Childhood infections linked to risk of adult death from respiratory disease
Respiratory infections contracted during early childhood are associated with an increased risk in death from respiratory illness between the ages of 26 and 73 years, according to a new study published in The Lancet.
This study, which spans eight decades, suggests that although the overall number of premature deaths from respiratory disease was small, people who had a lower respiratory tract infection (LRTI), such as bronchitis or pneumonia, by the age of two were 93% more likely to die prematurely from respiratory disease as adults, regardless of socioeconomic background or smoking status.
This could potentially account for one in five premature deaths from respiratory disease in England and Wales between 1972 and 2019 (179,188 out of 878,951 deaths).
Infant LRTIs have been shown to be linked to the development of adult lung function impairments, asthma, and chronic obstructive pulmonary disease, but it was previously unclear if there exists a link to premature death in adulthood. The new research is the first lifetime-spanning study on this topic.
‘Current preventative measures for adult respiratory disease mainly focus on adult lifestyle risk factors such as smoking,” said lead author Dr James Allinson of Imperial College London. ‘Linking one in five of adult respiratory deaths to common infections many decades earlier in childhood shows the need to target risk well before adulthood.
‘To prevent the perpetuation of existing adult health inequalities we need to optimise childhood health, not least by tackling childhood poverty. Evidence suggesting the early life origins of adult chronic diseases also helps challenge the stigma that all deaths from diseases such as COPD are related to lifestyle factors’.
The study used data from a nationwide British cohort which recruited individuals at birth in 1946, and looked at health and death records up to 2019. Of the 3,589 study participants, 25% had an LRTI before the age of two. By the end of 2019, 19% of participants had died before the age of 73 years old. Among these 674 premature adult deaths, 8% of participants died from respiratory disease, mostly COPD.
Analysis adjusting for socioeconomic background during childhood and smoking status suggests children who had an LRTI by the age of two were 93% more likely to die prematurely as adults from respiratory disease, than children who had not had a LRTI by age two.
This equates to a 2.1% rate of premature adult death from respiratory disease among those who had a LRTI in early childhood, compared to 1.1% among those who did not report a LRTI before the age of two.
Having an LRTI before the age of two was only associated with an increased risk of premature death from respiratory diseases, and not other illnesses, such as heart disease or cancers.
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