The Case Against Acetaminophen as a Wheezing Disorders Promoter
In 1998, Varner et al. proposed, mostly on theoretical grounds, the hypothesis that decreased use of pediatric aspirin had contributed to the increasing prevalence of childhood wheezing disorders. Two years later the first two studies providing epidemiological evidence supporting the hypothesis that acetaminophen exposure was associated with an increased prevalence of asthma appeared. The study by Shaheen et al. showed an association between recent acetaminophen consumption and asthma at the individual level in a case–control study in adults, with an apparent dose-response pattern and, quite interestingly, no association between aspirin use and asthma. In the second study, Newson et al., in an ecological study, found an association between higher national acetaminophen consumption and higher prevalence of asthma, rhinitis and eczema according to the data obtained from the European Community Respiratory Health Survey and the International Study of Asthma and Allergies in Childhood (ISAAC). This association was found in adults and the two age groups of children in the ISAAC, and was mainly driven by the English-speaking countries. Since then, a large body of evidence has been accrued in support of this hypothesis, mostly from epidemiological studies.
Expert Rev Resp Med. 2013;7(2):113-122. © 2013 Expert Reviews Ltd.