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Cited by 128Asthma and respiratory diseasesChronic Obstructive Pulmonary Disease (COPD) ResearchSmoking Behavior and Cessation

The interplay between the effects of lifetime asthma, smoking, and atopy on fixed airflow obstruction in middle age

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Perret, Jennifer L., Dharmage, Shyamali C., Matheson, Melanie C., Johns, David P., Gurrin, Lyle C., Burgess, John A., Marrone, John, Markos, James +9 more·2013·American Journal of Respiratory and Critical Care Medicine
DOI 10.1164/rccm.201205-0788oc
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Abstract

RATIONALE: The contribution by asthma to the development of fixed airflow obstruction (AO) and the nature of its effect combined with active smoking and atopy remain unclear. OBJECTIVES: To investigate the prevalence and relative influence of lifetime asthma, active smoking, and atopy on fixed AO in middle age. METHODS: The population-based Tasmanian Longitudinal Health Study cohort born in 1961 (n = 8,583) and studied with prebronchodilator spirometry in 1968 was retraced (n = 7,312) and resurveyed (n = 5,729 responses) from 2002 to 2005. A sample enriched for asthma and chronic bronchitis underwent a further questionnaire, pre- and post-bronchodilator spirometry (n = 1,389), skin prick testing, lung volumes, and diffusing capacity measurements. Prevalence estimates were reweighted for sampling fractions. Multiple linear and logistic regression were used to assess the relevant associations. MEASUREMENTS AND MAIN RESULTS: Main effects and interactions between lifetime asthma, active smoking, and atopy as they relate to fixed AO were measured. The prevalence of fixed AO was 6.0% (95% confidence interval [CI], 4.5-7.5%). Its association with early-onset current clinical asthma was equivalent to a 33 pack-year history of smoking (odds ratio, 3.7; 95% CI, 1.5-9.3; P = 0.005), compared with a 24 pack-year history for late-onset current clinical asthma (odds ratio, 2.6; 95% CI, 1.03-6.5; P = 0.042). An interaction (multiplicative effect) was present between asthma and active smoking as it relates to the ratio of post-bronchodilator FEV(1)/FVC, but only among those with atopic sensitization. CONCLUSIONS: Active smoking and current clinical asthma both contribute substantially to fixed AO in middle age, especially among those with atopy. The interaction between these factors provides another compelling reason for atopic individuals with current asthma who smoke to quit.

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  • Both early and late onset adult current asthma were associated with a reduction in lung function and an increased risk of fixed airflow obstruction at 45 years.

    “It has been shown that both early and late onset adult current asthma were associated with a reduction in lung function and an increased risk of fixed airflow obstruction at 45 years, with the effect of early onset asthma being greater than late onset asthma (165–167).”

    From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [165]

  • The effect of early onset asthma on reduction in lung function and fixed airflow obstruction at 45 years was greater than late onset asthma.

    “It has been shown that both early and late onset adult current asthma were associated with a reduction in lung function and an increased risk of fixed airflow obstruction at 45 years, with the effect of early onset asthma being greater than late onset asthma (165–167).”

    From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [165]

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Research works printed but not linked: 3

  1. Australian Institute of Health and Welfare 2010: Asthma, chronic obstructive pulmonary disease and other respiratory diseases in Australia. Cat. no. ACM 20. Canberra: AIHW.
  2. Chu EK, Drazen JM. Asthma: One hundred years of treatment and onward. Am J Respir Crit Care Med 2005;171:1202-1208.
  3. Australian Centre for Asthma Monitoring 2008. Asthma in Australia 2008. AIHW Asthma series no. 3. Cat. no. ACM 14. Canberra: AIHW.

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Authors
Perret, J. L., Dharmage, S. C., Matheson, M. C., Johns, D. P., Gurrin, L. C., Burgess, J. A., Marrone, J., Markos, J., Morrison, S., Feather, I., Thomas, P. S., McDonald, C. F., Giles, G. G., Hopper, J. L., Wood-Baker, R., Abramson, M. J., & Walters, E. H.
Affiliations
  • The University of Melbourne (AU)
  • Menzies Institute for Medical Research (AU)
  • Launceston General Hospital (AU)
  • The University of Queensland (AU)
  • Gold Coast Hospital (AU)
  • UNSW Sydney (AU)
  • Austin Hospital (AU)
  • Monash University (AU)
  • University of Tasmania (AU)
Corresponding author
Perret, Jennifer L.
ORCID
Venue
American Journal of Respiratory and Critical Care Medicine
Publisher
Oxford University Press (OUP)
Published
2013-01-01
Volume
187
Issue
1
Pages
42-48
ISSN
  • 1073-449X (ISSN-L)
  • 1535-4970
DOI
10.1164/rccm.201205-0788oc
OpenAlex
W2103031437
Cited by
128
References
41
Citations by year
2025: 5 · 2024: 3 · 2023: 4 · 2022: 6 · 2021: 6 · 2020: 6 · 2019: 11 · 2018: 13 · 2017: 17 · 2016: 24 · 2015: 13 · 2014: 15 · 2013: 4
FWCI
6.83
Type
journal article
Language
en
Open access
Licence
academic.oup.com/pages/standard-publication-reuse-rights (vor)
Locations
  • American Journal of Respiratory and Critical Care Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion)
  • eCite Digital Repository (University of Tasmania) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
Keywords
fixed airflow obstruction, asthma, smoking, atopy, chronic bronchitis, middle age (human life stage), FEV1/FVC ratio, pack-years, atopic sensitization, Tasmanian Longitudinal Health Study
MeSH terms
Adult, Airway Obstruction, Asthma, Female, Health Status, Humans, Male, Middle Aged, Prospective Studies, Pulmonary Diffusing Capacity, Smoking, Spirometry, Time Factors, Logistic Models, Age of Onset

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