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Zhang X, Gray AR, Hancox RJ. Distinct trajectories of lung function from childhood to mid-adulthood. Thorax 2024; 79:754-761. [PMID: 38499347 DOI: 10.1136/thorax-2023-220436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 02/10/2024] [Indexed: 03/20/2024]
Abstract
RATIONALE Life course trajectories of lung function development and decline influence the risk for lung disease but are poorly documented. OBJECTIVE To document lung function trajectories from childhood to mid-adult life. METHODS We modelled forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC at ages 9, 11, 13, 15, 18, 21, 26, 32, 38 and 45 years from a population-based cohort using latent profile analysis to identify distinct subgroups of participants with similar lung function trajectories. Regression analyses were used to assess associations between the trajectories, early life factors and postbronchodilator airflow obstruction at age 45. RESULTS Among 865 participants with ≥6 measures of lung function, we identified 10 distinct FEV1 trajectories. Most were approximately parallel except for a childhood airway hyper-responsiveness-related persistently low trajectory (3% of study population); two accelerated-decline trajectories, one of which (8%) was associated with smoking and higher adult body mass index (BMI) and a catch-up trajectory (8%). Findings for FEV1/FVC trajectories were similar. Nine trajectories were identified for FVC: most were also approximately parallel except for a higher BMI-related accelerated-decline trajectory. The three FEV1 trajectories leading to the lowest FEV1 values comprised 19% of the cohort but contributed 55% of airflow obstruction at age 45. CONCLUSIONS Lung function trajectories to mid-adult life are largely established before adolescence, with a few exceptions: a childhood airway hyper-responsiveness-related persistently low trajectory, which starts low and gets worse with age, and accelerated adult decline trajectories associated with smoking and obesity. Adverse trajectories are associated with a high risk of airflow obstruction in mid-adult life.
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Affiliation(s)
- Xian Zhang
- Department of Preventive & Social Medicine, University of Otago, Dunedin, New Zealand
- National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Andrew R Gray
- Biostatistics Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Robert J Hancox
- Department of Preventive & Social Medicine, University of Otago, Dunedin, New Zealand
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Paciência I, Moreira A, Moreira C, Cavaleiro Rufo J, Sokhatska O, Rama T, Hoffimann E, Santos AC, Barros H, Ribeiro AI. Neighbourhood green and blue spaces and allergic sensitization in children: A longitudinal study based on repeated measures from the Generation XXI cohort. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 772:145394. [PMID: 33561602 DOI: 10.1016/j.scitotenv.2021.145394] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 06/12/2023]
Abstract
Evidence on the effect of natural environments on atopy in children is limited and inconsistent, disregarding the time-varying and cumulative exposures throughout the life course. To assess critical periods of exposure as well as the effect of longitudinal trajectories of exposure to green and blue spaces on the development of allergic sensitization in children at the age of 10 years. A longitudinal study was conducted involving 730 children enrolled in Generation XXI, a population-based birth cohort from the Porto Metropolitan Area (Portugal). Food and aeroallergens sensitization were evaluated at 10 years of age using Phadiatop Infant, Phadiatop fx1 and fx22 ImmunoCAP (Thermo Fisher Scientific, Uppsala, Sweden). Residential Normalized Difference Vegetation Index (NDVI) and distance to the nearest blue space (sea, river) were assessed using a Geographic Information System. Latent class linear mixed models were fitted to determine longitudinal trajectories of exposure. Associations were estimated using Cox proportional hazards regression models and expressed using hazard ratios (HR) and 95% confidence intervals (95% CI). Residing in neighbourhoods surrounded by more vegetation at 10 years, as well as lifetime exposure to a trajectory of higher levels of NDVI, were associated with a lower risk of allergic sensitization [HR (95% CI) = 0.095 (0.011, 0.823) and HR (95% CI) = 0.539 (0.301, 0.965), respectively]. Our findings support a role for both longitudinal, but particularly late-childhood, exposure to green spaces, in the prevention of allergic sensitization in children.
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Affiliation(s)
- Inês Paciência
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal.
| | - André Moreira
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Carla Moreira
- Cmat - Centre of Mathematics School of Sciences, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - João Cavaleiro Rufo
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Oksana Sokhatska
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Tiago Rama
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Elaine Hoffimann
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Ana Cristina Santos
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Henrique Barros
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Ana Isabel Ribeiro
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
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Carreras G, Lugo A, Gallus S, Cortini B, Fernández E, López MJ, Soriano JB, López-Nicolás A, Semple S, Gorini G. Burden of disease attributable to second-hand smoke exposure: A systematic review. Prev Med 2019; 129:105833. [PMID: 31505203 DOI: 10.1016/j.ypmed.2019.105833] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 08/30/2019] [Accepted: 09/05/2019] [Indexed: 10/26/2022]
Abstract
Our aim was to provide a systematic review of studies on the burden of disease due to second-hand smoke (SHS) exposure, reviewing methods, exposure assessment, diseases causally linked to SHS, health outcomes, and estimates available to date. A literature review of studies on the burden of disease from SHS exposure, available in PubMed and SCOPUS, published 2007-2018 in English language, was carried out following the PRISMA recommendations. Overall, 588 studies were first identified, and 94 were eligible. Seventy-two studies were included in the systematic review. Most of them were based on the comparative risk assessment approach, assessing SHS exposure using mainly surveys on exposure at home/workplaces. Diseases more frequently studied were: lung cancer, ischemic heart disease, stroke, chronic obstructive pulmonary disease, asthma and breast cancer in adults; lower respiratory tract infection, otitis media, asthma, sudden infant death syndrome and low birth weight in children. The SHS exposure assessment and the reported population attributable fractions (PAF) were largely heterogeneous. As an example, the PAF from lung cancer varied between 0.6% and 20.5%. Moreover, PAF were estimated applying relative risks and SHS exposures with no consistent definitions or with different age classes. The research gap on the SHS exposure burden is shrinking. However, estimates are not yet available for a number of countries, particularly the Middle Eastern and African countries, and not all diseases with the strongest evidence of causation, such as sudden infant death syndrome, have been explored. Moreover, in some cases the applied methodology revealed relatively low quality of data.
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Affiliation(s)
- Giulia Carreras
- Oncologic Network, Prevention and Research Institute (ISPRO), via Cosimo il Vecchio 2, 50139 Florence, Italy.
| | - Alessandra Lugo
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS (IRFMN), Via La Masa 19, 20156 Milan, Italy
| | - Silvano Gallus
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS (IRFMN), Via La Masa 19, 20156 Milan, Italy
| | - Barbara Cortini
- Oncologic Network, Prevention and Research Institute (ISPRO), via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Esteve Fernández
- Catalan Institute of Oncology (ICO), Granvia de L'Hospitalet, 199-203, PC 08908 L'Hospitalet de Llobregat, Spain; Bellvitge Biomedical Research Institute (IDIBELL), Granvia de L'Hospitalet, 199, PC 08908 L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, Campus de Bellvitge, School of Medicine and Health Sciences, University of Barcelona, Feixa Llarga, s/n, PC 08907 L'Hospitalet de Llobregat, Spain
| | - Maria José López
- Public Health Agency of Barcelona (ASPB). Pl. Lesseps, 1, PC 08023 Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0. PC 28029, Madrid, Spain; Institut d'Investigació Biomèdica de Sant Pau (IIB Sant Pau), Sant Antoni Maria Claret, 167, PC 08025 Barcelona, Spain
| | - Joan B Soriano
- Hospital Universitario La Princesa (IISP), Diego de León, 62 1st floor, PC 28006 Madrid, Spain
| | - Angel López-Nicolás
- Polytechnic University of Cartagena (UPCT), Plaza Cronista Isidoro Valverde, s/n, PC 30202 Cartagena, Spain
| | - Sean Semple
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, Scotland, UK
| | - Giuseppe Gorini
- Oncologic Network, Prevention and Research Institute (ISPRO), via Cosimo il Vecchio 2, 50139 Florence, Italy
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