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Assessment of chronic bronchitis and risk factors in young adults: Results from BAMSE

Gang Wang, Jenny Hallberg, Petra Um Bergström, Christer Janson, Göran Pershagen, Olena Gruzieva, Marianne van Hage, Antonios Georgelis, Anna Bergström, Inger Kull, Anders Lindén, Erik Melén
European Respiratory Journal 2020; DOI: 10.1183/13993003.02120-2020
Gang Wang
1Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Sichuan, China
2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
3Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
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Jenny Hallberg
3Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
4Sachs’ Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
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Petra Um Bergström
3Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
4Sachs’ Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
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  • ORCID record for Petra Um Bergström
Christer Janson
5Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Sweden
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Göran Pershagen
2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
6Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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Olena Gruzieva
2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
6Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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Marianne van Hage
7Division of Immunology and Allergy, Department of Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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Antonios Georgelis
2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
6Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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Anna Bergström
2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
6Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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Inger Kull
2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
3Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
4Sachs’ Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
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Anders Lindén
2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
8Department of Respiratory Medicine and Allergy, Karolinska University Hospital Solna, Stockholm, Sweden
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Erik Melén
2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
3Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
4Sachs’ Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
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Abstract

Background Chronic bronchitis is associated with substantial morbidity among elderly adults, but little is known about its prevalence and risk factors in young adults. Our aim was to assess the prevalence and early life risk factors for chronic bronchitis in young adults.

Methods Questionnaire data and clinical measures from the 24-year follow-up of the Swedish BAMSE cohort were used. We assessed chronic bronchitis (CB) as the combination of cough and mucus production in the morning during winter. Environmental and clinical data from birth and onwards were used for analyses of risk factors.

Results At the 24-year follow-up, 75% (n=3064) participants completed the questionnaire and 2030 performed spirometry. The overall prevalence of CB was 5.5% (n=158) with similar estimates in males and females. Forty-nine percent of CB cases experienced more than 3 self-reported respiratory infections in the last year compared to 18% in non-CB subjects (p<0.001), and 37% of cases were current smokers (versus 19%). Statistically significant lower post-FEV1/FVC were observed in CB compared to non-CB subjects (mean z-score −0.06 versus 0.13, p=0.027). Daily smoking (adjusted Odds Ratio, aOR=3.85, p<0.001), air pollution exposure (black carbon during ages 1–4 years old, aOR=1.71 per 1 μg·m3 increase, p=0.009) and exclusive breast-feeding during four months or more (aOR=0.66, p=0.044) were associated with CB.

Conclusion Chronic bronchitis in young adults is associated with recurrent respiratory infections. Besides smoking, our results support role of early life exposures, such as air pollution and exclusive breast-feeding, for respiratory health later in life.

Footnotes

This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Wang has nothing to disclose.

Conflict of interest: Dr. Hallberg has nothing to disclose.

Conflict of interest: Dr. Bergström has nothing to disclose.

Conflict of interest: Dr. Janson has nothing to disclose.

Conflict of interest: Dr. Pershagen has nothing to disclose.

Conflict of interest: Dr. Gruzieva has nothing to disclose.

Conflict of interest: Dr. van Hage reports personal fees from Thermo Fisher Scientific and ALK, outside the submitted work.

Conflict of interest: Dr. Georgelis has nothing to disclose.

Conflict of interest: Dr. Bergström has nothing to disclose.

Conflict of interest: Dr. Kull has nothing to disclose.

Conflict of interest: Dr. Lindén has nothing to disclose.

Conflict of interest: Dr. Melén has nothing to disclose.

This is a PDF-only article. Please click on the PDF link above to read it.

  • Received June 2, 2020.
  • Accepted September 11, 2020.
  • Copyright ©ERS 2020
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Assessment of chronic bronchitis and risk factors in young adults: Results from BAMSE
Gang Wang, Jenny Hallberg, Petra Um Bergström, Christer Janson, Göran Pershagen, Olena Gruzieva, Marianne van Hage, Antonios Georgelis, Anna Bergström, Inger Kull, Anders Lindén, Erik Melén
European Respiratory Journal Jan 2020, 2002120; DOI: 10.1183/13993003.02120-2020

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Assessment of chronic bronchitis and risk factors in young adults: Results from BAMSE
Gang Wang, Jenny Hallberg, Petra Um Bergström, Christer Janson, Göran Pershagen, Olena Gruzieva, Marianne van Hage, Antonios Georgelis, Anna Bergström, Inger Kull, Anders Lindén, Erik Melén
European Respiratory Journal Jan 2020, 2002120; DOI: 10.1183/13993003.02120-2020
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