Childhood asthma increases respiratory morbidity, but not all-cause mortality in adulthood: The Busselton Health Study

• Published in: Respiratory medicine Vol. 171; p. 106095
• Main Authors: Ng, Christopher A.C.M., Knuiman, Matthew W., Murray, Kevin, Divitini, Mark L., Musk, Arthur W. (Bill), James, Alan L.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2020; Elsevier Limited
• Subjects: Adolescent; Adult; Adults; Age; Age Factors; Age of Onset; Asthma; Asthma - complications; Asthma - epidemiology; Body mass; Body mass index; Body size; Bronchitis; Cause of Death; Child; Child mortality; Childhood; Children; Children & youth; Chronic illnesses; Chronic obstructive pulmonary disease; Cohort analysis; Cohort Studies; Cohort study; Disease; Female; Hay fever; Health risks; Hospitalization - statistics & numerical data; Hospitals; Humans; Male; Morbidity; Mortality; Patient admissions; Regression analysis; Respiratory diseases; Respiratory function; Respiratory Tract Diseases - epidemiology; Respiratory Tract Diseases - etiology; Respiratory Tract Diseases - mortality; Risk; Signs and symptoms; Spirometry; Subgroups; Young Adult; Australia; United States > US; Western Australia Australia; Mortality; CI; HRs; WA; ICD; BHS; Morbidity; Asthma; Respiratory diseases; Cohort study; Childhood; FEV1; COPD
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2020.106095

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. 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. 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). Childhood asthma is associated with increased risk of respiratory disease-related hospital admissions and death but not all-cause mortality in adulthood. •Childhood asthma increases respiratory morbidity in adulthood.•There is no impact of childhood asthma on all-cause mortality in adulthood.•Long term impact of adequately treated childhood asthma should be investigated.