Aims: The pulmonary outcome of extreme prematurity remains to be established in adults. We determined respiratory health and lung function status in a population‐based, complete cohort of young preterms approaching adulthood. Methods. Forty‐six preterms with gestational age ±28 wk or birthweight ±1000g, born between 1982 and 1985, were compared to the temporally nearest term‐born subject of equal gender. Spirometry, plethysmography, reversibility test to salbutamol and methacholine bronchial provocation test were performed. Neonatal data were obtained from hospital records and current symptoms from validated questionnaires. Results: When entering the study at a mean age of 17.7 (SD: 1.2) y, a doctor's diagnosis of asthma and use of asthma inhalers were significantly more prevalent among preterms than controls (one asthmatic control compared to nine preterms, all but one using asthma inhalers). Peak expiratory flow (PEF) and forced expiratory volume in 1 s (FEV1) were decreased and the discrepancies relative to controls increased parallel to increased severity of neonatal lung disease. Parameters of increased neonatal oxygen exposure significantly predicted FEV1. Adjusted for height, gender and age, FEV1 was reduced by a mean of 580 ml/s in subjects with a history of bronchopulmonary dysplasia. Fifty‐six percent of preterms had a positive methacholine provocation test compared to 26% of controls. Conclusion: A substantially decreased FEV1, increased bronchial hyperresponsiveness and a number of established risk factors for steeper age‐related decline in lung function were observed in preterms. A potential for early onset chronic obstructive pulmonary disease is present in subsets of this group.

Study objective-The aim was to examine causes for non-response in a community survey, and how non-response influences prevalence estimates of some exposure and disease variables, and associations between the variables.Design-This was a cross sectional questionnaire study with two reminder letters. In a postal survey on airborne occupational exposures and lung disorders in Hordaland county, Norway, we examined the causes for non-response, and the characteristics of respondents and nonrespondents. We also wished to investigate how non-response rates may change (1) the estimated prevalences of exposures (smoking and airborne occupational exposure) and lung disorders, and (2) the associations between these exposures and disorders.

There have been few community-based randomized, controlled intervention trials for cessation in high-risk smokers. In such a trial we evaluated the effects of postal smoking cessation advice in smokers with asbestos exposure and/or reduced forced expiratory volume in one second (FEV1). All men aged 30-45 yrs (n=22,392) living in 34 municipalities in western Norway were invited to a cross-sectional community survey. Information on smoking habits and occupational asbestos exposure were obtained from self-administered questionnaires and measurements of FEV1 were performed with dry-wedge bellow spirometers. Among 16,393 participants we identified a group of 2,610 smokers with previous occupational asbestos exposure and/or adjusted FEV1 in the lowest quartile. A random half (n=1,300) received a mailed personal letter from a respiratory physician with a person-specific health advice to quit smoking and a pamphlet on smoking cessation. The remaining smokers (n=1,310) acted as controls and did not receive any information. Twelve months after the intervention, information on smoking habits was re-examined using a postal questionnaire. Among the respondents (n=2,282), smoking cessation was reported altogether by 13.7% in the intervention group versus 9.9% in the control group (p<0.01). The 1 yr sustained quit rate (no smoking at all during the last year) was 5.6 versus 35% (p<0.05), respectively. Measurements of carbon monoxide in expired air (with < or = 10 parts per million) confirmed self-reported nonsmoking in samples of the two groups. In a community this simple postal smoking cessation advice from a respiratory physician based on person-specific risk factors improved the 1 yr sustained success rate by 60% in identified high-risk smokers.

The ω-3 polyunsaturated fatty acids of fish, primarily eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), act as competitive inhibitors of arachidonic acid metabolism, thereby reducing the amount of active inflammatory mediators such as prostaglandins and leukotrienes from the cyclooxygenase and the lipoxygenase enzyme systems [1]. During the last decade, inflammation has increasingly been recognized as a major aspect of bronchial asthma and the leukotrienes generated from metabolism of arachidonic acid have a potent bronchoconstriction effect [2]. A study of dietary supplementation with fish oil lipids in patients with mild asthma did not improve clinical performance or symptom scores, but inhibition of leukotriene B 4 generation could be demonstrated [3]. Aspects of the relationship between dietary fish oil consumption and airways obstruction have been discussed [4] and the role of fish intake in the occurrence of bronchial asthma and asthma-like symptoms remains unclear.The aim of the present study was to investigate the relationship between dietary fish consumption and respiratory symptoms, among young adults of a Norwegian community with an overall high fish intake. Subjects and methods SampleThis cross-sectional study, in the city of Bergen, Norway, was performed as part of the European Community Respiratory Health Survey [5]. A random sample of 4,300 subjects, aged 20-44 yrs, of a survey population of 82,227 subjects in that age category were sent a postal questionnaire on October 1, 1991. Those not returning the questionnaire received a second and, if there was still no response, a third questionnaire, after 3 and 8 weeks, respectively. Subjects not returning the questionnaire after three letters were classed as nonresponders. The reasons for nonresponse were: moved out of the study area (2%), unknown new address after moving (1%) and unknown (17%). A total of 3,450 subjects (80%) responded to the postal questionnaire. The response rate increased with increasing age and was 77% among those aged 20-24 yrs and 82% among those aged 40-44 yrs. Among the responders 51% were female. The mean age was 31 yrs in both males and Fish consumption and respiratory symptoms among young adults in a Norwegian community. Ø. Fluge, E. Omenaas, G.E. Eide, A. Gulsvik. ©ERS Journals Ltd 1998.ABSTRACT: The aim of this study was to investigate the relationship between dietary fish consumption and self-reported respiratory symptoms among young adults.A random sample of 4,300 subjects, aged 20-44 yrs, living in Bergen, Norway, received a postal questionnaire on respiratory symptoms, of whom 80% responded. Mean fish consumption was assessed in a food-frequency questionnaire by asking how often the subject consumed units of fish (150 g) during the last year.Average fish consumption was 1.8 units·week -1 . Fish intake of <1 unit·week -1 was reported by 24%, 41% reported consumption of 1 unit·week -1 and 35% intake of >1 unit·week -1 . A high fish intake was significantly associated with increasing age after adjusting for sm...

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The purpose of this study was to determine whether the presence of serum specific immunoglobulin E (IgE) antibodies was associated with increased bronchial responsiveness in adults.We studied cross-sectionally a random community sample of 18-73 year old adults, of whom 83% (n=489) performed bronchial responsiveness testing as well as serum measurements of five specific IgE antibodies.In the crude data, 39% of those with house dust mite antibodies (n=18) had a bronchial responsiveness ≤32 g·L -1 methacholine compared with 19% in subjects without any of the five specific IgE antibodies (n=453). The corresponding percentages for subjects with timothy antibodies (n=16) was 25%, birch antibodies (n=13) 23%, cat antibodies (n=10) 40% and mould antibodies (n=2) 50%. When assessing the multivariate relationship between the presence of one specific IgE antibody and degree of bronchial responsiveness we used a semi-proportional hazards model with the response as a 20% fall in forced expiratory volume in one second (FEV1) from pretest value. Covariates included in the model were: gender, age, pretest FEV1, smoking habits, pack-years, season and other specific IgE antibodies than that examined. The presence of house dust mite antibodies was a significant predictor (p<0.01) of increased bronchial responsiveness in never-and ex-smokers. Indoor allergic sensitization (house dust mite, cat and mould) was a significant predictor of increased bronchial responsiveness, while outdoor allergic sensitization (timothy and birch) was not. Excluding subjects with obstructive lung disease (n=39) or including the covariate log total serum IgE as a potential confounder yielded the same result.Thus, in this community, indoor allergic sensitization rather than allergic sensitization per se was related to increased bronchial responsiveness after adjusting for other relevant covariates. Eur Respir J., 1996, 9, 919-925 Allergen challenge has been shown to influence the degree of bronchial responsiveness to nonsensitizing stimuli [1]. A number of studies in children [2][3][4] as well as in adults with allergy skin test reactivity [5][6][7][8][9] have documented increased bronchial responsiveness, although not all studies have shown this relationship [10,11]. Furthermore, in children, increased bronchial responsiveness has been associated with specific allergy against indoor allergens (house dust mite, cat, dog and mould) rather than against outdoor allergens (tree and grass pollen) [12][13][14][15][16]. However, it has not yet been established whether this applies to adults from a general population.In a cross-sectional community study in Norwegian adults [17][18][19], we wanted to determine whether allergy, assessed as the presence of some common serum specific immunoglobulin E (IgE) antibodies, was associated with increased bronchial responsiveness to nonsensitizing stimuli. Furthermore, we wanted to discover whether these relationships were influenced by demographic and environmental factors. Material and methods Study designThe sur...

In this cross-sectional study we investigated whether the presence of specific serum IgE antibodies to house dust mite, timothy, birch, cat, and mold was associated with a reduced FEV1 in adults. We performed complete examinations on 82% of a stratified random sample of 18 to 73-yr-old adults (n = 1,239). Subjects with house-dust-mite antibodies had lower (p = 0.002) sex, age, and height standardized residuals of FEV1 (SFEV1) than those without any specific IgE antibody. This relationship did not differ significantly by sex, age, smoking habit, total serum IgE level, or season, and remained significant after excluding subjects with obstructive lung disease. For house-dust-mite antibodies we also observed a dose-response relationship between antibody levels and impaired lung function. In a final multiple linear regression analysis the presence of house-dust-mite antibodies was the only significant predictor (regression coefficient: -0.425; SE = 0.189; p = 0.02) of reduced SFEV1 after adjusting for smoking habit and lifetime tobacco consumption, season, total serum IgE level, and respiratory-symptom and disease status. Thus, house-dust-mite allergy is an independent predictor of reduced lung function in adults of a wide age range.

Reduced single-breath transfer factors of the lung for carbon monoxide are seen in a number of conditions. The hypothesis of the present study was that selfreported respiratory symptoms differ in their prediction of TL,CO level in a general population in Norway.A cross-sectional survey of a general population sample in Norway, made up of 1,275 subjects aged 18±73 yrs, was conducted in 1987±1988. The attendees (84% response rate) filled in a questionnaire on respiratory symptoms and underwent standardized spirometric and TL,CO measurements and clinical examination. Associations between TL,CO and respiratory symptoms were assessed using multiple regression models. Tests for interaction were used to examine whether these associations varied with sex, age and smoking habits. Data from 1,221 subjects were analysed.Both males and females who reported respiratory symptoms had significantly lower TL,CO after adjusting for age and height. In a multiple linear regression analysis of TL,CO, adjusting for sex, age, height and smoking habits, the symptoms for which statistical significance was attained, were morning cough, chronic cough and breathlessness. However, only the breathlessness score was independently associated with the TL,CO (-0.42 mmol . min -1 . kPa -1 per breathlessness score unit) after adjusting for other respiratory symptoms, and the relationship was stronger in males than in females.In this study, the strongest predictor for a decreased single-breath transfer factor of the lung for carbon monoxide was the presence of self-reported breathlessness, regardless of age, smoking habits and height.