Gayan Bowatte

• Doctor of Philosophy
• PostDoc Position at University of Melbourne

Background and Objective The impact of lifetime body mass index (BMI) trajectories on adult lung function abnormalities has not been investigated previously. We investigated associations of BMI trajectories from childhood to mid‐adulthood with lung function deficits and COPD in mid‐adulthood. Methods Five BMI trajectories ( n = 4194) from age 5 to...

Introduction: Post-COVID-19 symptoms have been identified among a considerable proportion of individuals following acute COVID-19. This study cross-sectionally analyzed the post-COVID-19 symptoms of confirmed COVID-19 patients, between April – September 2021 who visited the post-COVID clinic, Teaching Hospital, Peradeniya, Sri Lanka.Methods: Patien...

Air pollution is the leading environmental hazard that has devastating health effects on human health. Identification of trends and patterns of air pollution is crucial in a specific geographic area to inform and implement effective control and mitigation measurements. Standard air pollution monitoring networks are costly for most low-and middle-in...

Rationale: The term ‘pre-COPD’ refers to individuals at high-risk of developing Chronic Obstructive Pulmonary Disease (COPD) who do not meet conventional spirometric criteria for airflow obstruction. New approaches to identifying these individuals are needed, particularly in younger populations. Objective: To determine whether lung function thresh...

Air pollution is one of the leading environmental hazards that causes devastating health effects on human health. Identifying air pollution trends and patterns in a particular geographic area is essential for controlling air pollution. Monitoring air pollution in most low- and middle-income countries using standard air pollution monitoring networks...

Objectives There is a scarcity of evidence on occupational exposures that may increase eczema in adults. We aimed to investigate potential associations between occupational exposures and eczema in middle-aged adults. Methods A lifetime work history calendar was collected from the Tasmanian Longitudinal Health Study participants when they were at a...

Rationale: Understanding the pathobiology of life-course lung function trajectories that progress to COPD, especially with a rapidly declining phenotype, can inform preventive interventions. Genetic and environmental interactions may contribute to these high-risk trajectories through epigenetic variation Objectives: A pilot to broadly characterise...

Despite substantial disease burden, existing evidence on the risk factors for obstructive sleep apnea (OSA) have been derived primarily from cross-sectional studies without determining temporality. Therefore, we aimed to systematically synthesize the literature on longitudinal risk factors for sleep study-assessed OSA and questionnaire-assessed pro...

Background: The few studies that have examined associations between greenspace and lung function in adulthood have yielded conflicting results and none have examined whether the rate of lung function decline is affected. Objective: We explored the association between residential greenspace and change in lung function over 20 years in 5559 adults...

Rationale: Asthma is a heterogeneous condition and longitudinal phenotyping may provide new insights into origins and outcomes of the disease. Objective: We aimed to characterize the longitudinal phenotypes of asthma between the first and sixth decades of life in a population-based cohort study. Methods: Respiratory questionnaires were collect...

Background/objective: Obesity is a risk factor for multimorbidity, including depression and possibly anxiety. However, it is currently unclear how patterns of change in BMI over the life course differentially influence the magnitude in risk of depression and anxiety in mid-adulthood. We aimed to examine associations between BMI trajectories from c...

Accumulating evidence indicates a high prevalence rate of persistent symptoms leading to post-acute COVID-19 syndrome. It has been identified as a multi-organ disease with a wide range of prolonged symptoms that may be reflective of underlying respiratory, cardiovascular, neuropsychiatric, gastrointestinal, dermatological, renal, and endocrine diso...

Background The extent to which biomarkers of asthma activity persist in spontaneous asthma remission and whether such markers are associated with future respiratory outcomes remained unclear. We investigated the association between sub‐clinical inflammation in adults with spontaneous asthma remission and future asthma relapse and lung function decl...

Background: Interest in lifetime lung function trajectories has increased in the context of emerging evidence that chronic obstructive pulmonary disease (COPD) can arise from multiple disadvantaged lung function pathways, including those that stem from poor lung function in childhood. To our knowledge, no previous study has investigated both obstr...

Motor vehicle emissions are the primary air pollution source in cities worldwide. Changes in traffic flow in a city can drastically change overall levels of air pollution. The level of air pollution may vary significantly in some street segments compared to others, and a small number of stationary ambient air pollution monitors may not capture this...

Background and objective: The association between birth weight, particularly relative to gestational age, and adult lung function is uncertain. We investigated the associations between birth weight relative to gestational age and measures of lung function in middle age, and mediation of these associations by adult height. Methods: Participants i...

Background: Complementary and Alternative Medicine (CAM) consists of a group of medical and health care systems, practices, and products delivered outside the mainstream health care system. CAM treatments can be used not only to treat diseases but also to promote wellness, disease prevention, and manage symptoms. However, someone’s attitudes toward...

Human Milk Oligosaccharides (HMOs), the complex, unique glycans present in human milk, are essential for infants’ early development and provide many health benefits to humans. Although the effects of all the individual HMOs are not fully understood, studies have revealed many health benefits of HMOs acting as prebiotics. They shape the gut microbio...

Background Chronic bronchitis in childhood is associated with a diagnosis of asthma and/or bronchiectasis a few years later, however, consequences into middle-age are unknown. Objective To investigate the relationship between childhood bronchitis and respiratory-related health outcomes in middle-age. Design Cohort study from age 7 to 53 years. S...

Background High body mass index trajectories from childhood to adulthood are associated with development of some chronic diseases, but whether such trajectories influence adult asthma has not been investigated to date. Therefore, we investigated associations between body mass index trajectories from childhood to middle age (5–43 years) and incidenc...

Background: Most households in low- and middle-income countries (LMICs) rely on biomass fuel for daily cooking. Studies investigating the association between early life exposure to household air pollution and health outcomes in children in LMICs are limited. Objective: To investigate the effects of biomass fuel for cooking and different types of...

Background Prematurity has been linked to reduced lung function up to age 33 years, but its long-term effects on lung function and chronic obstructive pulmonary disease (COPD) are unknown. To address this question, we investigated associations between prematurity, lung function, and COPD in the sixth decade of life using data from the Tasmanian Lon...

Background Recent evidence suggests that parental exposures before conception can increase the risk of asthma in offspring. Objective We investigated the association between parental preconception Body Mass Index (BMI) trajectories from childhood to adolescence and subsequent risk of asthma in their offspring. Methods Using group-based trajectory...

Objective: To evaluate the associations between childhood, parental, and grandparental asthma. Methods: We studied 59,484 children randomly selected from 94 kindergartens, elementary, and middle schools in seven Chinese cities from 2012 to 2013, using a cross-sectional survey-based study design. Information on their and their family members' (paren...

This study provides novel insights into mechanisms of traffic-related air pollution-induced allergy by down-regulation via complement regulators (CFI, PROS1 and PLG) and its interaction with vitamin D deficiency via the complement inhibitor PLG https://bit.ly/3x0jYOw.

Evidence of associations between exposure to ambient air pollution and health outcomes are sparse in the South Asian region due to limited air pollution exposure and quality health data. This study investigated the potential impacts of ambient particulate matter (PM) on respiratory disease hospitalization in Kandy, Sri Lanka for the year 2019. The...

Rationale The naturally occurring age-dependent decline in lung function accelerates after menopause, likely due to the change of the endocrine balance. Although increasing evidence shows suboptimal lung health in early life can increase adult susceptibility to insults, the potential effect of poor childhood lung function on menopause-dependent lun...

The COVID-19 pandemic has led to the complete lockdown of many cities worldwide. Lockdowns have significantly changed human behaviour, such as fewer or no industrial activities and limited road and air transport, affecting the environment. In this study, we aimed to assess the variability and trends of PM2.5 (mass concentration of airborne particul...

Background and objective Different lung function trajectories through life can lead to chronic obstructive pulmonary disease (COPD) in adulthood. This study investigates if circulating levels of biomarkers can differentiate those with accelerated (AD) from normal decline (ND) trajectories. Methods The Tasmanian Longitudinal Health Study (TAHS) is...

Background: The majority of households in low- and middle-income countries (LMICs) rely on biomass fuel for daily cooking. Studies investigating the association between early life exposure to household air pollution and health outcomes in children in LMICs have been limited. This study aimed to investigate the effects of use of biomass fuel for coo...

Background: Recent studies suggest that household endotoxin and allergens can modify the impact of air pollutants on development of asthma; however, epidemiological evidence is limited and conflicting. Objectives: To investigate whether pet ownership modified the association between ambient air pollution and asthma in children. Methods: We con...

Background There is limited information on risk factors for eczema in adults. Recent evidence suggests that air pollution may be associated with increased incidence of eczema in adults. We aimed to assess this possible association. Methods Ambient air pollution exposures (distance from a major road, nitrogen dioxide [NO2], fine particulate matter...

The aim of this study was to investigate the impact of biomass fuel for cooking on adverse fetal growth outcomes in Sri Lanka. A cross-sectional study of mothers recruited at maternity clinics in rural communities in Sri Lanka’s Central Province was undertaken. Data pertaining to household air pollution and fetal growth parameters were collected us...

Bronchodilator reversibility (BDR) is often used as a diagnostic test for adult asthma. However, there has been limited assessment of its diagnostic utility. We aimed to determine the discriminatory accuracy of common BDR cut-offs in the context of current asthma and asthma-COPD overlap (ACO) in a middle-aged community sample. The Tasmanian Longitu...

Background: The majority of households in low- and middle-income countries (LMICs) rely on biomass fuel for daily cooking. Studies investigating the association between early life exposure to household air pollution and health outcomes in children in LMICs have been limited. This study aimed to investigate the effects of use of biomass fuel for coo...

Background Longitudinal trajectories of asthma and allergies from childhood to adulthood might be differentially associated with lung function and chronic obstructive pulmonary disease (COPD), but associations with extrapulmonary comorbidities have not been well investigated. We aimed to assess these trajectories and examine their associations with...

Ambient air pollution is a global environmental hazard, particularly affecting urban areas. Sudden spikes of air pollution in the atmosphere in a given area can occur due to many factors, either individually or combined. Generally, local effects are due to anthropogenic sources, while large scale variations occur due to natural events such as dust...

The question addressed by the study: Are long-term Household Air Pollutions (HAPs) associated with asthma and lung function decline in middle-aged adults, and whether these associations were modified by GST gene variants, ventilation and atopy. Materials and methods: Prospective data on HAPs (heating, cooking, mould, smoking) and asthma were col...

Background Human Milk Oligosaccharides (HMO) are a diverse range of sugars secreted in breast milk that have direct and indirect effects on immunity. The profiles of HMOs produced differ between mothers. Objective To determine the relationship between maternal HMO profiles and offspring allergic diseases up to 18 years Methods Colostrum and early...

Recent evidence suggests that air pollution exposure may be a contributing risk factor for obstructive sleep apnea (OSA), however, current evidence is conflicting. This systematic review aims to determine the association between air pollution and OSA in the general population, and examine for potential effect modification by seasonality, temperatur...

RATIONALE: On November 21, 2016 in Australia, a major thunderstorm-asthma epidemic struck Melbourne with an unprecedented number of emergency presentations, hospital admissions and fatalities. OBJECTIVES: We identified affected patients who presented to The Royal Melbourne Hospital, an adult tertiary center in North-West Melbourne. We aimed to char...

Background Previous studies have reported an association between weight increase and excess lung function decline in young adults followed for short periods. We aimed to estimate lung function trajectories during adulthood from 20-year weight change profiles using data from the population-based European Community Respiratory Health Survey (ECRHS)....

Rationale: Poor lung function, a significant predictor of mortality, has been observed in post-menopausal women when compared to those still menstruating. Menopausal age is a risk factor for several adverse health outcomes, but little evidence exists on the impact of menopausal age on lung function impairments, especially on post-bronchodilator lu...

Rationale: Interactions between early life and adult insults on lung function decline are not well understood, with most studies investigating pre-bronchodilator (BD) FEV1 decline. Objective: To investigate relationships between adult risk factors and pre- and post-BD lung function decline and their potential effect modification by early life an...

Background and objective: Early menarche is increasing in prevalence worldwide, prompting clinical and public health interest on its links with pulmonary function. We aimed to investigate the relationship between early menarche and lung function in middle age. Methods: The population-based Tasmanian Longitudinal Health Study (born 1961; n = 8583...

Air pollution in urban areas is a major global public health issue. Very little work has been done to monitor the ambient air pollution in Sri Lanka's cities. Spot measurements have indicated that the pollution levels in Colombo are well above the standard levels recommended by the World Health Organization. The aim of this study is to continuously...

Objective To examine the utility of apnoea screening questionnaires, alone and in combination with the Epworth sleepiness scale (ESS), for detecting obstructive sleep apnoea (OSA) in primary care. Design, setting Prospective validation study in an Australian general population cohort. Participants 424 of 772 randomly invited Tasmanian Longitudina...

Importance Which cardiometabolic risk factors (eg, hypertension, type 2 diabetes, overweight or obesity, and dyslipidemia) are more sensitive to long-term exposure to ambient air pollution and whether participants with these conditions are more susceptible to the cardiovascular effects of air pollution remain unclear. Objectives To evaluate the as...

Background: Glutathione S-transferase (GST) genes are involved in the management of oxidative stress in the lungs. We aimed to determine whether they modify the associations between early life smoke exposure and adverse lung health outcomes. Methods: The Melbourne Atopy Cohort study (a high-risk birth cohort) enrolled 620 children and followed t...

The concordance of different indices from type‐4 sleep studies in diagnosing and categorising the severity of obstructive sleep apnoea is not known. This is a critical gap as type‐4 sleep studies are used to diagnose obstructive sleep apnoea in some settings. Therefore, we aimed to determine the concordance between flow‐based apnoea–hypopnoea index...

Background: Residing in greener places may be protective against diabetes mellitus (DM) but evidence is scarce and comes mainly from developed countries. Objectives: To investigate associations of residential greenness with DM prevalence and glucose-homeostasis markers in Chinese adults and whether these associations were mediated by air polluti...

In the last decade, studies investigating greenspace have highlighted several benefits to human health. However, the effect of greenspace on allergies and atopic sensitization in children was not clear. While several studies have investigated this link, the evidence has not been systematically synthesized. We conducted a systematic search of eight...

Background There is increasing interest in the role of traffic-related air pollution (TRAP) in allergic airway diseases. Few studies investigate the relationship between TRAP exposure and acute exacerbations of asthma. Objective The 2016 Melbourne thunderstorm asthma epidemic provided an opportunity to investigate the relationship between proxies...

Background and objectives: Little is known about PM1 effects on respiratory health, relative to larger size fractions (PM2.5). To address this literature gap, we assessed associations between PM1 exposure and asthmatic symptoms in Chinese children and adolescents, compared with PM2.5. Methods: A total of 59,754 children, aged 2-17 years, were re...

Background: Very few studies have examined whether a long-term beneficial effect of physical activity on lung function can be influenced by living in polluted urban areas. Objective: We assessed whether annual average residential concentrations of nitrogen dioxide (NO2) and particulate matter with aerodynamic diameters < 2.5 μm (PM2.5) and <10 μ...

Background: Little information exists on the lipidemic effects of air pollution, particularly in developing countries. We aimed to investigate the associations of long-term exposure to ambient air pollutants with lipid levels and dyslipidemias in China. Methods: In 2009, a total of 15,477 participants aged 18-74 years were recruited from the 33...

The monotypic genus Lankanectes, considered an evolutionary long branch with India's Nyctibatrachus as its sister lineage, is represented by L. corrugatus, a species widely distributed within the wet zone of Sri Lanka up to 1500 m asl, where it inhabits a variety of lotic and lentic habitats. Here, following an integrative taxonomic approach using...

Early identification of people at risk of developing COPD is crucial for implementing preventive strategies. We aimed to systematically review and assess the performance of all published models that predicted development of COPD. A search was conducted to identify studies that developed a prediction model for COPD development. The Checklist for Cri...

Rationale: Childhood risk factors for long-term lung health often co-exist and their specific patterns may affect subsequent lung function differently. Objectives: To identify childhood risk factor profiles, their influence on lung function and chronic obstructive pulmonary disease (COPD) in middle-age and potential pathways. Methods: Profiles...

Background: Lifetime lung function is related to quality of life and longevity. Over the lifespan, individuals follow different lung function trajectories. Identification of these trajectories, their determinants, and outcomes is important, but no study has done this beyond the fourth decade. Methods: We used six waves of the Tasmanian Longitudi...

Purpose of review: Glutathione S-transferase (GST) genes are involved in oxidative stress management and may modify the impact of indoor air pollution. We aimed to assess the influence of GST genes on the relationship between indoor air pollution and allergy/lung function. Recent findings: Our systematic review identified 22 eligible studies, wi...

Introduction Eczema is a common childhood ailment responsible for a considerable disease burden. Both timing of introduction to solid food and allergenic food are believed to be related to childhood eczema. Despite the growing body of evidence, the relationship between timing of any solid food introduction (allergenic and/or non-allergenic) and dev...

Background and aims: Traffic Related Air Pollution (TRAP) exposure is known to exacerbate existing respiratory diseases. We investigated longer term effects of TRAP exposure for individuals with or without existing asthma, and with or without lower lung function. Methods: Associations between TRAP exposure and asthma (n = 689) and lung function...

Young children are particularly vulnerable to otitis media (OM) which globally affects over 80% of children below the age of 3 years. Although there is convincing evidence for an association between environmental tobacco smoke exposure and OM in children, the relationship with ambient air pollution is not clear. We aimed to systematically review th...

Current evidence concerning the impact of exposure to traffic-related air pollution (TRAP) on adult respiratory morbidity mainly comes from cross-sectional studies. We sought to establish more robust measures of this association and potential gene–environment interactions using longitudinal data from an established cohort study. Associations betwee...

Introduction: Dietary poly unsaturated fatty acids (PUFA) have immune regulatory properties. Breast milk is rich in PUFA, and it has been hypothesised that these PUFAs may be important in the aetiology of allergic diseases. Despite a growing body of evidence, the associations between breast milk PUFA and allergic disease have not previously been s...