A study, led by researchers from Imperial College London and published in The Lancet, has found that children who had a lower respiratory tract infection (LRTI), such as bronchitis or pneumonia, by the age of two were almost twice as likely to die prematurely in adulthood from respiratory diseases. The research showed the rate of premature death from respiratory disease was about 2% for those who had a LRTI in early childhood, compared to around 1% for those who did not. The findings remained after adjusting for socioeconomic factors and smoking status.
Chronic respiratory diseases are a major public health problem, accounting for an estimated 3.9 million deaths, or 7 per cent of all deaths worldwide, in 2017. Most of these deaths were caused by chronic obstructive pulmonary disease (COPD) – a group of lung conditions that cause breathing difficulties, such as emphysema and chronic bronchitis.
Previous research has linked infant LRTIs to the development of adult lung function impairments, asthma, and COPD, but it has been unclear if there is also a link to premature death in adulthood. This first-of-its-kind study spans more than 73 years and provides the best evidence to date that early respiratory health has an impact on mortality later in life.
The findings challenge the misconception that adult deaths from respiratory diseases are determined only by behavior in adulthood, such as smoking. The researchers say that this highlights the need to prevent childhood respiratory infection and improve the health of children, through targeted public health measures and health service interventions, such as vaccination, improving living conditions, and better diagnosis and treatment of underlying health conditions.
Dr. James Allinson, lead author for the study, from the National Heart & Lung Institute at Imperial College London, said, “Current preventative measures for adult respiratory disease mainly focus on adult lifestyle risk factors such as smoking. Linking one in five adult respiratory deaths to common infections many decades earlier in childhood shows the need to target risk well before adulthood.
“To prevent the perpetuation of existing adult health inequalities we need to optimize childhood health, not least by tackling childhood poverty. Evidence suggesting the early life origins of adult chronic diseases also helps challenge the stigma that all deaths from diseases such as COPD are related to lifestyle factors.”
Professor Rebecca Hardy, co-author for the study, from University College London and Loughborough University, said, “The results of our study suggest that efforts to reduce childhood respiratory infections could have an impact on tackling premature mortality from respiratory disease later in life. We hope that this study will help guide the strategies of international health organisations in tackling this issue.”
