COPD has been mainly attributed to active smoking in adulthood, but some patients are diagnosed with COPD in the absence of a smoking history and only 20–25% of smokers develop COPD…
Taken together, these findings clearly point towards the importance of early life for the development of COPD.
Three-quarters of chronic obstructive pulmonary disease (COPD) cases have their origins in poor lung function pathways beginning in childhood.
These pathways are associated with exposures in childhood, and amplified by factors in adulthood, according to a cohort study.
“Reduction of maternal smoke exposure and personal smoking and promotion of immunisation are identified as public health targets to prevent poor lung function pathways.
Doctors and patients with asthma should be made aware of the potential long-term implications of non-optimal asthma control throughout life, and this should be investigated in future research.” In the first study, 2438 participants from the Tasmanian Longitudinal Health Study (Australia) were tracked from childhood to the age of 53 – making it the largest and longest-running study of its kind.While smoking remains the biggest risk factor for COPD, the study demonstrates that childhood illnesses (such as asthma, bronchitis, pneumonia, allergic rhinitis, eczema) and exposures to parental smoking are also linked to the disease.These pathways are associated with exposures in childhood, and amplified by factors in adulthood, according to a cohort study published in The Lancet Respiratory Medicine journal.The authors say that these insights are important for lung disease prediction, prevention, and treatment.“These findings highlight the importance of preventing both early life adverse exposures that could lead to poorer lung growth, and adult risk factors contributing to accelerated lung decline.COPD is expected to be the third largest cause of death globally by 2030, and it is important that we identify its key causes so that this burden can be reduced,” says study author Professor Shyamali Dharmage, School of Population and Global Health, The University of Melbourne, Australia.Lung function was measured at the ages of 7, 13, 18, 45, 50 and 53 years old, and participants’ exposure to various risk factors was also recorded.The authors identified six distinct pathways describing how lung function changes with age .They suggest that interventions to maximise lung growth in early childhood might modify the risk of COPD in older age.Writing in a linked Comment, Professor Erika von Mutius, Dr von Hauner Children’s Hospital, Ludwig Maximilians University, Germany, said: “Chronic obstructive pulmonary disease (COPD) is a common condition in adults, with high morbidity and mortality.Most people who develop COPD are older with a history of smoking. The following cases are designed to help you learn how to interpret pulmonary function tests.