Childhood Exposures and COPD Risk
It appears what happens at home during the formative years influences the development and severity of lifelong health problems including Chronic Obstructive Pulmonary Disease (COPD).1 That’s the finding from investigators examining the impact on adult health status from childhood maltreatment (CM). Studies are looking at whether diseases in adulthood could originate from childhood adversities.2 From independent pediatrician reports to retrospective data analyses of Adverse Childhood Experience (ACE) scores against reported health outcomes; it appears that childhood adversity, can affect adult physical health. Stress, asthma and other traumatic childhood experiences can contribute to the risk of developing COPD as an adult.1
COPD is a group of debilitating and degenerative lung conditions including emphysema and chronic bronchitis.2 It is responsible for the significant presence of illness (morbidity) and cause of death factors (mortality) in the United States.
COPD is typically caused by cigarette smoking, accounting for approximately 80%–90% of cases.2 Environmental factors including industrial and toxic exposure to dust, exhaust fumes, exposure to secondhand smoke, and air pollution may also contribute to the development and prognosis of COPD.2 Medicine has limited information on the influence of childhood stressors on the eventual development of COPD.
Childhood maltreatment is associated with several physical, chronic conditions in adulthood including smoking – the primary underlying cause of COPD. It is also related to starting smoking at an early age, and heavier and long-term smoking, all of which can elevate the risk for, and severity of, COPD.2 But early smoking is not the only risk; mental health and substance abuse problems have also been shown to contribute to COPD risk.1,2,3
Adverse Childhood Experiences (ACEs)
Two studies report similar correlations between childhood events and eventual health outcomes. One was conducted by the Kaiser Foundation Health Plan and the Centers for Disease Control (CDC) and another was a population-based survey of Canadian adults.1,2 They looked at different kinds of abuse including physical, emotional or sexual; physical or emotional neglect, familial mental illness, substance abuse, incarceration, parental separation, and divorce or episodes of domestic violence. Researchers examined ACE scores against health outcomes.1
The Kaiser study looked at more than 15,000 adult HMO members who were enrolled in the Adverse Childhood Experiences (ACE) Study from 1995 to 1997 and were then eligible for the prospective phase; meaning they were children in the 90’s and are presently adults. The Canadian study used a large sample of the Canadian adult population based on the 2012 Canadian Community Health Survey – Mental Health (CCHS-MH). It collected data on over 25,000 people in each household age 15 or older living in the Canadian provinces.2
A dose-response relationship
Two notable outcomes were the high incidence of adverse childhood experiences across the populations and that the incidence of a high “dose-response relationship” between negative childhood events and adult health. Elevated ACE scores equated to poorer adult health outcomes.1,2,3 Some gender differences have also been noted. Females who experienced significant childhood maltreatment appear to suffer from greater respiratory damage due to smoking or exposure to second-hand smoke than do males.2 One note, perhaps accounting for some of these differences, is the increased likelihood of female reporting of their negative childhood experiences.2
Further investigation may help
Years after experiencing ACEs, there remain increased risks for developing COPD, even in non-smokers. This raises the question of what to do about the impact of ACEs on developing lung conditions and other poor health outcomes. Early identification of at-risk populations combined with improved school and physician education could help to counter the ill effects on later physical health. Further investigation and the development of evaluation tools may help raise awareness and lead to improved health outcomes in the future.
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