Is COPD Risk Determined During Childhood?

There is no question that tobacco smoking is the biggest risk factor in the development of COPD. However, two new retrospective studies published in the Lancet medical journal have found that as many as 75% of COPD cases may have originated with poor lung function pathways that began in childhood. Exposure to the following childhood illnesses and environments may further amplify risk factors as an adult:

• Asthma
• Bronchitis
• Pneumonia
• Nasal allergies
• Eczema
• Regular exposure to second hand smoke

Lung function can change over the course of life, but taking steps to reduce these threats during childhood might improve the degree of risk during adulthood. Identifying key causes of lung dysfunction can be important in terms of prevention and treatment in the future.

The Tasmanian Longitudinal Health Study

This study, conducted by Australian researchers, tracked 2438 participants from childhood to the age of 53. Here are the details of the study:

• Lung function was measured at the ages of 7, 13, 18, 45, 50 and 53 years old
• Exposure to various risk factors was recorded throughout
• Six distinct pathways of lung function changes over time were tracked
• 75.3% of all COPD cases were linked to 3 of the 6 pathways
• The same 3 pathways were linked to participants who had childhood asthma, bronchitis, pneumonia, allergic rhinitis, eczema, parents having asthma or smoking, or who had smoked themselves

According to one commentator, these findings might help explain why only 20 to 25% of smokers end up with COPD, while the rest do not. It could also be a partial answer as to why some people with no history of smoking develop COPD.

The authors of the study encourage measures aimed at reducing parental smoking and increasing immunization. Smoking should also be discouraged in all adults, but especially those who have some of the childhood risk factors mentioned above. Adequate asthma treatment for all people with asthma is also important in lowering future risk for COPD.

The researchers acknowledge that the study would be more meaningful had it followed participants past the age of 53. Most COPD is diagnosed after the age of 60. Therefore, tracking lung function pathways later into participants' lives may have given a clearer picture of their COPD risk later in their lives.

Second Unnamed Study

In a second study, also published in the same issue of Lancet, researchers tracked and measured lung function in 2632 participants from birth to age 24. Here are some additional details on this study:

• Slightly less than half the participants were aged 5 to 16
• The rest were aged 8 to 24
• Found that those who'd had issues with poor lung function during the first 6 months of life did improve throughout childhood into young adulthood

Their evidence seems to support the findings in the other study. These researchers also recommend that early intervention with lung function problems during childhood may reduce the risk of COPD down the road.

In Summary

These comprehensive, long-range studies do suggest that risk for COPD may begin in childhood. Lung function develops throughout life. The changes that happen as we age may be influenced by how healthy our lungs were early in life. So, it makes sense that focusing efforts on education and improvements to access of health care in childhood can improve lung function outcomes throughout our lifespans.