Risk factors of new‐onset asthma in adults: a population‐based international cohort study

Allergy: European Journal of Allergy and Clinical Immunology - Tập 65 Số 8 - Trang 1021-1030 - 2010
José Luis Sánchez‐Ramos1,2,3,4, Jordi Sunyer1,2,3,4, Xavier Basagaña1,2,3, Raquel García‐Esteban1,2,3, Isa Cerveri5, Roberto Bono6, Joachim Heinrich7, C. Janson8, Deborah Jarvis9, Manolis Kogevinas1,2,3, Nino Künzli1,2,10,11, Bénédicte Leynaert12, Cecilie Svanes13, Matthias Wjst14,15, Þórarinn Gíslason16, Peter Burney9
1CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
2Centre for Research in Environmental Epidemiology (CREAL), Barcelona
3Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona
4Universitat Pompeu Fabra, Barcelona
5Division of Respiratory Diseases, Fondazione IRCCS, University of Pavia, Pavia
6Department of Medicine and Public Health, Epidemiology & Medical Statistics, University of Verona, Verona, Italy
7Helmholtz Center Munich, German Research Centre for Environmental Health, Institute of Epidemiology, Munich, Germany
8Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden
9Respiratory Epidemiology and Public Health Group, National Heart and Lung Institute, Imperial College, London, UK
10ICREA Foundation, Barcelona, Spain
11Institute for Social and Preventive Medicine at Swiss Tropical Institut, Basel, Switzerland
12Epidemiology, Faculty of Medicine X Bichat, Paris, France
13Section of Thoracic Medicine, Institute of Medicine, University of Bergen, Bergen, Norway
14Institute of Genetic Medicine, EURAC Research, Bozen, Italy
15Institute of Inhalation Biology, Helmholtz Centre, Munich, Germany
16Landspitali University Hospital, Reykjavik, Iceland

Tóm tắt

To cite this article: Antó JM, Sunyer J, Basagaña X, Garcia‐Esteban R, Cerveri I, de Marco R, Heinrich J, Janson C, Jarvis D, Kogevinas M, Kuenzli N, Leynaert B, Svanes C, Wjst M, Gislason T, Burney P. Risk factors of new‐onset asthma in adults: a population‐based international cohort study. Allergy 2010; 65: 1021–1030AbstractBackground:  The occurrence of new‐onset asthma during adulthood is common, but there is insufficient understanding of its determinants including the role of atopy.Objective:  To assess the risk factors for the development of new‐onset asthma in middle‐aged adults and to compare them according to atopy.Methods:  A longitudinal analysis of 9175 young adults who participated in two surveys of the European Community Respiratory Health Survey (ECRHS) conducted 9 years apart.Findings:  We observed 179 cases of new‐onset asthma among 4588 participants who were free of asthma and reported at the beginning of the follow‐up that they had never had asthma (4.5 per 1000 person‐years). In a logistic regression, the following risk factors were found to increase the risk of new‐onset asthma: female gender (OR: 1.97; 95% confidence interval (CI): 1.38,2.81), bronchial hyperresponsiveness (3.25; 2.19,4.83), atopy (1.55;1.08,2.21), FEV1 < 100 % predicted (1.87;1.34,2.62), nasal allergy (1.98;1.39,2.84) and maternal asthma (1.91;1.13;3.21). Obesity, respiratory infections in early life and high‐risk occupations increased the risk of new‐onset asthma although we had limited power to confirm their role. Among the atopics, total IgE and sensitization to cat were independently related to the risk of new‐onset asthma. The proportion of new‐onset asthma attributable to atopy varied from 12% to 21%.Conclusion:  Adults reporting that they had never had asthma were at a substantial risk of new‐onset asthma as a result of multiple independent risk factors including lung function. Atopy explains a small proportion of new‐onset adult asthma.

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Allergy: European Journal of Allergy and Clinical Immunology

Tập 65 Số 8

1021-1030

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