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Original Research |

Childhood Infections and the Risk of AsthmaChildhood Infections and Asthma: A Longitudinal Study Over 37 Years

John A. Burgess, PhD; Michael J. Abramson, PhD; Lyle C. Gurrin, PhD; Graham B. Byrnes, PhD; Melanie C. Matheson, PhD; Cathryn L. May, BAppSc; Graham G. Giles, PhD; David P. Johns, PhD; John L. Hopper, PhD; E. Haydn Walters, DM; Shyamali C. Dharmage, PhD
Author and Funding Information

From the Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology (Drs Burgess, Gurrin, Matheson, Giles, Hopper, and Dharmage), The University of Melbourne, Carlton, VIC, Australia; the Department of Epidemiology and Preventive Medicine (Dr Abramson), Monash University, The Alfred, Melbourne, VIC, Australia; Biostatistics Group (Dr Byrnes), International Agency for Research on Cancer, Lyon, France; the Victorian Cervical Cytology Registry (Ms May), East Melbourne, VIC, Australia; the Cancer Epidemiology Centre (Dr Giles), The Cancer Council Victoria, Carlton, VIC, Australia; and the Respiratory Research Group (Drs Johns and Walters), Menzies Research Institute, The University of Tasmania, Hobart, TAS, Australia.

Correspondence to: John A. Burgess, PhD, Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Level 3, 207 Bouverie St, Carlton, VIC, 3053, Australia; e-mail: jburgess@unimelb.edu.au


Funding/Support: The Tasmanian Longitudinal Health Study is supported by grants from the National Health and Medical Research Council, Australia; the Victorian, Queensland, and Tasmanian Asthma Foundations; the Clifford Craig Medical Research Trust; the Royal Hobart Hospital Research Foundation; and the University of Melbourne. Drs Matheson, Hopper, Gurrin, and Dharmage are supported by the National Health and Medical Research Council, Australia. Dr Burgess is supported by the Centre for Research Excellence in Chronic Respiratory Disease, School of Medicine, University of Tasmania.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(3):647-654. doi:10.1378/chest.11-1432
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Background:  Few studies have examined common childhood infections and adult asthma. We examined associations between childhood infectious diseases, childhood pneumonia, and current, persisting, and incident asthma to middle age.

Methods:  We analyzed data from the Tasmanian Longitudinal Health Study (TAHS). A history of pneumonia was ascertained from their parents when the TAHS participants were 7 years old. Measles, rubella, mumps, chickenpox, diphtheria, and pertussis were identified from school medical records. Associations with current, persisting, or incident asthma were examined using regression techniques.

Results:  Greater infectious diseases load was negatively associated with persisting asthma at all ages. Individually, pertussis (adjusted OR [aOR], 0.53; 95% CI, 0.28-1.00) was negatively associated with asthma persisting to age 13 years, chickenpox (aOR, 0.58; 95% CI, 0.38-0.88) was negatively associated with asthma persisting to age 32 years, and rubella was negatively associated with asthma persisting to ages 32 (aOR, 0.61; 95% CI, 0.31-0.96) and 44 years (aOR 0.53; 95% CI, 0.35-0.82). Pertussis was associated with preadolescent incident asthma (adjusted hazard ratio [aHR], 1.80; 95% CI, 1.10-2.96), whereas measles was associated with adolescent incident asthma (aHR, 1.66; 1.06-2.56). Childhood pneumonia was associated with current asthma at ages 7 (aOR, 3.12; 95% CI, 2.61-3.75) and 13 years (aOR, 1.32; 95% CI, 1.00-1.75), an association stronger in those without than those with eczema (aOR, 3.46; 95% CI, 2.83-4.24 vs aOR, 2.08; 95% CI, 1.38-3.12).

Conclusions:  Overall, childhood infectious diseases protected against asthma persisting in later life, but pertussis and measles were associated with new-onset asthma after childhood. Measles and pertussis immunization might lead to a reduction in incident asthma in later life.

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