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

Perret, Jennifer L., Dharmage, Shyamali C., Matheson, Melanie C., Johns, David P., Gurrin, Lyle C., Burgess, John A., Marrone, John, Markos, James, Morrison, Stephen, Feather, Iain, Thomas, Paul S., McDonald, Christine F., Giles, Graham G., Hopper, John L., Wood-Baker, Richard, Abramson, Michael J. and Walters, Eugene H. (2013) The interplay between the effects of lifetime asthma, smoking, and atopy on fixed airflow obstruction in middle age. American Journal of Respiratory and Critical Care Medicine, 187 1: 42-48. doi:10.1164/rccm.201205-0788OC


Author Perret, Jennifer L.
Dharmage, Shyamali C.
Matheson, Melanie C.
Johns, David P.
Gurrin, Lyle C.
Burgess, John A.
Marrone, John
Markos, James
Morrison, Stephen
Feather, Iain
Thomas, Paul S.
McDonald, Christine F.
Giles, Graham G.
Hopper, John L.
Wood-Baker, Richard
Abramson, Michael J.
Walters, Eugene H.
Title The interplay between the effects of lifetime asthma, smoking, and atopy on fixed airflow obstruction in middle age
Journal name American Journal of Respiratory and Critical Care Medicine   Check publisher's open access policy
ISSN 1073-449X
1535-4970
Publication date 2013-01
Year available 2012
Sub-type Article (original research)
DOI 10.1164/rccm.201205-0788OC
Volume 187
Issue 1
Start page 42
End page 48
Total pages 7
Place of publication New York, NY., United States
Publisher American Thoracic Society
Collection year 2013
Language eng
Formatted 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 inmiddle 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 AOwas 6.0%(95%confidence interval [CI], 4.5-7.5%). Its associationwith early-onset current clinical asthma was equivalent to a 33 pack-year history ofsmoking (odds ratio, 3.7;95% CI,1.5-9.3; P = 0.005),comparedwitha24pack-yearhistoryforlate- onset current clinical asthma (odds ratio, 2.6; 95% CI, 1.03-6.5; P = 0.042). An interaction(multiplicativeeffect)waspresentbetweenasthmaandactive smoking as it relates to the ratio of post-bronchodilator FEV1/FVC, but only among those with atopic sensitization.

Conclusions: Activesmokingandcurrent clinicalasthmabothcontribute 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.
Keyword Fixed airflow obstruction
Lifetime asthma
Active smoking
Atopy
Interaction
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published ahead of print on November 15, 2012,

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
 
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