By Amy Orciari Herman
Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS
Risk factors for chronic obstructive pulmonary disease (COPD) are evident in childhood and present opportunities to minimize one's risk, suggest two studies in the Lancet Respiratory Medicine.
In the first, researchers examined forced expiratory volume (FEV1) scores from ages 7 to 53 years in over 2400 people. They identified six trajectories of lung function, of which three — persistently low; early below average with accelerated decline; and below average — predicted increased COPD risk at age 53. These three trajectories accounted for 75% of the COPD burden. Childhood factors associated with these trajectories included asthma, allergic rhinitis, bronchitis, pneumonia, and maternal smoking. Risk was exacerbated in those who smoked or had asthma as adults.
In the second study, researchers showed that individuals with low FEV1 scores from childhood into early adulthood had persistent wheezing and asthma. Childhood factors linked to persistently low scores included recurrent wheeze, early allergic sensitization, and tobacco smoke exposure. The researchers call for "aggressive strategies to reduce environmental tobacco smoke exposure and novel strategies to prevent early-life sensitization and exacerbations of early-childhood wheezing."
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