부산대학교 도서관

Helena Backman,1,* Laxmi Bhatta,2,3,* Linnea Hedman,1 Ben Brumpton,2 Iida Vähätalo,4,5 Paul G Lassmann-Klee,6 Bright I Nwaru,7 Linda Ekerljung,7 Steinar Krokstad,8,9 Sigrid Anna Aalberg Vikjord,2 Anne Lindberg,10 Hannu Kankaanranta,7 Eva Rönmark,1,* Arnulf Langhammer8,* 1Section of Sustainable Health/ the OLIN Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; 2K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology NTNU, Trondheim, Norway; 3Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; 4Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland; 5Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; 6Clinical Physiology and Nuclear Medicine Unit, Helsinki University Hospital’s Diagnostic Center and University of Helsinki, Helsinki, Finland; 7Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 8HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway; 9Nord-Trøndelag Hospital Trust, Levanger Hospital, Levanger, Norway; 10Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden*These authors contributed equally to this workCorrespondence: Helena Backman, Email helena.backman@norrbotten.seBackground and Aim: The relationship between socioeconomic status (SES), asthma and mortality is complex and multifaceted, and it is not established if educational level modifies the association between asthma and mortality. The aim was to study the association between asthma and mortality in Sweden and Norway and to what extent educational level modifies this association.Participants and Methods: Within the Nordic EpiLung Study, > 56,000 individuals aged 30– 69 years participated in population-based surveys on asthma and associated risk factors in Sweden and Norway during 2005– 2007. Data on educational level and 10-year all-cause mortality were linked by national authorities. The fraction of mortality risk attributable to asthma was calculated, and Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for mortality related to asthma, stratified by educational level.Results: In total, 5.5% of all deaths was attributed to asthma. When adjusted for potential confounders, the HR for mortality related to asthma was 1.71 (95% CI 1.52– 1.93). Those with primary level of education had higher hazard of all-cause death related to asthma than those with tertiary level (HR 1.80, 95% CI 1.48– 2.18, vs HR 1.39, 95% CI 0.99– 1.95).Conclusion: Asthma was associated with an overall 71% increased all-cause mortality and 5.5% of deaths can be attributed to asthma. Educational levels modified the risk of mortality associated with asthma, with the highest risk among those with primary education.Keywords: epidemiology, cohort, prognosis