childhood asthma.
- Childhood asthma does not appear to influence overall adult mortality.
Background:
Long-term childhood asthma studies that investigate adult outcomes other than lung function are lacking. This study examines the associations of childhood asthma and the occurrence of respiratory events and all-cause mortality in adulthood.
Methods:
A cohort of 4430 school children (aged to 17 years) who attended the Busselton Health Study between 1967 and 1983 were analysed. Self-reported history of asthma was determined using questionnaires. Participants were followed until 2014 for respiratory disease-related events (hospital admissions or death) and all-cause mortality using the Western Australia Data Linkage System. Cox regression models were used to investigate the impact of childhood asthma on respiratory events and all-cause mortality in adulthood. A subgroup of 2153 participants who re-attended a survey in young adulthood was also analysed.
Results:
A total of 462 (10%) of the cohort had childhood asthma. During follow-up 791 participants experienced a respiratory event and 140 participants died. Childhood asthma was associated with an increased risk of respiratory events in adulthood (unadjusted HR 1.84, 95% CI 1.52 to 2.23; P < 0.0001). The result remained significant after adjusting for adult-onset asthma, FEV1, body mass index, smoking, dusty job, hay fever, and respiratory symptoms (adjusted HR 1.68, 95% CI 1.07 to 2.64; P = 0.0247). Childhood asthma was not associated with all-cause mortality in adulthood (unadjusted HR 1.08, 95% CI 0.63 to 1.84; P = 0.7821).
Conclusion:
Childhood asthma is associated with increased risk of respiratory disease-related hospital admissions and death but not all-cause mortality in adulthood.
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