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Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6-7 years: analysis from Phase Three of the ISAAC programme.
Lancet 2008; 372(9643):1039-48Lct

Abstract

BACKGROUND

Exposure to paracetamol during intrauterine life, childhood, and adult life may increase the risk of developing asthma. We studied 6-7-year-old children from Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC) programme to investigate the association between paracetamol consumption and asthma.

METHODS

As part of Phase Three of ISAAC, parents or guardians of children aged 6-7 years completed written questionnaires about symptoms of asthma, rhinoconjunctivitis, and eczema, and several risk factors, including the use of paracetamol for fever in the child's first year of life and the frequency of paracetamol use in the past 12 months. The primary outcome variable was the odds ratio (OR) of asthma symptoms in these children associated with the use of paracetamol for fever in the first year of life, as calculated by logistic regression.

FINDINGS

205 487 children aged 6-7 years from 73 centres in 31 countries were included in the analysis. In the multivariate analyses, use of paracetamol for fever in the first year of life was associated with an increased risk of asthma symptoms when aged 6-7 years (OR 1.46 [95% CI 1.36-1.56]). Current use of paracetamol was associated with a dose-dependent increased risk of asthma symptoms (1.61 [1.46-1.77] and 3.23 [2.91-3.60] for medium and high use vs no use, respectively). Use of paracetamol was similarly associated with the risk of severe asthma symptoms, with population-attributable risks between 22% and 38%. Paracetamol use, both in the first year of life and in children aged 6-7 years, was also associated with an increased risk of symptoms of rhinoconjunctivitis and eczema.

INTERPRETATION

Use of paracetamol in the first year of life and in later childhood, is associated with risk of asthma, rhinoconjunctivitis, and eczema at age 6 to 7 years. We suggest that exposure to paracetamol might be a risk factor for the development of asthma in childhood.

Authors+Show Affiliations

Medical Research Institute of New Zealand, Wellington, New Zealand.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18805332

Citation

Beasley, Richard, et al. "Association Between Paracetamol Use in Infancy and Childhood, and Risk of Asthma, Rhinoconjunctivitis, and Eczema in Children Aged 6-7 Years: Analysis From Phase Three of the ISAAC Programme." Lancet (London, England), vol. 372, no. 9643, 2008, pp. 1039-48.
Beasley R, Clayton T, Crane J, et al. Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6-7 years: analysis from Phase Three of the ISAAC programme. Lancet. 2008;372(9643):1039-48.
Beasley, R., Clayton, T., Crane, J., von Mutius, E., Lai, C. K., Montefort, S., & Stewart, A. (2008). Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6-7 years: analysis from Phase Three of the ISAAC programme. Lancet (London, England), 372(9643), pp. 1039-48. doi:10.1016/S0140-6736(08)61445-2.
Beasley R, et al. Association Between Paracetamol Use in Infancy and Childhood, and Risk of Asthma, Rhinoconjunctivitis, and Eczema in Children Aged 6-7 Years: Analysis From Phase Three of the ISAAC Programme. Lancet. 2008 Sep 20;372(9643):1039-48. PubMed PMID: 18805332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6-7 years: analysis from Phase Three of the ISAAC programme. AU - Beasley,Richard, AU - Clayton,Tadd, AU - Crane,Julian, AU - von Mutius,Erika, AU - Lai,Christopher K W, AU - Montefort,Stephen, AU - Stewart,Alistair, AU - ,, PY - 2008/9/23/pubmed PY - 2008/10/4/medline PY - 2008/9/23/entrez SP - 1039 EP - 48 JF - Lancet (London, England) JO - Lancet VL - 372 IS - 9643 N2 - BACKGROUND: Exposure to paracetamol during intrauterine life, childhood, and adult life may increase the risk of developing asthma. We studied 6-7-year-old children from Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC) programme to investigate the association between paracetamol consumption and asthma. METHODS: As part of Phase Three of ISAAC, parents or guardians of children aged 6-7 years completed written questionnaires about symptoms of asthma, rhinoconjunctivitis, and eczema, and several risk factors, including the use of paracetamol for fever in the child's first year of life and the frequency of paracetamol use in the past 12 months. The primary outcome variable was the odds ratio (OR) of asthma symptoms in these children associated with the use of paracetamol for fever in the first year of life, as calculated by logistic regression. FINDINGS: 205 487 children aged 6-7 years from 73 centres in 31 countries were included in the analysis. In the multivariate analyses, use of paracetamol for fever in the first year of life was associated with an increased risk of asthma symptoms when aged 6-7 years (OR 1.46 [95% CI 1.36-1.56]). Current use of paracetamol was associated with a dose-dependent increased risk of asthma symptoms (1.61 [1.46-1.77] and 3.23 [2.91-3.60] for medium and high use vs no use, respectively). Use of paracetamol was similarly associated with the risk of severe asthma symptoms, with population-attributable risks between 22% and 38%. Paracetamol use, both in the first year of life and in children aged 6-7 years, was also associated with an increased risk of symptoms of rhinoconjunctivitis and eczema. INTERPRETATION: Use of paracetamol in the first year of life and in later childhood, is associated with risk of asthma, rhinoconjunctivitis, and eczema at age 6 to 7 years. We suggest that exposure to paracetamol might be a risk factor for the development of asthma in childhood. SN - 1474-547X UR - https://www.unboundmedicine.com/medline/citation/18805332/Association_between_paracetamol_use_in_infancy_and_childhood_and_risk_of_asthma_rhinoconjunctivitis_and_eczema_in_children_aged_6_7_years:_analysis_from_Phase_Three_of_the_ISAAC_programme_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0140-6736(08)61445-2 DB - PRIME DP - Unbound Medicine ER -