Getting bronchitis or pneumonia at age 2 increases risk of premature death from respiratory causesPixabay

Respiratory infections contracted during early childhood are associated with a greater risk of death from respiratory disease between 26 and 73 yearsaccording to a new study published in the journal ‘The Lancet’.

This first-of-its-kind study spanning eight decades suggests that, although the overall number of premature deaths from respiratory disease was small, people who have had an LRTI such as bronchitis or pneumonia, at two years old they were 93% more likely to die prematurely from respiratory illnesses in adulthoodregardless of their socioeconomic background or smoking habit.

That could explain one in five premature deaths from respiratory disease in England and Wales between 1972 and 2019 (179,188 of 878,951 deaths).

early death

To the Chronic respiratory diseases are an important public health problemwith an estimated 3.9 million deaths in 2017, representing 7% of all deaths in the world. Chronic obstructive pulmonary disease (COPD) caused most of these deaths.

LRTIs in childhood have been shown to be related to the development of impaired lung function in adulthood, asthma, and chronic obstructive pulmonary diseasebut until now it was unclear whether it was related to premature death in adulthood.

Impact on adult life

This new research is the first lifetime study on this topicand provides the best evidence to date to suggest thate Early respiratory health has an impact on mortality later in life.

“Current measures for the prevention of respiratory diseases in adulthood are mainly focused on whats lifestyle-related risk factors, such as smoking — says Dr. James Allinson, from Imperial College London (UK) and lead author of the study–. Linking one in five deaths by respiratory diseases in adulthood with common infections occurring many decades earlier, in childhood, demonstrates the need to focus on risks well before adulthood.”

A pediatrician attends to a child in the office.

Optimize child health

Thus, he points out that “by prevent health inequalities from perpetuating existing in adulthood, we must optimize children’s health, especially in combating childhood poverty. The data that point to the early onset of chronic diseases in adulthood also help to combat the stigma that all deaths from diseases such as COPD are related to lifestyle factors.”

The study uses data from a national British cohort (The National Survey of Health and Development), which recruited individuals at birth in 1946 and examines health and death records through 2019.

The study

Of the 3,589 study participants, 25% (913/3,589) had IVRI within two years. At the end of 2019, 19% (674/3,589) of participants died before age 73. Among these 674 premature adult deaths, 8% (52/674) of participants died of respiratory illnesses, primarily COPD.

The analysis, adjusted for childhood socioeconomic background and smoking, suggests that children who suffered a LRTI at age two were 93% more likely to die prematurely from respiratory disease in adulthood than children who did not have an LRTI at age two.

This equates to a rate of 2.1% premature death in adulthood from respiratory disease among those who had an LRTI in early childhood, compared to 1.1% among those who did not report having an IVRI before two years.

premature deaths

This risk represents one in five (20.4%) ofand premature deaths of adults from respiratory causes, which corresponds to an excess of 179,188 deaths from respiratory diseases across England and Wales between 1972 and 2019.

In comparison, adult respiratory deaths attributable to smoking accounted for three in five deaths (57.7%) from respiratory disease in England and Wales during the same period (507,223 of 878,951 deaths).

Having a lower respiratory tract infection before the age of two was only associated with an increased risk of premature death from respiratory disease, and not to other illnesses such as heart disease or cancer.


“The results of our study suggest that Efforts to reduce childhood respiratory infections could have an impact in the fight against premature mortality by respiratory illnesses later in life. We hope this study will help guide the strategies of international health organizations to deal with this problem,” says Professor Rebecca Hardy, Loughborough University and University College London, UK.

the authors rrecognize some limitations of the study. Although socioeconomic background and smoking were taken into account in the analysis, it is possible that there were other unreported factors such as parental smoking or premature birth. During this lifetime study, societal changes may also have led to changes in lung function in subsequent cohorts, altering the results. The study could not investigate which bacteria or viruses caused the LRTIs in the children.


In a linked commentary, Heather Zar of the University of Cape Town, South Africa, who was not involved in this research, states that “outlining the long-term effect of mild respiratory infections in children is a difficult task, but important to understand the origins of the disease in adulthood and strengthen preventive interventions.

“Current global efforts to reduce premature mortality in adulthood are largely focused on adult exposure,” he continued. of childhood exposures that are largely preventable.