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Defining the risk factors for acute, subacute and chronic cough: a cross-sectional study in a Finnish adult employee population
  1. Anne M Lätti1,2,
  2. Juha Pekkanen3,4,
  3. Heikki O Koskela1,2
  1. 1 Unit for Medicine and Clinical Research, Pulmonary Division, Kuopio University Hospital, Kuopio, Finland
  2. 2 School of Medicine, Institute of Clinical Sciences, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
  3. 3 Department of Public Health, University of Helsinki, Helsinki, Finland
  4. 4 Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
  1. Correspondence to Dr Heikki O Koskela; heikki.koskela{at}kuh.fi

Abstract

Objectives Chronic cough is linked to various long-standing risk factors like asthma, chronic rhinitis and oesophageal reflux disease. On the contrary, acute and subacute cough are usually considered to be caused by acute respiratory infections. Little is known about the possible long-standing risk factors for acute and subacute cough. In this study, we have identified the long-standing risk factors for acute, subacute and chronic cough in order to identify the risk factors specifically associated with chronic cough.

Design A comprehensive 80-item questionnaire was sent via email to the participants.

Setting A community-based study to all public service employees of two towns in central Finland.

Participants There were 13 980 employees, of them 3697 responded (26.4%). Among the responders, there were 199 subjects with current daily acute cough (duration <3 weeks, prevalence 5.4%), 126 subjects with current daily subacute cough (duration 3–8 weeks, prevalence 3.4%) and 267 subjects with current daily chronic cough (duration >8 weeks, prevalence 7.2%).

Primary outcome measures The risk factors that associated with each cough subtype. The subjects without any cough formed the reference group.

Results Several risk factors were associated with both short and long cough subtypes namely family history of chronic cough, moisture damage exposure and number of reported somatic symptoms. Furthermore, allergy was associated with acute and subacute cough. Current asthma and chronic rhinitis were associated with subacute and chronic cough. Oesophageal reflux disease and advanced age were associated with chronic cough.

Conclusions The specific risk factors for chronic cough were oesophageal reflux disease and advanced age. Acute and subacute cough should not be regarded merely as symptoms of acute respiratory infections but possible manifestations of long-standing risk factors. A new risk factor for all cough types was family history of chronic cough.

  • asthma
  • thoracic medicine
  • allergy
  • chronic airways disease
  • epidemiology

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Footnotes

  • Contributors AML made substantial contributions to the conception and design of the work, the acquisition, analysis and interpretation of data for the work, and drafting the work. She mainly wrote the manuscript. She made the final approval of the version to be published and an agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. JP made substantial contributions to the conception and design of the work and interpretation of data for the work, and drafting the work. He made the final approval of the version to be published and an agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. HOK made substantial contributions to the conception and design of the work, the acquisition, analysis and interpretation of data for the work, and drafting the work. He made the final approval of the version to be published and an agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The study was funded by grants from Kuopion Hengityssäätiö and Hengityssairauksien Tutkimussäätiö foundations.

  • Competing interests AML reports grants from Kuopion Hengityssäätiö Foundation, grants from Hengityssairauksien Tutkimussäätiö, during the conduct of the study; personal fees from Orion, Boehringer-Ingelheim, Roche to visit international scientific meetings , outside the submitted work. HOK reports grants from Kuopion Hengityssäätiö Foundation, grants from Hengityssairauksien Tutkimussäätiö, during the conduct of the study; personal fees from Mundipharma, Orion Pharma, Oy, Eli Lilly Finland, Boehringer Ingelheim Finland as payments for giving scientific lectures in gatherings organised by medical companies, personal fees from Takeda Leiras, Boehringer Ingelheim and Mundipharma to visit international scientific meetings, other from owning shares of Orion Pharma worth €25 000, outside the submitted work.

  • Patient consent Not required.

  • Ethics approval The study was approved by the Ethics Committee of Kuopio University Hospital (289/2015).

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

  • Data sharing statement There are no additional unpublished data.

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