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Allergy. 2010 Aug;65(8):1021-30. doi: 10.1111/j.1398-9995.2009.02301.x. Epub 2010 Feb 4.

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

Author information

1
Centre for Research in Environmental Epidemiology (CREAL), Barcelona. jmanto@creal.cat

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), FEV(1) < 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.

[Indexed for MEDLINE]

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