Asthma linked with Paracetamol Use

A study published in The Lancet suggests that using paracetamol in the first year of life is linked to an increased risk of asthma and other allergies.

This study assessed over 200,000 children from 31 countries and found that giving paracetamol to treat fever in children in the first year of life, means that child has a 46% greater risk of having asthma symptoms at age 6 to 7. The study also found that 6 to 7 year-olds who had taken paracetamol once a month in the 12 months prior had a had a three fold increase risk of asthma.

An explanation of how this may be possible is that paracetamol reduces antioxidant defences. This can lead to inflammation in the airways, which is the basis of asthma. It may switch the immune system to become more allergic.

Australian paediatric allergy specialist Professor Andrew Kemp of Children's Hospital Westmead in Sydney says serious consideration should be given to this possible explanation for the findings.

It is important know the effects of it, because so many people take paracetamol. If the link is proven then 20 to 40% of asthma cases might be attributed to paracetamol exposure.

Dr Raymond Mullins, president of the Australasian Society for Clinical Immunology and Allergy says the new study is a fascinating one because there is no explanation as to why allergic disease is more common than it used to be.

This then presents the problem for parents, of what to do when their children get a fever. Firstly, paracetamol should be used only to treat fevers that are above 38.5°C.

Simple methods to reduce fever include giving the child plenty of fluids, removing their clothes, and sponging them with tepid water. Also, some children tolerate fevers better than others, so it’s not always necessary to treat a child every time they get a fever. The purpose of a fever is to kill the bugs that are causing it, so there is an argument for allowing the fever to run, especially in older children.

If there is a family history of allergies, avoiding paracetamol in the first year of life is preferable. Homeopathic medicines offer a safe alternative for fever management. Some are available in pharmacies, or you can see your health professional.

Decreasing the risk of asthma has simple guidelines – keep active, have plenty of fresh fish, fruit and vegetables, and only use medication if it is absolutely necessary.

Reference: 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

The Lancet, Volume 372, Issue 9643, 20 September 2008-26 September 2008, Pages 1039-1048,

Richard Beasley, Tadd Clayton, Julian Crane, Erika von Mutius, Christopher KW Lai, Stephen Montefort, Alistair Stewart and for the ISAAC Phase Three Study Group