Lifetime Risk Factors for Pre- and Post-Bronchodilator Lung Function Decline: A Population-based Study Academic Article uri icon


  • Rationale: Interactions between early life and adult insults on lung function decline are not well understood, with most studies investigating prebronchodilator (pre-BD) FEV1 decline.Objectives: To investigate relationships between adult risk factors and pre- and post-BD lung function decline and their potential effect modification by early life and genetic factors.Methods: Multiple regression was used to examine associations between adult exposures (asthma, smoking, occupational exposures, traffic pollution, and obesity) and decline in both pre- and post-BD spirometry (forced expiratory volume in 1 s [FEV1], forced vital capacity [FVC], and FEV1/FVC) between ages 45 and 53 years in the Tasmanian Longitudinal Health Study (n = 857). Effect modification of these relationships by childhood respiratory risk factors, including low childhood lung function and GST (glutathione S-transferase) gene polymorphisms, was investigated.Results: Baseline asthma, smoking, occupational exposure to vapors/gases/dusts/fumes, and living close to traffic were associated with accelerated decline in both pre- and post-BD FEV1. These factors were also associated with FEV1/FVC decline. Occupational exposure to aromatic solvents was associated with pre-BD but not post-BD FEV1 decline. Maternal smoking accentuated the effect of personal smoking on pre- and post-BD FEV1 decline. Lower childhood lung function and having the GSTM1 null allele accentuated the effect of occupational exposure to vapors/gases/dusts/fumes and personal smoking on post-BD FEV1 decline. Incident obesity was associated with accelerated decline in FEV1 and more pronounced in FVC.Conclusions: This study provides new evidence for accentuation of individual susceptibility to adult risk factors by low childhood lung function, GSTM1 genotype, and maternal smoking.


  • Bui, Dinh S
  • Perret, Jennifer L
  • Walters, E Haydn
  • Abramson, Michael J
  • Burgess, John A
  • Bui, Minh Q
  • Bowatte, Gayan
  • Lowe, Adrian J
  • Russell, Melissa A
  • Alif, Sheikh M
  • Thompson, Bruce R
  • Hamilton, Garun S
  • Giles, Graham G
  • Thomas, Paul S
  • Morrison, Stephen
  • Johns, David P
  • Knibbs, Luke D
  • Zock, Jan-Paul
  • Marcon, Alessandro
  • Garcia-Aymerich, Judith
  • Erbas, Bircan
  • Jarvis, Deborah
  • Svanes, Cecilie
  • Lodge, Caroline J
  • Dharmage, Shyamali C

publication date

  • 2019