Risk factors of new-onset asthma in adults: A population-based international cohort study

J. M. Antó, J. Sunyer, X. Basagaña, R. Garcia-Esteban, I. Cerveri, R. De Marco, J. Heinrich, C. Janson, D. Jarvis, M. Kogevinas, N. Kuenzli, B. Leynaert, C. Svanes, M. Wjst, T. Gislason, P. Burney

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Abstract

Background: The occurrence of new-onset asthma during adulthood is common, but there is insufficient understanding of its determinants including the role of atopy. Objective: To assess the risk factors for the development of new-onset asthma in middle-aged adults and to compare them according to atopy. Methods: A longitudinal analysis of 9175 young adults who participated in two surveys of the European Community Respiratory Health Survey (ECRHS) conducted 9 years apart. Findings: We observed 179 cases of new-onset asthma among 4588 participants who were free of asthma and reported at the beginning of the follow-up that they had never had asthma (4.5 per 1000 person-years). In a logistic regression, the following risk factors were found to increase the risk of new-onset asthma: female gender (OR: 1.97; 95% confidence interval (CI): 1.38,2.81), bronchial hyperresponsiveness (3.25; 2.19,4.83), atopy (1.55;1.08,2.21), FEV1 <100 % predicted (1.87;1.34,2.62), nasal allergy (1.98;1.39,2.84) and maternal asthma (1.91;1.13;3.21). Obesity, respiratory infections in early life and high-risk occupations increased the risk of new-onset asthma although we had limited power to confirm their role. Among the atopics, total IgE and sensitization to cat were independently related to the risk of new-onset asthma. The proportion of new-onset asthma attributable to atopy varied from 12% to 21%. Conclusion: Adults reporting that they had never had asthma were at a substantial risk of new-onset asthma as a result of multiple independent risk factors including lung function. Atopy explains a small proportion of new-onset adult asthma.

Original languageEnglish
Pages (from-to)1021-1030
Number of pages10
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume65
Issue number8
DOIs
Publication statusPublished - 2010

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Keywords

  • asthma
  • atopy
  • bronchial hyperresponsiveness
  • ECRHS
  • environment
  • lung function
  • respiratory symptoms

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy
  • Medicine(all)

Cite this

Antó, J. M., Sunyer, J., Basagaña, X., Garcia-Esteban, R., Cerveri, I., De Marco, R., Heinrich, J., Janson, C., Jarvis, D., Kogevinas, M., Kuenzli, N., Leynaert, B., Svanes, C., Wjst, M., Gislason, T., & Burney, P. (2010). Risk factors of new-onset asthma in adults: A population-based international cohort study. Allergy: European Journal of Allergy and Clinical Immunology, 65(8), 1021-1030. https://doi.org/10.1111/j.1398-9995.2009.02301.x