Printed in UK- all rights reserved Copyright ERS Journals Ltd 1997 European Respiratory Journal

Birth weight, education, environment, and lung function at school age: a community study in an alpine area P. Lercher*, R. Schmitzberger** Birth weight, education, environment, and lung function at school age: a community study in an alpine area. P. Lercher, R. Schmitzberger. ERS Journals Ltd 1997. ABSTRACT: Our aim was to assess the effect of birth weight, gestational age, pre-dispositions, education, housing and environmental factors on indices of lung func-tion and to evaluate selective interactions among the main predictors. We studied schoolchildren (aged 7.5–12 yrs) in a cross-sectional survey of 13 small alpine communities in Tyrol (Austria). Data were collected retrospectively from self-administered questionnaires (n=796, 85 % response), public records and lung function testing (n=752, 80 % response). In the multivariate analysis it was found that a low birth weight (LBW), a low length of maternal education, a smaller gestational age, and a larger family size were all negatively associated with most lung function measures. Additionally, three significant interactions (birth weight with maternal education, birth weight with gestational age; and birth weight with family size) were observed. This implies that children of an LBW with mothers having a low level of education have a forced expiratory volume in one second (FEV1) value 148 mL lower than average values. Children born at term with an LBW have a 140 mL lower mean FEV1 value, and children of LBW from larger families display a 123 mL lower mean estimate of FEV1. However, subgroups were small (n=26, 17 and 27, respectively). The results support low birth weight as a significant predictor of decreased lung function at school age. However, the size and the direction of the association may differ depending on the levels of the interacting variables