The natural history of respiratory symptoms in a cohort of adolescents

Withers, Nicholas John (1998) The natural history of respiratory symptoms in a cohort of adolescents. University of Southampton, Doctoral Thesis.

Abstract

The aims of this study were to examine which familial and environmental factors were associated with the persistence of wheeze and cough from early childhood into adolescence and which factors were associated with new onset of respiratory symptoms in adolescence. In addition, the prevalence of smoking and its impact upon respiratory morbidity within a cohort of adolescents was examined.

In early 1995 a respiratory symptom questionnaire was sent to parents of all traceable children from a cohort previously studied in 1987, when aged 7-8 years. This questionnaire also contained questions concerning details of potential familial and environmental risk factors for wheeze and cough. A second simple questionnaire concerning current smoking habits was circulated to all children in the cohort. A total of 3089 (96.7%) of the original cohort were traced and response rates for the respiratory and smoking questionnaires were 75.5% and 71.3% respectively.

Data obtained from the questionnaires was used to divide children into symptom sub-groups: current symptoms (symptoms present in the previous 12 months), persistent symptoms (symptoms present both in 1987 and 1995) and late onset symptoms (symptoms not present by 1987 but present in 1995). Multivariate logistic regression models were employed to assess the independent associations of familial and environmental factors with the presence of a child in each of these sub-groups. In addition, the prevalence of regular smoking (at least one cigarette/week for 12 months) amongst the cohort was determined and multivariate regression models used to determine factors associated with a smoking habit.

A personal and family history of atopy were found to be associated with an increased likelihood of the presence of current, persistent and late onset symptoms. Several other factors were associated with certain symptom subgroups and, of these, smoking, both active and passive, appeared to be the most important. Active smoking was common amongst the cohort and was more common in smoking households, single parent households, and in older children.

We conclude that familial factors are consistently important in the development and persistence of wheeze and cough in adolescents.

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