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

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 (nZ8583) 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%, nZ97) and cancer (17.9%, nZ31). Males were more likely than females to have died (pZ<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 (pZ0.05); being male with a 3.6-fold increase in mortality (pZ0.0001); 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 (pZ0.03). Conclusions: Childhood lung health appears to be associated with increased mortality in adulthood, perhaps by affectingthe ability to survivetrauma,major illnesses and other physical stresses.