Effect of pneumonia and whooping cough in childhood on adult lung function.

BACKGROUND

Previous studies have suggested that respiratory infection during childhood is associated with respiratory disease in adulthood, but the link is unclear because of retrospective ascertainment of childhood infection, selection bias, and confounding factors.

METHODS

We studied the effects of childhood pneumonia and whooping cough in 1392 British adults followed from birth in 1958. Of these, 193 had a history of pneumonia and 215 a history of whooping cough by the age of seven years. When the subjects were 34 or 35 years old, their forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were measured before and after they inhaled albuterol.

RESULTS

A history of pneumonia was associated with deficits (+/-95 percent confidence limits) in both FEV1 (102+/-73 ml, P=0.006) and FVC (173+/-70 ml, P=0.001) when the analysis was adjusted for sex, height, and smoking, with no change in the ratio of FEV1 to FVC. These deficits persisted after inhalation of albuterol. In subjects with no history of wheezing, the deficit in FEV1 was 155+/-122 ml (P=0.01), in those with past wheezing it was 41+/-128 ml (P=0.53), and in those with current wheezing it was 119+/-133 ml (P=0.08). The effect was no greater for the subjects who had pneumonia at less than two years of age than for those who had it between the ages of two and seven years and was not diminished after control for multiple confounding factors. The deficits associated with whooping cough were smaller (FEV1, 41+/-70 ml; P=0.25; FVC, 81+/-76 ml; P=0.04).

CONCLUSIONS

Childhood pneumonia is associated with reduced ventilatory function in adults. This reduction is independent of a history of wheezing and is not explained by other confounding factors.