The Relationship of Respiratory Infections in Early Childhood to the Occurrence of Increased Levels of Bronchial Responsiveness and Atopy

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Abstract
The relationship of antecedent acute respiratory illness to the occurrence of airway responsiveness and atopy was assessed in a population-based cohort of 194 children, 12-16 yr of age, from East Boston. Massachusetts. A history of croup or bronchiolitis, as reported by their parents, was determined at study onset when the children were 5-9 yr of age. During the 2nd and 3rd yr of the study, acute respiratory illness was assessed. After the prospective respiratory illness assessment (5 yr), airway responsiveness was evaluated with eucapneic hyperpnea to subfreezing air, and atopy was evaluated with skin tests to 4 environmental antigens. Both a prior history of croup or bronchiolitis (OR [odds ratio] = 2.29, P = 0.04) and > 2 acute lower respiratory illnesses (OR = 3.72, P = 0.012) were associated with increased levels of airway responsiveness. Neither index of respiratory illness experience was related to the presence of atopy. However, maternal cigarette smoking was significantly associated with atopy in these children (OR = 2.24, P = 0.02). Respiratory illness in early life is apparently associated with airway hyperresponsiveness as measured later in childhood. The need for longitudinal studies is suggested to better assess the etiologic role of these potential risk factors.