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Eur Respir J 2003; 21:462-467
Copyright ©ERS Journals Ltd 2003


Long-term mortality among adults with or without asthma in the PAARC study

S. Vandentorren1, I. Baldi1, I. Annesi Maesano2, D. Charpin3, F. Neukirch4, L. Filleul1, A. Cantagrel1 and J.F. Tessier1

1 Laboratory of Occupational and Environmental Health, Victor Segalen Bordeaux 2 University, Bordeaux, 2 National Institute of Health and Medical Research U472, Villejuif, 3 Marseille University Hospital, Marseille and 4 National Institute of Health and Medical Research U408, Paris, France

CORRESPONDENCE: S. Vandentorren, Laboratoire Santé Travail Environnement, Université de Bordeaux 2, Institut de Santé Publique, d'Epidémiologie et de Développement, 146, rue Léo Saignat, 33076, Bordeaux Cedex, France. Fax: 33 557571698. E-mail: stephanie.vandentorren@isped.u-bordeaux2.fr

Keywords: asthma, cohort study, lung function, mortality, smoking

Received: April 12, 2002
Accepted October 21, 2002

This study was supported by the Programme de Recherche Interorganisme pour une Meilleure Qualité de l'Air à l'Achelle Locale (a governmental programme for improving air quality) - PREDIT programme and by the Association de Prévention contre la Pollution Atmosphérique (all government environmental departments, Paris, France).

The Pollution Atmosphérique et Affections Respiratoires Chroniques (PAARC; Air Pollution and Chronic Respiratory Diseases) study provided the opportunity to examine the 25-yr mortality of 940 asthmatic adults drawn from a large population-based sample of 14,267 adults investigated during 1974–1976 in seven French cities.

Vital statistics were collected in 2001 for the whole population. Multivariate survival analysis was used to assess exact survival rates in asthmatics and nonasthmatics taking relevant confounders into account.

On average, the mortality rates obtained were 10.4 and 6.9 deaths·1,000 person-yrs–1 in asthmatics and nonasthmatics, respectively. On univariate analysis, asthma increased the relative risk (RR) of death by 1.48 (95% confidence interval (CI) 1.29–1.69). The association between asthma and death had an RR of 1.16 (95% CI 0.99–1.37) when age, sex, educational level, smoking habits, occupational exposure and forced expiratory volume in one second (FEV1) were taken into account. FEV1 was an important contributive factor causing increased risk of death in both smokers and nonsmokers. For instance, in asthmatics, the numbers of deaths due to respiratory disease and cancer appeared excessive.

The present study suggests that asthmatics exhibit a higher risk of mortality.




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