Search tips
Search criteria 


Logo of bmjcredLink to Publisher's site
Br Med J (Clin Res Ed). 1988 March 26; 296(6626): 890–893.
PMCID: PMC2546285

Asthma as a link between chest illness in childhood and chronic cough and phlegm in young adults


The link between chest illnesses in childhood to age 7 and the prevalence of cough and phlegm in the winter reported at age 23 was investigated in a cohort of 10 557 British children born in one week in 1958 (national child development study). Both pneumonia and asthma or wheezy bronchitis to age 7 were associated with a significant excess in the prevalence of chronic cough and phlegm at age 23 after controlling for current smoking. This excess was largely attributable to the association of cough and phlegm at age 23 with a history of asthma or wheezy bronchitis from age 16. When adjustment was made for recent wheezing, current cigarette consumption, previous smoking habit, and passive exposure to smoke the relative odds of cough or phlegm, or both, in subjects with a history of childhood chest illness was 1·11 (95% confidence interval 0·97 to 1·27). When analysed separately asthma, wheezy bronchitis, and pneumonia up to age 7 did not significantly increase the prevalence of either cough or phlegm.

The explanation for the observed continuity between chest illness in childhood and respiratory symptoms in later life may lie more in the time course of functional disturbances related to asthma than in the persistence of structural lung damage.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (915K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Reid DD. The beginnings of bronchitis. Proc R Soc Med. 1969 Apr;62(4):311–316. [PMC free article] [PubMed]
  • Barker DJ, Osmond C. Childhood respiratory infection and adult chronic bronchitis in England and Wales. Br Med J (Clin Res Ed) 1986 Nov 15;293(6557):1271–1275. [PMC free article] [PubMed]
  • Colley JR, Reid DD. Urban and social origins of childhood bronchitis in England and Wales. Br Med J. 1970 Apr 25;2(5703):213–217. [PMC free article] [PubMed]
  • Burrows B, Knudson RJ, Lebowitz MD. The relationship of childhood respiratory illness to adult obstructive airway disease. Am Rev Respir Dis. 1977 May;115(5):751–760. [PubMed]
  • Colley JR, Douglas JW, Reid DD. Respiratory disease in young adults: influence of early childhood lower respiratory tract illness, social class, air pollution, and smoking. Br Med J. 1973 Jul 28;3(5873):195–198. [PMC free article] [PubMed]
  • Kiernan KE, Colley JR, Douglas JW, Reid DD. Chronic cough in young adults in relation to smoking habits, childhood environment and chest illness. Respiration. 1976;33(3):236–244. [PubMed]
  • Britten N, Wadsworth J. Long term respiratory sequelae of whooping cough in a nationally representative sample. Br Med J (Clin Res Ed) 1986 Feb 15;292(6518):441–444. [PMC free article] [PubMed]
  • HARNETT RW, MAIR A. Chronic bronchitis and the catarrhal child. Scott Med J. 1963 May;8:175–184. [PubMed]
  • Williams H, McNicol KN. Prevalence, natural history, and relationship of wheezy bronchitis and asthma in children. An epidemiological study. Br Med J. 1969 Nov 8;4(5679):321–325. [PMC free article] [PubMed]
  • Martin AJ, McLennan LA, Landau LI, Phelan PD. The natural history of childhood asthma to adult life. Br Med J. 1980 Jun 14;280(6229):1397–1400. [PMC free article] [PubMed]
  • Martin AJ, Landau LI, Phelan PD. Lung function in young adults who had asthma in childhood. Am Rev Respir Dis. 1980 Oct;122(4):609–616. [PubMed]
  • Martin AJ, Landau LI, Phelan PD. Asthma from childhood at age 21: the patient and his disease. Br Med J (Clin Res Ed) 1982 Feb 6;284(6313):380–382. [PMC free article] [PubMed]
  • Phelan PD. Does adult chronic obstructive lung disease really begin in childhood? Br J Dis Chest. 1984 Jan;78(1):1–9. [PubMed]
  • Anderson HR, Bland JM, Patel S, Peckham C. The natural history of asthma in childhood. J Epidemiol Community Health. 1986 Jun;40(2):121–129. [PMC free article] [PubMed]
  • Watkins CJ, Burton P, Leeder S, Sittampalam Y, Wever AM, Wiggins R. Doctor diagnosis and maternal recall of lower respiratory illness. Int J Epidemiol. 1982 Mar;11(1):62–66. [PubMed]
  • Fry J. "Acute Wheezy Chests". Br Med J. 1961 Jan 28;1(5221):227–232. [PMC free article] [PubMed]
  • Strachan DP. The prevalence and natural history of wheezing in early childhood. J R Coll Gen Pract. 1985 Apr;35(273):182–184. [PMC free article] [PubMed]
  • Woolcock AJ, Peat JK, Salome CM, Yan K, Anderson SD, Schoeffel RE, McCowage G, Killalea T. Prevalence of bronchial hyperresponsiveness and asthma in a rural adult population. Thorax. 1987 May;42(5):361–368. [PMC free article] [PubMed]
  • Corrao WM, Braman SS, Irwin RS. Chronic cough as the sole presenting manifestation of bronchial asthma. N Engl J Med. 1979 Mar 22;300(12):633–637. [PubMed]
  • Johnston ID, Anderson HR, Lambert HP, Patel S. Respiratory morbidity and lung function after whooping-cough. Lancet. 1983 Nov 12;2(8359):1104–1108. [PubMed]
  • Mok JY, Simpson H. Outcome for acute bronchitis, bronchiolitis, and pneumonia in infancy. Arch Dis Child. 1984 Apr;59(4):306–309. [PMC free article] [PubMed]
  • McConnochie KM, Roghmann KJ. Bronchiolitis as a possible cause of wheezing in childhood: new evidence. Pediatrics. 1984 Jul;74(1):1–10. [PubMed]
  • Peto R, Speizer FE, Cochrane AL, Moore F, Fletcher CM, Tinker CM, Higgins IT, Gray RG, Richards SM, Gilliland J, et al. The relevance in adults of air-flow obstruction, but not of mucus hypersecretion, to mortality from chronic lung disease. Results from 20 years of prospective observation. Am Rev Respir Dis. 1983 Sep;128(3):491–500. [PubMed]
  • Britten N, Davies JM, Colley JR. Early respiratory experience and subsequent cough and peak expiratory flow rate in 36 year old men and women. Br Med J (Clin Res Ed) 1987 May 23;294(6583):1317–1320. [PMC free article] [PubMed]

Articles from British Medical Journal (Clinical Research Ed.) are provided here courtesy of BMJ Publishing Group