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Title: Current asthma contributes as much as smoking to chronic bronchitis in middle age: a prospective population-based study.
Austin Authors: Dharmage, Shyamali C;Perret, Jennifer L ;Burgess, John A;Lodge, Caroline J;Johns, David P;Thomas, Paul S;Giles, Graham G;Hopper, John L;Abramson, Michael J;Walters, E Haydn;Matheson, Melanie C
Affiliation: Institute for Breathing and Sleep
Cancer Epidemiology Center, Cancer Council Victoria, Melbourne, VIC, Australia
"Breathe Well" Center of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, University of Tasmania, Hobart, TAS
Inflammation and Infection Research, Faculty of Medicine, University of New South Wales, Sydney, NSW..
Department of Public Health, Seoul National University, Seoul, South Korea
Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne
Allergy and Lung Health Unit, Center for Epidemiology and Biostatistics, The University of Melbourne
School of Medicine, University of Tasmania, Hobart, TAS, Australia
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC
Issue Date: 16-Aug-2016
Date: 2016
Publication information: International journal of chronic obstructive pulmonary disease 2016; 11: 1911-1920.
Abstract: Personal smoking is widely regarded to be the primary cause of chronic bronchitis (CB) in adults, but with limited knowledge of contributions by other factors, including current asthma. We aimed to estimate the independent and relative contributions to adult CB from other potential influences spanning childhood to middle age. The population-based Tasmanian Longitudinal Health Study cohort, people born in 1961, completed respiratory questionnaires and spirometry in 1968 (n=8,583). Thirty-seven years later, in 2004, two-thirds responded to a detailed postal survey (n=5,729), from which the presence of CB was established in middle age. A subsample (n=1,389) underwent postbronchodilator spirometry between 2006 and 2008 for the assessment of chronic airflow limitation, from which nonobstructive and obstructive CB were defined. Multivariable and multinomial logistic regression models were used to estimate relevant associations. The prevalence of CB in middle age was 6.1% (95% confidence interval [CI]: 5.5, 6.8). Current asthma and/or wheezy breathing in middle age was independently associated with adult CB (odds ratio [OR]: 6.2 [95% CI: 4.6, 8.4]), and this estimate was significantly higher than for current smokers of at least 20 pack-years (OR: 3.0 [95% CI: 2.1, 4.3]). Current asthma and smoking in middle age were similarly associated with obstructive CB, in contrast to the association between allergy and nonobstructive CB. Childhood predictors included allergic history (OR: 1.3 [95% CI: 1.1, 1.7]), current asthma (OR: 1.8 [95% CI: 1.3, 2.7]), "episodic" childhood asthma (OR: 2.3 [95% CI: 1.4, 3.9]), and parental bronchitis symptoms (OR: 2.5 [95% CI: 1.6, 4.1]). The strong independent association between current asthma and CB in middle age suggests that this condition may be even more influential than personal smoking in a general population. The independent associations of childhood allergy and asthma, though not childhood bronchitis, as clinical predictors of adult CB raise the possibility of some of this burden having originated in childhood.
DOI: 10.2147/COPD.S103908
ORCID: 0000-0001-7034-0615
Journal: International journal of chronic obstructive pulmonary disease
PubMed URL: 27574415
PubMed URL:
Type: Journal Article
Subjects: allergy history
current asthma
nonobstructive chronic bronchitis
obstructive chronic bronchitis
personal smoking
Appears in Collections:Journal articles

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