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Childhood infections and the risk of asthma: a longitudinal study over 37 years.

Chest. 2012 Mar 29. Burgess JA, Abramson MJ, Gurrin LC, Byrnes GB, Matheson MC, Wharton CL, Giles GG, Johns DP, Hopper JL, Walters EH, Dharmage SC. 1Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, The University of Melbourne, Level 3, 207 Bouverie St, Carlton, Victoria 3053. Australia.

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 analysed 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 Odds Ratio [aOR] 0.53; 95% CI 0.28-1.00) was negatively associated with asthma persisting to age 13 years, chicken-pox (aOR 0.58; 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; 0.31-0.96) and 44 years (aOR 0.53; 0.35-0.82). Pertussis was associated with pre-adolescent incident asthma (adjusted Hazard Ratio [aHR] 1.80; 95% CI 1.10-2.96) while 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; 2.61-3.75) and 13 years (aOR 1.32; 1.00-1.75), an association stronger in those without than those with eczema (aOR 3.46; 2.83-4.24 versus 2.08; 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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