This is a very interesting study because of its long follow-up over time (up to eight decades) in a representative sample of the British population. It finds that the risk of dying from respiratory causes is twice higher in those participants who had repeated respiratory infections during childhood, especially those who had them before the age of two, or who suffered more than three episodes.  

The study highlights how difficult it is to confirm with hard evidence something that we often observe in the clinic: children with poor respiratory health are often adults who are prone to disease, or die earlier.  

In this cohort, one in five premature respiratory deaths is attributed to repeated respiratory infections during childhood; by comparison, two in five are due to smoking.  

Adjusting for low socio-economic class or overcrowding (defined here as sleeping in the same room as other people) is relevant.  

The study has some limitations: it didn’t include respiratory function measurement via spirometry or peak-flow, and didn’t take into account compulsory vaccinations at these ages, which probably affected migrants and the lowest-income groups.