MR1249 - European Community Respiratory Health Survey III (ECRHS)

The ECRHS is a large (n=10000) multicentre international cohort study of adults specifically addressing development and prognosis of respiratory and allergic disease.

In the UK, the cohort were initially selected by random sampling from the Family Health Services Authority register. Detailed information on health status, lifestyle, occupational exposures and environmental exposures has been collected by postal questionnaire and by clinical assessment in two phases a) baseline (1991-1994) b) ten years later (2000-2002). We are currently recontacting the cohort to progress with a third follow-up. Similar protocols are being followed in over 20 research centres in 12 other countries.

This is one of the longest running cohorts with detailed information on respiratory and allergic symptoms, lung function measures and allergic status. Respiratory disease is a major cause of morbidity in the elderly and the ECRHS provides an opportunity to investigate factors that influence the development and prognosis of disease. The prevalence of allergic disease has increased over the last fifty years for as yet unknown reasons and its evolution in older adults is poorly understood.

The UK arm of the ECRHS will contact all eligible participants in Norwich and Ipswich and request they complete a twenty-item postal questionnaire asking about respiratory/allergic symptoms. The cohort was recruited in 1992, and from 1992-1993 1105 underwent detailed investigation. Participants provided the name/address of two friends/relatives who were likely to know their whereabouts in ten years time. In the year 2000, participants were contacted using last recorded address and completed a postal survey. If they had moved, new addresses were located by search of electoral rolls and from information provided by nominated contact. From this, 980 completed the postal questionnaire. Responders were invited to undergo detailed investigation (n=819) as in 1992, and those agreeing consented to 'electronic database follow-up' in the future (please see attached forms). Nominated contacts were also provided. In the last year we have re contacted our cohort using last known address. We would like to know the vital status and new PCT of those who have not responded. We would also like to know the cause of death of all those who have died. Amongst those who gave permission to be traced electronically in 2002 we request vital status and new PCT for about 250 subjects who we believe may have moved. We ask the committee to consider providing, in addition, new PCT for about 100 participants who expressed willingness to be contacted again in 1992 (by providing relatives names) and who completed the postal survey in 2002 but not the clinical assessment. This group have shown willingness to be followed up twice but because of personal circumstances were unable to complete the clinical interview in 2002 (and therefore were not given the opportunity to complete our consent forms.

We will approach new PCTs to request new addresses for our participants and we can then send them our questionnaire. Overall the data provided by the MRIS will 1) improve response 2) enable us to derive correct response rates to survey and 3) allow description of mortality in the cohort. Information provided will be stored until we are provided by the participant with further information long term in our databases to assist with follow-up of the cohort in future years. We are currently seeking ethical permission to invite responders to the postal survey for further investigation

The specific aims are to

1) Describe change in respiratory symptom prevalence in adults as they age

2) Assess change in IgE sensitisation to common allergens in adults as they age

3) Determine whether the prognosis of asthma is influenced by any observed change in atopic status

4) Assess whether atopic status and asthma as measured over a twenty year period is associated with lung function decline or the development of COPD in older adults

5) Describe the association of obesity and physical exercise with asthma, lung function, lung function decline and the prognosis of asthma

Throughout we will assess whether observed effects are similar in men and women.

Data generated through this project will also be analysed to provide observational evidence of associations of lifestyle and environmental factors (eg occupation and air pollution) with atopy, respiratory symptoms, lung function decline and the development of COPD.

Yielded Benefits is not a requirement for new applications.