The Journal of Allergy and Clinical Immunology
Volume 120, Issue 4 , Pages 863-869, October 2007

Childhood allergic rhinitis predicts asthma incidence and persistence to middle age: A longitudinal study

  • John A. Burgess, MEpid

      Affiliations

    • Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Melbourne, Australia
    • Corresponding Author InformationReprint requests: John A. Burgess, MEpid, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, the University of Melbourne, Level 2, 723 Swanston St, Carlton, Victoria 3053, Australia.
  • ,
  • E. Haydn Walters, DM

      Affiliations

    • Respiratory Research Group, Menzies Research Institute, University of Tasmania, Hobart, Australia
  • ,
  • Graham B. Byrnes, PhD

      Affiliations

    • Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Melbourne, Australia
  • ,
  • Melanie C. Matheson, PhD

      Affiliations

    • Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Melbourne, Australia
  • ,
  • Mark A. Jenkins, PhD

      Affiliations

    • Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Melbourne, Australia
  • ,
  • Cathryn L. Wharton, BApplSci

      Affiliations

    • Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Melbourne, Australia
  • ,
  • David P. Johns, PhD

      Affiliations

    • Respiratory Research Group, Menzies Research Institute, University of Tasmania, Hobart, Australia
  • ,
  • Michael J. Abramson, PhD

      Affiliations

    • Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
  • ,
  • John L. Hopper, PhD

      Affiliations

    • Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Melbourne, Australia
  • ,
  • Shyamali C. Dharmage, PhD

      Affiliations

    • Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Melbourne, Australia

Received 6 March 2007; received in revised form 5 June 2007; accepted 17 July 2007. published online 10 September 2007.

Background

The association between allergic rhinitis and asthma is well documented, but the temporal sequence of this association has not been closely examined.

Objective

We sought to assess the associations between childhood allergic rhinitis and (1) asthma incidence from preadolescence to middle age and (2) asthma persistence to middle age.

Methods

Data were gathered from the 1968, 1974, and 2004 surveys of the Tasmanian Asthma Study. Cox regression was used to examine the association between childhood allergic rhinitis and asthma incidence in preadolescence, adolescence, and adult life. Binomial regression was used to examine the association between childhood allergic rhinitis and asthma beginning before the age of 7 years and persisting at age 44 years.

Results

Childhood allergic rhinitis was associated with a significant 2- to 7-fold increased risk of incident asthma in preadolescence, adolescence, or adult life. Childhood allergic rhinitis was associated with a 3-fold increased risk of childhood asthma persisting compared with remitting by middle age.

Conclusions

Childhood allergic rhinitis increased the likelihood of new-onset asthma after childhood and the likelihood of having persisting asthma from childhood into middle age.

Clinical implications

Asthma burden in later life might be reduced by more aggressive treatment of allergic rhinitis in early life.

Key words: Childhood allergic rhinitis, incident asthma, persisting asthma, effect modification

Abbreviations used: ARR, Adjusted relative risk, TAS, Tasmanian Asthma Study

 

 The Tasmanian Asthma Study is supported by grants from the National Health and Medical Research Council of Australia, the Asthma Foundations of Victoria and Tasmania, the Clifford Craig Medical Research Trust, and the Royal Hobart Hospital Research Foundation. John Burgess is supported by a Research Scholarship from the University of Melbourne. Graham Byrnes, Melanie Matheson, John Hopper, and Shyamali Dharmage are supported by the National Health and Medical Research Council of Australia.

 Disclosure of potential conflict of interest: M. J. Abramson has consulting arrangements with the Australian Asthma Study, which was sponsored by GlaxoSmithKline; received an honorarium from Boehringer Ingelheim for a presentation at Airways 2006; and received travel support from AstraZeneca. The rest of the authors have declared that they have no conflict of interest.

PII: S0091-6749(07)01392-9

doi:10.1016/j.jaci.2007.07.020

The Journal of Allergy and Clinical Immunology
Volume 120, Issue 4 , Pages 863-869, October 2007