The Journal of Allergy and Clinical Immunology
Volume 122, Issue 2 , Pages 280-285, August 2008

Childhood eczema and asthma incidence and persistence: A cohort study from childhood to middle age

  • John A. Burgess, MBBS, FRACP, MEpid

      Affiliations

    • Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Carlton, Australia
    • Corresponding Author InformationReprint requests: John A. Burgess, MBBS, FRACP, MEpid, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Level 1, 723 Swanston Street, Carlton, Victoria 3053 Australia.
    • ,
  • Shyamali C. Dharmage, MBBS, MD, MSc, PhD

      Affiliations

    • Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Carlton, Australia
    • ,
  • Graham B. Byrnes, BSc (Hons), PhD

      Affiliations

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

      Affiliations

    • Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Carlton, Australia
    • ,
  • Lyle C. Gurrin, BSc (Hons), PhD, AStat

      Affiliations

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

      Affiliations

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

      Affiliations

    • Respiratory Research Group, Menzies Research Institute, University of Tasmania, Hobart, Australia
    • ,
  • Michael J. Abramson, MBBS, BMedSc (Hons), FRACP, PhD, FAFPHM

      Affiliations

    • Department of Epidemiology and Preventive Medicine, Monash University, The Alfred, Melbourne, Australia
    • ,
  • John L. Hopper, BSc, MSc, PhD, BA

      Affiliations

    • Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Carlton, Australia
    • ,
  • E. Haydn Walters, MA, DM, FRCP, FRACP

      Affiliations

    • Respiratory Research Group, Menzies Research Institute, University of Tasmania, Hobart, Australia

Received 19 September 2007; received in revised form 1 May 2008; accepted 5 May 2008. published online 24 June 2008.

Background

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

Objectives

To examine the association between childhood eczema and asthma incidence from preadolescence to middle age, and between childhood eczema and asthma persisting to middle age. A further aim was to examine any effect modification by nonallergic childhood exposures on the association between childhood eczema and both childhood asthma and later life incident asthma.

Methods

Data were gathered from the 1968, 1974, and 2004 surveys of the Tasmanian Longitudinal Health Study. Multivariable logistic regression examined the association between childhood eczema and childhood asthma. Cox regression examined the association between childhood eczema and asthma incidence in preadolescence, adolescence, and adult life. Binomial regression examined the association between childhood eczema and childhood asthma persisting to age 44 years.

Results

Childhood eczema was significantly associated with childhood asthma and with incident asthma in preadolescence (hazard ratio [HR], 1.70; 95% CI, 1.05-2.75), adolescence (HR, 2.14; 95% CI, 1.33-3.46), and adult life (HR, 1.63; 95% CI, 1.28-2.09). Although childhood eczema was significantly associated with asthma persisting from childhood to middle age (relative risk, 1.54; 95% CI, 1.17-2.04), this association was no longer evident when adjusted for allergic rhinitis.

Conclusion

Childhood eczema increased the likelihood of childhood asthma, of new-onset asthma in later life and of asthma persisting into middle age.

Key words: Childhood eczema, incident asthma, persisting asthma

Abbreviations used: AD, Atopic dermatitis, OR, Odds ratio, TAHS, Tasmanian Longitudinal Health Study

 

 The Tasmanian Longitudinal Health Study is supported by grants from the National Health and Medical Research Council of Australia, the Victorian and Tasmanian Asthma Foundations, the Clifford Craig Medical Research Trust, and the Royal Hobart Hospital Research Foundation. J.A.B. is supported by a Research Scholarship from the University of Melbourne. G.B.B., M.C.M., J.L.H., and S.C.D. are supported by the National Health and Medical Research Council of Australia.

 Disclosure of potential conflict of interest: S. C. Dharmage has received research support from the National Health Medical Research Council, the Asthma Foundation, and the Ilhan Allergy Foundation. M. J. Abramson has served as a member of the Australian Lung Foundation. E. H. Walters has received research support from the National Health Medical Research Council, GlaxoSmithKline, and the Royal Hobart Research Foundation. The rest of the authors have declared that they have no conflict of interest.

PII: S0091-6749(08)00954-8

doi:10.1016/j.jaci.2008.05.018

The Journal of Allergy and Clinical Immunology
Volume 122, Issue 2 , Pages 280-285, August 2008