Poor lung function and tonsillectomy in childhood are associated with mortality from age 18 to 44

Summary

Background

The aim of this analysis was to examine associations between lung health in childhood and mortality between ages 18 and 44 years in the Tasmanian Longitudinal Health Study (TAHS).

Methods

The 1961 Tasmanian birth cohort who attended school in 1968 (n = 8583) were linked to the Australian National Death Index (NDI) to identify deaths. Additional deaths were notified by families through a 37 year follow-up postal questionnaire. Information on lung health at age 7 years and on potential confounders was obtained from the original 1968 TAHS survey and school medical records. Cox proportional hazards modelling was used to assess determinants of mortality.

Results

A total of 264 (3%) deaths were identified. The principal causes of death were external injury (56.1%, n = 97) and cancer (17.9%, n = 31). Males were more likely than females to have died (p = <0.1). Only two (1.1%) participants had died from respiratory conditions. Having an FEV₁ < 80% predicted at 7 years of age was associated with a 2-fold increased incidence of death. Tonsillectomy before age 7 years was associated with a 1.5-fold increase in mortality (p = 0.05); being male with a 3.6-fold increase in mortality (p = 0.0001); and repeated chest illnesses at age 7 years causing >30 days confinement in the last year, was associated with a 2.2-fold increase in mortality (p = 0.03).

Conclusions

Childhood lung health appears to be associated with increased mortality in adulthood, perhaps by affecting the ability to survive trauma, major illnesses and other physical stresses.