COPD Risk: Smoking cough often has its origins in childhood

Our childhood has a big impact on COPD risk

Researchers have now found that three quarters of all cases of chronic obstructive pulmonary disease (COPD) can be attributed to childhood exposure. For example, diseases such as asthma, bronchitis and pneumonia increase the risk of developing such a disease. The probability is further increased if the parents are smokers.

In their current study, the University of Melbourne scientists found that many cases of chronic obstructive pulmonary disease result from various childhood exposures. The doctors published the results of their study in the English-language journal "The Lancet Respiratory Medicine".

What is chronic obstructive pulmonary disease?

A so-called chronic obstructive pulmonary disease (also known as smoker's cough) describes a group of various lung diseases that cause breathing problems including emphysema and chronic bronchitis. These complaints mainly affect middle-aged smokers or older adults. Smoking remains the biggest risk factor for COPD. But the new results suggest that childhood diseases such as asthma, bronchitis, pneumonia, and parents' smoking also have an impact on the development of the disease. COPD is often referred to as smoking cough.

Results could improve the treatment of lung diseases

There could be a time window in childhood in which the risk of poor lung function in later life can be reduced, the researchers suspect. The physicians identified various ways in which lung function changes over the course of life and is associated with different risk factors and disease risks in later life. These findings are particularly important for the prognosis, prevention and treatment of lung diseases.

Doctors examined over 2,400 subjects

The study conducted by the University of Melbourne included a total of 2,438 participants who had participated in the so-called Tasmanian Longitudinal Health Study. This monitored the subjects from childhood to the age of 53 years. It is one of the largest and longest running studies of this type. Lung function was measured at the ages of seven, 13, 18, 45, 50 and 53 years and the exposure of participants to various risk factors was also recorded.

Different ways lead to COPD

The authors identified six different pathways that describe how lung function changes with age, three of which are associated with COPD. These three routes included below-average lung function in early life, a rapid decrease in lung function in later life, and persistent low or below-average lung function. These three different routes have been estimated to be associated with approximately three quarters (75.2 percent in total) of all COPD diseases by the age of 53.

The experts also explain that the disease pathways mentioned were also associated with childhood asthma, bronchitis, pneumonia, allergic rhinitis, eczema, asthma diseases of the parents and their tobacco consumption. The risk factors are important indicators of the COPD risk for children, which are further aggravated by smoking and asthma in adulthood, the authors say. This increased the damage already caused by risk factors in childhood and may lead to a faster decline in lung function.

People with asthma should be treated appropriately

It is important that parents reduce smoking and promote immunization to promote healthy lung function pathways. This can minimize the risk of COPD, especially for people with low lung function in childhood or smoking parents. At best, parents should quit smoking. Appropriate treatment should also be given to all people with asthma, as this can be critical to maintaining lung function, the researchers explain.

COPD will be the third leading cause of death worldwide in 2030

These results underline the importance of prevention both in early life exposures, which can lead to poor lung growth, and in risk factors for adults, which contribute to accelerated lung decline, says study author Professor Shyamali Dharmage from the University of Melbourne. COPD is expected to be the third leading cause of death worldwide by 2030. "It is important that we identify the main causes so that this burden can be reduced," added the expert.

The second study included 2,632 subjects

In a second study, 2,632 participants were medically monitored from birth to 24 years of age and lung function was measured. It turned out that around three quarters of infants with poor lung function showed an improvement in lung function throughout childhood between the ages of one and six months, which indicates a possible time window by increasing lung function and thus the risk of COPD is reduced in later life. The study's authors say that these proposed interventions to maximize lung growth in early childhood could alter the risk of COPD in older age. (as)

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