Childhood infection ‘linked to risk of respiratory disease death as an adult’

Contracting a respiratory infection such as bronchitis or pneumonia during childhood is associated with a higher risk of death from a respiratory illness as an adult, research suggests.

Children who had a lower respiratory tract infection (LRTI) by the age of two were almost twice as likely to die prematurely between the ages of 26 and 73 years from respiratory diseases, the study suggests.

This was regardless of socioeconomic factors and smoking status, researchers said.

Although the overall number of premature deaths from respiratory disease was small, people who had an LRTI by the age of two were 93% more likely to die prematurely from respiratory disease as adults.

According to the study, which looked at data from 3,589 people over the age of 73, 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).

The findings suggest efforts to reduce childhood respiratory infections could have an impact on tackling premature mortality from respiratory disease later in life.

Study lead author Dr James Allinson, from Imperial College London, said: “Current preventative measures for adult respiratory disease mainly focus on adult lifestyle risk factors such as smoking.

“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 (chronic obstructive pulmonary disease) are related to lifestyle factors.”

Researchers say chronic respiratory diseases pose a major public health problem, with an estimated 3.9 million deaths in 2017, accounting for 7% of all deaths worldwide.

A previous study suggested that COPD caused most of these deaths.

The study, published in The Lancet, used data from a nationwide British cohort which recruited people at birth in 1946, and looked at health and death records up to the year 2019.

Of the 3,589 people in the study, 25% (913/3,589) had an LRTI before the age of two.

By the end of 2019, 19% (674/3,589) of people had died before the age of 73.

Among these 674 premature adult deaths, 8% (52/674) of people died from respiratory disease, mostly COPD.

After taking smoking and socioeconomic factors into consideration, the research 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 an LRTI by age two.

This equates to a 2.1% rate of premature adult death from respiratory disease among those who had an LRTI in early childhood, compared with 1.1% among those who did not.

The study found that having a lower respiratory infection 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.

Professor Rebecca Hardy, from Loughborough University and University College London, said: “The results of our study suggest that efforts to reduce childhood respiratory infections could have an impact on tackling premature mortality from respiratory disease later in life.

“We hope that this study will help guide the strategies of international health organisations in tackling this issue.”