Background: COPD is an important cause of morbidity and mortality worldwide. Although cigarette and biomass smoke are major risk factors, additional factors appear to be important. Studies tracking early-life lung function suggest that children who experience viral associated wheezing should be at risk of COPD as adults, however this needs to be shown.
Aims: To relate categories of wheeze assigned at 10 years of age to COPD and lung function decline in the 6th decade.
Methods: The WHEASE (What Happens Eventually to Asthmatic children: Sociologically and Epidemiologically) cohort was recruited in 1964, participants were randomly selected Aberdeen schoolchildren aged 10-15 years (n=2511), categorised into wheezing phenotypes: childhood asthma (CA), childhood wheezy bronchitis (CWB) and non-wheezing controls. The cohort was reassessed by questionnaire and spirometry in 1989, 1994, 2001 and 2014. COPD was defined as post-bronchodilator FEV1/FVC ratio<0.7.
Results: 330 cohort members took part in WHEASE 2014, mean age 61yrs, 52% male. There were 38 with CA, 53 with CWB and 239 non-childhood wheeze controls. In multivariate cross-sectional analysis CA adults were more likely to have COPD (OR 4.14, 95% CI 1.63-10.53, p=0.003), and CWB had a non-significant increase in COPD (1.33, 0.66-2.66, p=0.426). In multivariate longitudinal analysis of 1989, 1994, 2001 and 2014 data, both CA (8.23, 4.20-16.1) and CWB (1.69, 1.01-2.82) adults were independently more likely to have COPD. No difference across wheeze groups was found in the rate of FEV1 decline in 1989-2014, but CA and CWB groups had reduced FEV1 from the outset.
Conclusions: Childhood wheezing illness appears to be associated with an increased risk of COPD in adult life.