Abstract
There is a lack of knowledge to which extent heredity or familial risk factors are involved in the development of chronic bronchitis/emphysema (CBE). Smoking is regarded as the most important risk factor, but only about 15% of smokers develop airway obstruction. We evaluated the importance of familial risk factors compared to smoking and ex-smoking using an epidemiological approach. In 1992, a postal questionnaire was distributed to a study sample. In all, 43 questions were asked, in a previously evaluated questionnaire, regarding respiratory symptoms, self-reported lung diseases, smoking habits and familial occurrence of chronic bronchitis and asthma. The questionnaire was sent to 12,073 adults living in the southernmost part of Sweden. The age range was 20–59 years with an equal gender distribution. The study sample was drawn from the population records. The questionnaire was answered by 8469 subjects (70.1%), of whom 392 subjects (4.6%) stated that they had or had had CBE and 469 subjects (5.5%) stated that they had or had had asthma. In a model with logistic regression using the five explanatory variables gender, age, familial occurrence for asthma, familial occurrence for CBE and current or ex-smoking the most important risk factors for CBE were familial occurrence for chronic bronchitis [Odds ratios (OR): 5.19, 95% confidence interval (CI): 4.09–6.60, p = 0.000] and current or ex-smoking (OR: 1.74, 95% CI: 1.41–2.14, p = 0.000). The most important risk factors for asthma were familial occurrence for asthma (OR: 3.71, 95% CI: 3.06–4.51, p = 0.000) and current or ex-smoking (OR: 1.33, 95% CI: 1.09–1.61, p = 0.004). We have found that familial occurrence for CBE in first degree relatives together with smoking is a stronger risk factor for the development of CBE than is smoking.
Similar content being viewed by others
References
Sherman CB. The health consequences of cigarette smoking. Pulmonary diseases. Medical clinics of North America 1992; 76: 355–375.
Stato GW, Ingram RH. Chronic obstructive disease of the lung. Scientific Am 1994; 14: 1–25.
Fletcher C, Peto R. The natural history of chronic airflow obstruction. Br Med J 1977; 1: 1645–1648.
Edfors-Bubs ML. Allergy in 7000 twin pairs. Acta Allergol 1971; 26: 249–285.
Sandford AJ, Weir TD, Paré PD. The genetics of asthma. Am J Resp Crit Care Med 1996; 153: 1749–1765.
Sibbald B, Horn ME, Gregg I. A family study of the genetic basis of asthma and wheezy bronchitis. Arch Dis Child 1980; 55: 354–357.
Bleecker ER, Postma DS, Meyers DA. Evidence for multiple genetic susceptibility loci for asthma. Am J Resp Crit Care Med 1997; 156: S113-S117.
Laurell C, Eriksson S. The electrophoretic alpha-1-globulin pattern of serum in alpha-1-antitrypsin deficiency. Natural history and life expectancy in severe alpha-1-antitrypsin deficiency. Scand J Clin Lab Invest 1963; 15: 132–140.
Larson RK, Barman ML, Kueppers F, Fudenberg HH. Genetic and environmental determinants of chronic obstructive pulmonary disease. Ann Intern Med 1970; 72: 627–632.
Sandford AJ, Weir TD, Paré PD. Genetic risk factors for chronic obstructive pulmonary disease. Eur Resp J 1997; 10: 1380–1391.
Higgins M, Keller J. Familial occurrence of chronic respiratory disease and familial resemblance in ventilatory capacity. J Chron Dis 1975; 28: 239–251.
Khoury MJ, Beaty TH, Newill CA, Bryant S, Cohen BH. Genetic-environmental interactions in chronic airways obstruction. Int J Epidemiol 1986; 15(1): 65–72.
Madison R, Zelman R, Mittman C. Inherited risk factors for chronic lung disease. Chest 1980; 77(Suppl 2): 255–257.
Cohen BH, Diamond EL, Graves CG, et al. A common familial component in lung cancer and chronic obstructive pulmonary disease. Lancet 1977; ii: 523–526.
Tager I, Tishler PV, Rosner B, Speizer FE, Litt M. Studies of the familial aggregation of chronic bronchitis and obstructive airways disease. Int J Epidemiol 1978; 7: 55–62.
Speizer FE, Rosner B, Tager I. Familial aggregation of chronic obstructive respiratory disease: Use of national health interview survey data for specific hypothesis testing. Int J Epidemiol 1976; 5: 167–172.
Kueppers F, Miller RD, Gordon H, Hepper NG, Offord K. Familial prevalence of chronic obstructive pulmonary disease in a matched pair study. Am J Med 1977; 63: 2336–2342.
Webster PM, Lorimer EG, Man SF, Woolf CR, Zamel N. Pulmonary function in identical twins: Comparison of nonsmokers and smokers. ARRD 1979; 119: 223–228.
McClearn GE, Svartengren M, Pedersen NL, Heller DA, Plomin R. Genetic influences pulmonary function in ageing Swedish twins. J Gerontol 1994; 49: 264–268.
Chatterjee S, Das N. Lung function in Indian twin children: Comparison of genetic versus environmental influence. Ann hum Biol 1995; 22: 289–303.
Montnémery P, Ädelroth E, Heuman K, et al. Prevalence of obstructive lung diseases and respiratory symptoms in southern Sweden. Respir Med 1998; 92: 1337–1345.
Lundbäck B, Nyström L, Rosenhall L, Stjernberg N. Obstructive lung disease in northern Sweden: Respiratory symptoms assessed in a postal survey. Eur Respir J 1991; 4: 257–266.
Standardized questionnaires on respiratory symptoms. Br Med J 1960; 3: 1665.
Stato GWm Ingram Rh. Chronic obstructive diseases of the lung. Sci Am 1995; 14: 1–25.
Burrows B, Knudson RJ, Cline MG, Lebowitz D. Quantitative relationships between cigarette smoking and ventilatory function. Am Rev Respir Dis 1977; 115: 195–205.
Cederlof R, Edfors M-L, Friberg L, Jonsson E. Heriditary factors, “spontaneous cough”. Arch Environ Health 1967; 14: 401–406.
Tager IB, Weiss ST, Munoz A, Rosner B, Speizer FE. Longitudinal study of the effects of maternal smoking on pulmonary function in children. N Engl J Med 1983; 309: 699–703.
Magnus P, Jaakkola JJ. Secular trend in the occurrence of asthma among children and young adults: Critical appraisal of repeated cross sectional surveys. Br Med J 1997; 314(7097): 1795–1799.
Bai Y, Sherman S, Khoury MJ, Flanders WD. Bias associated with study protocols in epidemiologic studies of disease familial aggregation. Am J Epidemiol 2000; 151(9): 927–937.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Montnémery, P., Lanke, J., Lindholm, LH. et al. Familial related risk-factors in the development of chronic bronchitis/emphysema as compared to asthma assessed in a postal survey. Eur J Epidemiol 16, 1003–1007 (2000). https://doi.org/10.1023/A:1011004420173
Issue Date:
DOI: https://doi.org/10.1023/A:1011004420173