Family history for chronic lung diseases and epidemiological determinants of COPD in three European countries

In order to investigate the effect of family history of lung diseases on chronic obstructive pulmonary disease (COPD), the authors analysed pooled data from England, the Netherlands and Italy in the framework of Concerted Action on COPD (BIOMED1). A total of 3,596 subjects (aged >35 yrs) were studied; information on respiratory symptoms and reported family history of chronic bronchitis, asthma and allergic disorders was collected by standardized questionnaires; bronchial hyperreactivity (BHR), immunoglobulin (Ig)E level, and skin reactivity (SR) were determined in each study with comparable methods. Multiple logistic regression models were used for statistical analyses. Family history of asthma was associated with symptoms, in particular asthma attacks, BHR, IgE level and SR; risks increased when considering asthma in the first degree of relatives. Family history of allergic disorders was associated with hay fever and with SR. Family history of chronic bronchitis was associated with symptoms, in particular cough/phlegm, but no effect was observed on BHR, IgE and SR. These results were evident in both never- and ever-smokers. However, the impairment of lung function (forced expiratory volume in one second (FEV1) expressed as a percentage of the predicted value) was found only in smokers with a family history of chronic bronchitis. Family history of asthma did not significantly affect pulmonary function and that of allergic disorders was associated with higher FEV1% values. In asymptomatic subjects, the association between the presence of family history of asthma and BHR, IgE, and of family history of allergy with SR were still present. In conclusion, a familiarity for different chronic respiratory conditions was associated with specific epidemiological determinants of chronic obstructive pulmonary disease, asthma and allergic disorders. Family history of chronic bronchitis significantly affected lung function only in ever-smoker subjects.