title: Social predictors of adult asthma: a co-twin case-control study.
abstract: BACKGROUND
  Environmental factors are needed to explain the observed increase in the prevalence of asthma during recent decades, despite the existence of a recognised genetic component in asthma. A co-twin case-control study was undertaken to examine possible social risk factors for asthma.
  
  
  METHODS
  Asthma diagnoses were based on register data of reimbursed asthma medication. During 17 years follow up of the Finnish twin cohort, 262 twin pairs discordant for incident asthma were identified. Conditional logistic regression for 1-1 matched data was used for risk calculation.
  
  
  RESULTS
  The atopic twin had an increased risk of asthma compared with the non-atopic co-twin (RR 2.91, 95% CI 1.81 to 4.68). The more educated twin had a decreased risk of asthma compared with his/her twin sibling with less education (RR 0.45, 95% CI 0.23 to 0.86), and the twin who participated in conditioning exercise had a decreased risk of asthma compared with the more sedentary co-twin (RR 0.55, 95% CI 0.34 to 0.88).
  
  
  CONCLUSIONS
  In addition to allergic diseases, educational level and physical activity are associated with adult onset asthma, which indicates a role for factors associated with life style.
authors.affiliation: Department of Public Health, University of Helsinki, Finland. elisa.huovinen@helsinki.fi
authors.forename: E
authors.initials: E
authors.lastname: Huovinen
authors.forename: J
authors.initials: J
authors.lastname: Kaprio
authors.forename: L A
authors.initials: LA
authors.lastname: Laitinen
authors.forename: M
authors.initials: M
authors.lastname: Koskenvuo
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology*; D016022:Case-Control Studies; D004522:Educational Status; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012931:Social Environment