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

Beasley, Richard; Clayton, Tadd; Crane, Julian; Mutius, Erika von; Lai, Christopher; Montefort, Stephen; Stewart, Alistair

doi:10.1016/s0140-6736(08)61445-2

Cited by 353 publications

(264 citation statements)

References 44 publications

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“…The analysis of data from countries participating in ISAAC evaluations showed a strong association between acetaminophen use and symptoms of asthma, AR, and eczema in children aged 6 -7 years. It indicates that the acetaminophen effect is not restricted to the airways (24). In agreement with these analyses, it also seems that the association between acetaminophen and asthma has a cause-effect relationship.…”

Section: Discussionsupporting

confidence: 77%

Evaluation of Allergic Symptoms Prevalence and Its Relationship with Acetaminophen/Antibiotic Use and Hospitalization Among School-Aged Children in Tehran, Iran

Fazlollahi

Abbasi

Dana

et al. 2017

Iran Red Crescent Med J

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Background: Increasing of childhood allergic diseases throughout the world and its heavy socioeconomic burden have posed an important health concern. Therefore, providing the updated relevant epidemiological information is robustly recommended. Objectives: The study aimed to determine the prevalence of asthma, allergic rhinitis (AR), and eczema symptoms in primary school children aged 6 -7 years and ascertain the association of acetaminophen use, antibiotic consumption, and hospitalization for respiratory infection in early life with allergic symptoms. Methods: In this cross-sectional study conducted on primary school children aged 6 -7 years from May to July 2012 in Tehran (Iran), a total of 4993 individuals took part. Cluster sampling was used for random selection of primary schools. Data were gathered by using a modified questionnaire of international study of asthma and allergies in childhood (ISAAC). Then, the questionnaires were completed by parents of the children. Results:The prevalence rates of current wheeze, wheeze ever, current itching rash, itchy rash ever, and rhinitis ever were found to be 19.64%, 27.49%, 8.95%, 8.28%, and 21.87%, respectively. Physician-diagnosed asthma, eczema, and AR were reported in 4.32%, 7.29%, and 9.61% of children, respectively. Univariate logistic regression analysis showed that antibiotic use was significantly associated with symptoms of allergic rhinitis (P = 0.001). Also, the strongest association was found between asthma and atopic dermatitis symptoms and hospitalization due to respiratory infection in early life by multivariate analysis (P = 0.002 and P = 0.009, respectively). Conclusions: This study determined the rising pattern of allergic symptoms in 6 -7 year old children in Tehran. Moreover, acetaminophen/antibiotic use and hospitalization due to respiratory infection in early life were detected as significant risk factors for the appearance of childhood allergic symptoms.

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Section: Discussionsupporting

confidence: 77%

Evaluation of Allergic Symptoms Prevalence and Its Relationship with Acetaminophen/Antibiotic Use and Hospitalization Among School-Aged Children in Tehran, Iran

Fazlollahi

Abbasi

Dana

et al. 2017

Iran Red Crescent Med J

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“…No information was available on the causes of fever. Additionally, ISAAC Phase III reported paracetamol use for fever in year1 was associated with asthma symptoms at 6-7 yrs [23]. Similar associations were reported for rhinoconjunctivitis and eczema.…”

Section: Discussionmentioning

confidence: 56%

Febrile respiratory illnesses in infancy and atopy are risk factors for persistent asthma and wheeze

Kusel

Kebadze²,

Johnston³

et al. 2011

Eur Respir J

107

145

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Severe viral respiratory illnesses and atopy are risk factors for childhood wheezing and asthma. The aim of this study was to explore associations between severe respiratory infections and atopy in early childhood with wheeze and asthma persisting into later childhood.147 children at high atopic risk were followed from birth to age 10 yrs. Data on all respiratory infections occurring in infancy were collected prospectively and viral aetiology ascertained. Atopy was measured by skin prick tests at 6 months, and 2 and 5 yrs. History of wheeze and doctordiagnosed eczema and asthma was collected regularly until 10 yrs of age.At 10 yrs, 60% of the cohort was atopic, 25.9% had current eczema, 18.4% current asthma and 20.4% persistent wheeze. 35.8% experienced at least one lower respiratory infection (LRI) associated with fever and/or wheeze in first year of life. Children who had wheezy or, in particular, febrile LRI in infancy and were atopic by 2 yrs, were significantly more likely to have persistent wheeze (RR 3.51, 95% CI 1.83-6.70; p,0.001) and current asthma (RR 4.92, 95% CI 2.59-9.36; p,0.001) at 10 yrs.Severe viral respiratory infections in infancy and early atopy are risk factors for persistent wheeze and asthma. The strongest marker of the asthmatogenic potential of early life infections was concurrent fever. The occurrence of fever during respiratory illnesses is an important marker of risk for wheeze and asthma later in childhood, suggesting it should be measured in prospective studies of asthma aetiology.

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“…Paracetamol (acetaminophen) use during pregnancy 46 and for fever in the child's first year of life 47 have been associated with increased prevalence of asthma in children.…”

Section: Other Risk Factorsmentioning

confidence: 99%

Global strategy for the diagnosis and management of asthma in children 5 years and younger

Pedersen

Hurd

Lemanske

et al. 2010

Pediatric Pulmonology

267

207

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Asthma is the most common chronic disease of childhood and the leading cause of childhood morbidity from chronic disease as measured by school absences, emergency department visits, and hospitalions1. During the past two decades, many scientific advances have improved our understanding of asthma and our ability to manage and control it effectively. However, in children 5 years and younger, the clinical symptoms of asthma are variable and non‐specific. Furthermore, neither airflow limitation nor airway inflammation, the main pathologic hallmarks of the condition, can be assessed routinely in this age group. For this reason, to aid in the diagnosis of asthma in young children, a symptoms‐only descriptive approach that includes the definition of various wheezing phenotypes has been recommended2. In 1993, the Global Initiative for Asthma (GINA) was implemented to develop a network of individuals, organizations, and public health officials to disseminate information about the care of patients with asthma while at the same time assuring a mechanism to incorporate the results of scientific investigations into asthma care. Since then, GINA has developed and regularly revised a Global Strategy for Asthma Management and Prevention. Publications based on the Global Strategy for Asthma Management and Prevention have been translated into many different languages to promote international collaboration and dissemination of information.In this report, Global Strategy for Asthma Management and Prevention in Children 5 Years and Younger, an effort has been made to present the special challenges that must be taken into account in managing asthma in children during the first 5 years of life, including difficulties with diagnosis, the efficacy and safety of drugs and drug delivery systems, and the lack of data on new therapies. Approaches to these issues will vary among populations in the world based on socioeconomic conditions, genetic diversity, cultural beliefs, and differences in healthcare access and delivery. Patients in this age group are often managed by pediatricians and general practitioners routinely faced with a wide variety of issues related to childhood diseases. Pediatr Pulmonol. 2011; 46:1–17. © 2010 Wiley‐Liss, Inc.

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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

Cited by 353 publications

References 44 publications

Evaluation of Allergic Symptoms Prevalence and Its Relationship with Acetaminophen/Antibiotic Use and Hospitalization Among School-Aged Children in Tehran, Iran

Evaluation of Allergic Symptoms Prevalence and Its Relationship with Acetaminophen/Antibiotic Use and Hospitalization Among School-Aged Children in Tehran, Iran

Febrile respiratory illnesses in infancy and atopy are risk factors for persistent asthma and wheeze

Global strategy for the diagnosis and management of asthma in children 5 years and younger

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