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Association between exposure to the Chinese famine during infancy and the risk of self-reported chronic lung diseases in adulthood: a cross-sectional study
  1. Zhenghe Wang,
  2. Zhiyong Zou,
  3. Zhongping Yang,
  4. Yanhui Dong,
  5. Jun Ma
  1. School of Public Health, Institute of Child and Adolescent Health, Peking University Health Science Center, Beijing, China
  1. Correspondence to Professor Jun Ma; majunt{at}


Objective To examine the association between early-life exposure to the Chinese famine and the risk of chronic lung diseases in adulthood.

Design Data analysis from a cross-sectional survey.

Setting and participants 4135 subjects were enrolled into the study from the China Health and Retirement Longitudinal Study (CHARLS) 2011–2012 baseline survey to analyse the associations between prenatal and early postnatal famine exposure and the risk of chronic lung diseases in adulthood.

Main outcome measures Chronic lung diseases were defined based on self-reported information.

Results The prevalence of self-reported chronic lung diseases in fetus-exposed, infant-exposed, preschool-exposed, and non-exposed groups was 6.5%, 7.9%, 6.8%, and 6.1%, respectively. The risk of chronic lung diseases in the infant-exposed group was significantly higher (OR 1.95, 95% CI 1.10 to 3.44) than the non-exposed group in severely affected areas, even after adjusting for gender, smoking, and drinking, family economic status, and the highest educational attainment of the parents (OR 2.57, 95% CI 1.26 to 5.25). In addition, after stratification by gender and famine severity, we found that only infant exposure to the severe famine was associated with the elevated risk of chronic lung diseases among male adults (OR 3.16, 95% CI 1.17 to 8.51).

Conclusions Severe famine exposure during the period of infancy might increase the risk of chronic lung diseases in male adults.

  • Famine
  • Developmental Origins of Health and Disease
  • Chronic Lung Diseases
  • Infant

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors JM and ZW were co-investigators and designed the study, ZW, ZZ, ZY and YD carried out the initial analysis, and supervised data analysis. All authors were involved in writing the paper and had final approval of the submitted and published versions.

  • Funding This work was supported by National Science Foundation of China (NSFC 81402692).

  • Competing interests None declared.

  • Ethics approval The Medical Ethics Committee of Peking University.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The datasets analyzed in the current study are available online (

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