University of Oulu

Holma, P., Pesonen, P., Mustonen, O., Järvelin, M.-R., Kauma, H., Auvinen, J., & Hautala, T. (2022). 52-year follow-up of a birth cohort reveals a high pneumonia incidence among young men. ERJ Open Research, 8(2), 00707–02021.

52-year follow-up of a birth cohort reveals a high pneumonia incidence among young men

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Author: Holma, Pia1; Pesonen, Paula2; Mustonen, Olli1;
Organizations: 1Research Unit of Internal Medicine, Dept of Internal Medicine, Division of Infectious Diseases, University of Oulu and Oulu University Hospital, Oulu, Finland
2Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
3Dept of Epidemiology and Biostatistics, MRC-PHE Centre for Environment & Health, School of Public Health, Imperial College London, London, UK
4Center for Life Course Health Research, University of Oulu, Unit of Primary Care, Oulu University Hospital, Oulu, Finland
5Dept of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK
6Research Unit of Biomedicine, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
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Language: English
Published: European Respiratory Society, 2022
Publish Date: 2023-02-08


Background: Knowledge of pneumonia incidence and risk factors in adults is mainly based on clinical studies of selected patient data and registers with ageing populations. Prospective population-based investigations, such as birth cohort studies, are needed to understand pneumonia incidence and risk factors among young and working-age populations.

Methods: Northern Finland Birth Cohort (NFBC) 1966 data (n=6750) were analysed for pneumonia incidence and risk factors. Incidence analysis was replicated using data from an independent NFBC 1986 cohort (n=9207). Pneumonia in relation to chronic conditions and lifestyle factors was analysed.

Results: A peak with a maximum of 227 pneumonia episodes per 10 000 among men between the ages of 19 and 21 years was found in two independent cohorts. Pneumonia was associated with male sex (relative risk 1.72, 95% CI 1.45–2.04; p<0.001), low educational level (relative risk 2.30, 95% CI 1.72–3.09; p<0.001), smoking (relative risk 1.55, 95% CI 1.31–1.84; p<0.001), asthma (relative risk 2.19, 95% CI 1.73–2.75; p<0.001), cardiovascular diseases (relative risk 2.50, 95% CI 2.04–3.07; p=0.001), kidney diseases (relative risk 4.14, 95% CI 2.81–6.10; p<0.001), rheumatoid arthritis (relative risk 2.69, 95% CI 1.80–4.01; p<0.001), psoriasis (relative risk 2.91, 95% CI 1.92–4.41; p<0.001) and type II diabetes (relative risk 1.80, 95% CI 1.34–2.42; p<0.001). Men with excessive alcohol consumption at age 31 years were at risk of future pneumonia (relative risk 2.40, 95% CI 1.58–3.64; p<0.001).

Conclusions: Birth cohort data can reveal novel high-risk subpopulations, such as young males. Our study provides understanding of pneumonia incidence and risk factors among young and working age populations.

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Series: ERJ open research
ISSN: 2312-0541
ISSN-E: 2312-0541
ISSN-L: 2312-0541
Volume: 8
Issue: 2
Article number: 00707-2021
DOI: 10.1183/23120541.00707-2021
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3142 Public health care science, environmental and occupational health
Funding: The study was supported by Oulu University Hospital VTR K74809. T. Hautala has received support from CSL-Behring. NFBC1966 and NFBC1986 have received core support from multiple funders. The NFBC 1966 31-year follow-up received financial support from University of Oulu Grant number 65354; Oulu University Hospital grant numbers 2/97 and 8/97; Ministry of Health and Social Affairs grant numbers 23/251/97, 160/97 and 190/97; National Institute for Health and Welfare, Helsinki grant number 54121; and Regional Institute of Occupational Health, Oulu, Finland grant numbers 50621 and 54231. The NFBC 1966 46-year follow-up received financial support from University of Oulu grant number 24000692, Oulu University Hospital grant number 24301140 and ERDF European Regional Development Fund grant number 539/2010 A31592. The data generation, curation and manpower were also supported by the following EU H2020 grants: DynaHEALTH (grant number 633595), LifeCycle (733206), LongITools (873749), EarlyCause, EDCMET (825762) and the Medical Research Council, UK (MRC/BBSRC MR/S03658X/1) (JPI HDHL H2020). M-R. Järvelin is partly supported by the MRC Centre for Environment and Health at ICL, which is currently funded by the Medical Research Council (MR/S019669/1). Funding information for this article has been deposited with the Crossref Funder Registry.
EU Grant Number: (633595) DYNAHEALTH - Understanding the dynamic determinants of glucose homeostasis and social capability to promote Healthy and active aging
(733206) LIFECYCLE - Early-life stressors and LifeCycle health
(874739) LONGITOOLS - Dynamic longitudinal exposome trajectories in cardiovascular and metabolic non-communicable diseases
(848158) EarlyCause - Causative mechanisms & integrative models linking early-life-stress to psycho-cardio-metabolic multi-morbidity
(825762) EDCMET - Metabolic effects of Endocrine Disrupting Chemicals: novel testing METhods and adverse outcome pathways
Copyright information: ©The authors 2022. This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.