The Melbourne Asthma Study: 1964-1999

doi:10.1067/mai.2002.120951

Journal of Allergy and Clinical Immunology

Volume 109, Issue 2, February 2002, Pages 189-194

https://doi.org/10.1067/mai.2002.120951 Get rights and content

Abstract

A group of children with a past history of wheezing was randomly selected from the Melbourne community at the age of 7 years in 1964, and a further group of children with severe wheezing was selected from the same birth cohort at the age of 10 years. These subjects have been followed prospectively at 7-year intervals, with the last review in 1999, when their average age was 42 years. Eighty-seven percent of the original cohort who were still alive participated in the 1999 review. This study showed that the majority of children who had only a few episodes of wheezing associated with symptoms of a respiratory infection had a benign course, with many ceasing to wheeze by adult life. Most who continued with symptoms into adult life were little troubled by them. Conversely, those children with asthma mostly continued with significant wheezing into adult life, and the more troubled they were in childhood, the more likely symptoms continued. There was a loss in lung function by the age of 14 years in those with severe asthma, but the loss did not progress in adult life. The childhood asthma had been treated before the availability of inhaled steroids. There was no significant loss of lung function in those with milder symptoms. (J Allergy Clin Immunol 2002;109:189-94.)

Section snippets

The study group

The original study group was randomly selected from 7-year-old Melbourne schoolchildren during a routine school medical examination. The sample was stratified to provide 3 groups of approximately equal size of children with a history of wheezing of varying frequency and a control group with no history of wheezing.¹ When the children were reviewed at age 10 years, it was realized that there were very few with severe asthma, and a further sampling was done from the same birth cohort.² Thus the

The reviews

All subjects attended personally with a parent, usually the mother, for review at ages 7, 10, and 14 years. At subsequent reviews, most subjects attended personally, but those who had moved away from Melbourne elsewhere in Australia or overseas or who had work or other commitments that prevented their attending were interviewed by telephone. By 42 years, 15 subjects had died, only 1 from asthma.⁷

At each review, a clinical history was taken, focusing on the frequency of wheezing episodes.

Key findings and their implications

As a result of the reviews at 7, 10, and 14 years, McNicol and Williams³ concluded that there was a spectrum of asthma in children, from those who had a few episodes of wheezing associated with symptoms of a viral respiratory tract infection to those who had daily or near-daily symptoms throughout childhood and into early adolescence. Those with infrequent episodes of wheezing, on the basis of a history obtained from the mother, had usually ceased to have symptoms by early adolescence, whereas

Significance of the Melbourne Asthma Study

The Melbourne Asthma Study has demonstrated that it is possible to do a long-term study over 35 years with periodic reviews and a high follow-up rate. Although this to some extent reflects the relative geographic stability of the Australian population, other circumstances and strategies have been important. One of us (P.D.P.) was associated with the Department of Respiratory Medicine for over 30 years, a second for over 20 years (A.O.), and the third for 17 years (C.F.R.). Other staff have been

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^☆: Supported by a grant from Glaxo Wellcome, Inc, Research Triangle Park, NC Supported by grants from the National Health and Medical Research Council, Australia.

^☆☆: Reprints not available from the authors.

^★: Series editor: Harold S. Nelson, MD

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Current Reviews of Allergy and Clinical ImmunologyThe Melbourne Asthma Study: 1964-1999☆,☆☆,★

Abstract

Section snippets

The study group

The reviews

Key findings and their implications

Significance of the Melbourne Asthma Study

Lancet

Prevalence, natural history and relationship of wheezy bronchitis and asthma in children. An epidemiological study

BMJ

Chest deformity, residual airways obstruction and hyperinflation, and growth in children with asthma. I. Prevalence findings from an epidemiological study

Arch Dis Child

Spectrum of asthma in children. I. Clinical and physiological components

BMJ

The natural history of childhood asthma to adult life

BMJ

Childhood asthma in adult life: a further study at 28 years of age

BMJ

Outcome of childhood asthma in mid-adult life

BMJ

Asthma and wheezing in the first six years of life

N Engl J Med

Asthma from childhood at age 21: the patient and his disease

BMJ

Childhood asthma and lung function in mid-adult life

Pediatr Pulmonol

Current Reviews of Allergy and Clinical Immunology
The Melbourne Asthma Study: 1964-1999☆,☆☆,★