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Childhood eczema and rhinitis predict atopic but not nonatopic adult asthma: A prospective cohort study over 4 decades


Martin, PE and Matheson, MC and Gurrin, L and Burgess, JA and Osborne, N and Lowe, AJ and Morrison, S and Meszaros, D and Giles, GG and Abramson, MJ and Walters, EH and Allen, KJ and Dharmage, SC, Childhood eczema and rhinitis predict atopic but not nonatopic adult asthma: A prospective cohort study over 4 decades, Journal of Allergy and Clinical Immunology, 127, (6) pp. 1473-1479. ISSN 0091-6749 (2011) [Refereed Article]

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Copyright © 2011 American Academy of Allergy, Asthma & Immunology The definitive version is available at

DOI: doi:10.1016/j.jaci.2011.02.041


Background: The evidence on whether the atopic march observed in childhood (ie, the progression from eczema to allergic rhinitis and asthma) extends to adulthood is sparse, and there is no evidence on whether the progression leads to a specific phenotype of asthma. Objective: We sought to assess whether childhood eczema and rhinitis are risk factors for specific phenotypes of adult asthma. Methods: Participants of the Tasmanian Longitudinal Health Study recruited in 1968 (age range, 6.0-7.0 years) were followed up at age 44 years. The risk of current atopic or nonatopic asthma in middle age characterized by sensitization to aeroallergens given childhood eczema, rhinitis, or both was calculated by using multinomial logistic regression. Results: No association was found between childhood eczema or rhinitis and nonatopic adult asthma. In contrast, childhood eczema and rhinitis in combination predicted both new-onset atopic asthma by middle age (adjusted multinomial odds ratio [aMOR], 6.3; 95% CI, 1.7-23.2) and the persistence of childhood asthma to adult atopic asthma (aMOR, 11.7; 95% CI, 3.6-37.9). Participants with childhood eczema alone were at increased risk of new-onset atopic asthma (aMOR, 4.1; 95% CI, 1.9-8.8), whereas rhinitis alone predicted the persistence of childhood asthma to atopic asthma (aMOR, 2.7; 95% CI, 1.3-5.6). Of all asthma, 29.7% of persistent atopic asthma and 18.1% of newonset atopic asthma could be attributed to having childhood eczema and rhinitis. Conclusion: Childhood eczema and rhinitis are strongly associated with the incidence and persistence of adult atopic asthma.

Item Details

Item Type:Refereed Article
Keywords:Eczema, asthma, rhinitis, population, childhood, adulthood, epidemiology, atopy, atopic march
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:Meszaros, D (Dr Desiree Meszaros)
UTAS Author:Walters, EH (Professor Haydn Walters)
ID Code:72587
Year Published:2011
Web of Science® Times Cited:68
Deposited By:Menzies Institute for Medical Research
Deposited On:2011-08-29
Last Modified:2017-11-06

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