| 1. |
- de Marco, Roberto, et al.
(författare)
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Asthma, COPD and overlap syndrome : a longitudinal study in young European adults
- 2015
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Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 46:3, s. 671-679
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Tidskriftsartikel (refereegranskat)abstract
- We compared risk factors and clinical characteristics, 9-year lung function change and hospitalisation risk across subjects with the asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS), asthma or COPD alone, or none of these diseases. Participants in the European Community Respiratory Health Survey in 1991-1993 (aged 20-44 years) and 1999-2001 were included. Chronic airflow obstruction was defined as pre-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity
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| 2. |
- de Marco, Roberto, et al.
(författare)
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Risk Factors for Chronic Obstructive Pulmonary Disease in a European Cohort of Young Adults
- 2011
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Ingår i: American Journal of Respiratory and Critical Care Medicine. - 1073-449X .- 1535-4970. ; 183:7, s. 891-897
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Tidskriftsartikel (refereegranskat)abstract
- Rationale: Few studies have investigated the factors associated with the early inception of chronic obstructive pulmonary disease (COPD). Objectives: We investigated COPD risk factors in an international cohort of young adults using different spirometric definitions of the disease. Methods. We studied 4,636 subjects without asthma who had prebronchodilator FEV1/FVC measured in the European Community Respiratory Health Survey both in 1991 to 1993 (when they were 20-44 yr old) and in 1999 to 2002. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease fixed cut-off criterion (FEV1/FVC < 0.70), and two criteria based on the Quanjer and LuftiBus reference equations (FEV1/FVC less than lower limit of normal). COPD determinants were studied using two-level Poisson regression models. Measurements and Main Results: COPD incidence ranged from 1.85 (lower limit of normal [Quanjer]) to 2.88 (Global Initiative for Chronic Obstructive Lung Disease) cases/1,000/yr. Although about half of the cases had smoked less than 20 pack-years, smoking was the main risk factor for COPD, and it accounted for 29 to 39% of the new cases during the follow-up. Airway hyperresponsiveness was the second strongest risk factor (15-17% of new cases). Other determinants were respiratory infections in childhood and a family history of asthma, whereas the role of sex, age, and of being underweight largely depended on the definition of COPD used. Conclusions: COPD may start early in life. Smoking prevention should be given the highest priority to reduce COPD occurrence. Airway hyperresponsiveness, a family history of asthma, and respiratory infections in childhood are other important determinants of COPD. We suggest the need for a definition of COPD that is not exclusively based on spirometry.
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| 3. |
- Leynaert, Benedicte, et al.
(författare)
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Gender differences in prevalence, diagnosis and incidence of allergic and non-allergic asthma : a population-based cohort
- 2012
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Ingår i: Thorax. - : BMJ. - 0040-6376 .- 1468-3296. ; 67:7, s. 625-631
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Tidskriftsartikel (refereegranskat)abstract
- Background Although women with severe non-allergic asthma may represent a substantial proportion of adults with asthma in clinical practice, gender differences in the incidence of allergic and non-allergic asthma have been little investigated in the general population. Methods Gender differences in asthma prevalence, reported diagnosis and incidence were investigated in 9091 men and women randomly selected from the general population and followed up after 8-10 years as part of the European Community Respiratory Health Survey. The protocol included assessment of bronchial responsiveness, IgE specific to four common allergens and skin tests to nine allergens. Results Asthma was 20% more frequent in women than in men over the age of 35 years. Possible under-diagnosis of asthma appeared to be particularly frequent among non-atopic individuals, but was as frequent in women as in men. The follow-up of subjects without asthma at baseline showed a higher incidence of asthma in women than in men (HR 1.94; 95% CI 1.40 to 2.68), which was not explained by differences in smoking, obesity or lung function. More than 60% of women and 30% of men with new-onset asthma were non-atopic. The incidence of non-allergic asthma was higher in women than in men throughout all the reproductive years (HR 3.51; 95% CI 2.21 to 5.58), whereas no gender difference was observed for the incidence of allergic asthma. Conclusions This study shows that female sex is an independent risk factor for non-allergic asthma, and stresses the need for more careful assessment of possible non-allergic asthma in clinical practice, in men and women.
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| 4. |
- Norbäck, Dan, et al.
(författare)
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Lung function decline in relation to mould and dampness in the home : the longitudinal European Community Respiratory Health Survey ECRHS II
- 2011
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Ingår i: Thorax. - : BMJ. - 0040-6376 .- 1468-3296. ; 66:5, s. 396-401
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Tidskriftsartikel (refereegranskat)abstract
- Background: There are few longitudinal studies that have examined the association of lung function decline with indoor mould and dampness. Lung function decline in relation to dampness and mould in the home has studied in adults over a 9 year period. Methods Spirometry was performed twice in participants in the European Respiratory Health Survey (ECRHS I and II) who were initially examined aged 20-45 years, in 1990-1995 and 9 years later (n=6443). Information on their current home was collected twice by interview. Dampness (water damage or damp spots) and indoor mould, ever and in the last 12 months, were assessed. A dampness score and a mould score were calculated. In addition, 3118 homes at 22 centres were inspected directly at follow-up for the presence of dampness and mould. Results Dampness and mould were common. Overall, 50.1% reported any dampness and 41.3% any indoor mould in either ECRHS I or ECRHS II. Women with dampness at home had an additional decline in forced expiratory volume in 1 s (FEV1) of -2.25 ml/year (95% CI -4.25 to -0.25), with a significant trend in increased lung function decline in relation to the dampness score (p=0.03). The association in women was significant when excluding those with asthma at baseline. Observed damp spots in the bedroom was associated with a significant additional decline in FEV1 of -7.43 ml/year (95% CI -13.11 to 1.74) in women. Conclusion Dampness and indoor mould growth is common in dwellings, and the presence of damp is a risk factor for lung function decline, especially in women.
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| 5. |
- Norbäck, Dan, et al.
(författare)
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Mould and dampness in dwelling places, and onset of asthma : the population-based cohort ECRHS
- 2013
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 70:5, s. 325-331
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To study new onset of adult asthma in relation to dampness and moulds in dwelling places. Methods Totally, 7104 young adults from 13 countries who participated in the European Community Respiratory Health Survey (ECRHS I and II) who did not report respiratory symptoms or asthma at baseline were followed prospectively for 9 years. Asthma was assessed by questionnaire data on asthmatic symptoms and a positive metacholine challenge test at follow-up. Data on the current dwelling was collected at the beginning and at the end of the follow-up period by means of an interviewer-led questionnaire, and by inspection. Relative risks (RR) for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking and study centre. Results There was an excess of new asthma in subjects in homes with reports on water damage (RR 1.46; 95% CI 1.09 to 1.94) and indoor moulds (RR=1.30; 95% CI 1.00 to 1.68) at baseline. A dose-response effect was observed. The effect was stronger in those with multisensitisation and in those sensitised to moulds. Observed damp spots were related to new asthma (RR=1.49; 95% CI 1.00 to 2.22). The population-attributable risk was 3-10% for reported, and 3-14% for observed dampness/moulds. Conclusions Dampness and mould are common in dwellings, and contribute to asthma incidence in adults.
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