Adults' breathing troubles may begin in childhood

NEW YORK (Reuters Health) - New research hints that how well your lungs function in adulthood and your risk of developing chronic breathing problems is partly determined in childhood.

In a study, researchers found that early childhood “disadvantage factors” -- such as being around someone who smoked or suffering lung infections - seemed to help fuel the development of chronic obstructive pulmonary disease, or COPD, much later in life.

“People with early life disadvantage have permanently lower lung function, no catch-up with age but a slightly larger decline in lung function and a substantially increased COPD risk,” Dr. Cecilie Svanes, at Haukeland University Hospital in Norway, and colleagues report in the journal Thorax.

COPD is a progressive lung disease that makes it hard to breathe. It covers emphysema, chronic bronchitis, and severe asthma. COPD is chiefly caused by cigarette smoking.

Among more than 13,000 men and women 20 to 45 years old, Svanes team found that 40 percent had at least one “childhood disadvantage” such as exposure to secondhand smoke, lung infections prior to the age of 5, having parents with asthma, or having a personal history of asthma.

The researchers compared how these early life “disadvantages” associated with lung function tests completed 9 years apart in roughly 7,700 of these individuals.

Compared with those having no “childhood disadvantages,” COPD was six- and seven-times more likely, respectively, in men and women exposed to any three such factors, after allowing for multiple other factors, including current smoking and childhood asthma.

Exposure to two “disadvantages” seemed to confer five-times the COPD risk in men and doubled the risk in women.

Moreover, Svanes commented in an email to Reuters Health, “The effects of childhood disadvantage on lung function was as strong for the 50 year olds as for the 30 year olds.”

The author of a commentary on the study points out that combining childhood risk factors (such as asthma in the child or parent, or early lung infections) with early exposure to secondhand smoke resulted in a risk for COPD that “rivaled or exceeded that seen from the traditional COPD risk factor of cigarette smoking.”

Svanes and colleagues say their findings linking COPD to childhood factors are new and need confirmation in more detailed investigations. However, if confirmed, these findings suggest, “adult respiratory health to a large extent originates early in life,” they conclude.

“My hope,” Dr. David M. Mannino of University of Kentucky in Lexington wrote in his commentary, “is that a better understanding of the early life factors that increase the risk of disease might lead to better early detection and intervention efforts.”

SOURCE: Thorax, January 2010