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Perret JL, Matheson MC, Gurrin LC, Johns DP, Burgess JA, Thompson BR, Lowe AJ, Markos J, Morrison SS, McDonald CF, Wood-Baker R, Svanes C, Thomas PS, Hopper JL, Giles GG, Abramson MJ, Walters EH, Dharmage SC. Childhood measles contributes to post-bronchodilator airflow obstruction in middle-aged adults: A cohort study. Respirology 2018; 23:780-787. [PMID: 29560611 DOI: 10.1111/resp.13297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 01/09/2018] [Accepted: 02/20/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVE Chronic obstructive pulmonary disease (COPD) has potential origins in childhood but an association between childhood measles and post-bronchodilator (BD) airflow obstruction (AO) has not yet been shown. We investigated whether childhood measles contributed to post-BD AO through interactions with asthma and/or smoking in a non-immunized middle-aged population. METHODS The population-based Tasmanian Longitudinal Health Study (TAHS) cohort born in 1961 (n = 8583) underwent spirometry in 1968 before immunization was introduced. A history of childhood measles infection was obtained from school medical records. During the fifth decade follow-up (n = 5729 responses), a subgroup underwent further lung function measurements (n = 1389). Relevant main associations and interactions by asthma and/or smoking on post-BD forced expiratory volume in 1 s/forced vital capacity (FEV1 /FVC; continuous variable) and AO (FEV1 /FVC < lower limit of normal) were estimated by multiple regression. RESULTS Sixty-nine percent (n = 950) had a history of childhood measles. Childhood measles augmented the combined adverse effect of current clinical asthma and smoking at least 10 pack-years on post-BD FEV1 /FVC ratio in middle age (z-score: -0.70 (95% CI: -1.1 to -0.3) vs -1.36 (-1.6 to -1.1), three-way interaction: P = 0.009), especially for those with childhood-onset asthma. For never- and ever-smokers of <10 pack-years who had current asthma symptoms, compared with those without childhood measles, paradoxically, the odds for post-BD AO was not significant in the presence of childhood measles (OR: 12.0 (95% CI: 3.4-42) vs 2.17 (0.9-5.3)). CONCLUSION Childhood measles infection appears to compound the associations between smoking, current asthma and post-BD AO. Differences between asthma subgroups provide further insight into the complex aetiology of obstructive lung diseases for middle-aged adults.
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Affiliation(s)
- Jennifer L Perret
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia.,Department of Respiratory and Sleep Medicine, Austin Hospital, Melbourne, VIC, Australia.,Institute for Breathing and Sleep (IBAS), Melbourne, VIC, Australia
| | - Melanie C Matheson
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia
| | - Lyle C Gurrin
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia
| | - David P Johns
- "Breathe Well" Centre of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - John A Burgess
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia
| | - Bruce R Thompson
- Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, VIC, Australia.,Department of Medicine, Monash University, Melbourne, VIC, Australia
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia
| | - James Markos
- Launceston General Hospital, Hobart, TAS, Australia
| | - Stephen S Morrison
- Department of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Christine F McDonald
- Department of Respiratory and Sleep Medicine, Austin Hospital, Melbourne, VIC, Australia.,Institute for Breathing and Sleep (IBAS), Melbourne, VIC, Australia
| | - Richard Wood-Baker
- "Breathe Well" Centre of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Cecilie Svanes
- Centre for International Health, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukelaud University Hospital, Bergen, Norway
| | - Paul S Thomas
- Prince of Wales' Hospital Clinical School and School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - John L Hopper
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia.,Department of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Graham G Giles
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia.,Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Michael J Abramson
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - E Haydn Walters
- "Breathe Well" Centre of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia
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