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Current asthma contributes as much as smoking to chronic bronchitis in middle age: A prospective population-based study


Dharmage, SC and Perret, JL and Burgess, JA and Lodge, CJ and Johns, DP and Thomas, PS and Giles, GG and Hopper, JL and Abramson, MJ and Walters, EH and Matheson, MC, Current asthma contributes as much as smoking to chronic bronchitis in middle age: A prospective population-based study, International Journal of COPD, 11, (1) pp. 1911-1920. ISSN 1178-2005 (2016) [Refereed Article]


Copyright Statement

Copyright 2016 Dharmage et al. Licensed under Creative Commons Attribution-NonCommercial 3.0 Unported (CC BY-NC 3.0)

DOI: doi:10.2147/COPD.S103908


Background and objective: 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.

Methods: 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.

Results: 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]).

Conclusion: 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.

Item Details

Item Type:Refereed Article
Keywords:nonobstructive chronic bronchitis, obstructive chronic bronchitis, current asthma, personal smoking, allergy history
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Respiratory diseases
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Johns, DP (Associate Professor David Johns)
UTAS Author:Walters, EH (Professor Haydn Walters)
ID Code:117084
Year Published:2016
Web of Science® Times Cited:10
Deposited By:Medicine
Deposited On:2017-05-30
Last Modified:2022-08-25
Downloads:136 View Download Statistics

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