Every year, tens of thousands of men, women and children are newly diagnosed with asthma. With 1 in 12* people suffering from asthma in the United States, there is a constant push for better diagnosis and treatment. With no known cure or definitive causes, theories as to why asthma occurs in a growing segment of the population are numerous.
Despite not knowing the exact reason why people develop asthma, numerous factors have been identified as things which can increase the risk of developing this disease, including exposure to tobacco smoke and other environmental factors. In a research paper published in December, Dr. John T. McBride stirred national attention by advising against the use of acetaminophen for children with asthma. As the second study released in a year on the topic, the article, "The Association of Acetaminophen and Asthma Prevalence and Severity," in Pediatrics examines previous research to determine that the link between acetaminophen and asthma is too great to ignore.
Though not the first study or research that leans towards a potential causal relationship between acetaminophen and asthma, it is the first in which the lead researcher advocates avoiding this popular pain reliever.
Much of the previous research has led to two potential relationships between acetaminophen and asthma. The first is that the use of acetaminophen actually increases airway inflammation, increasing severity and frequency of asthma attacks. The second possibility is that exposure to the pain reliever in utero, or in the first year after birth, may lead to an increased risk of developing asthma later in life. Dr. McBride's research focuses on an examination of research regarding the former.
In examining several previous studies of children who have used acetaminophen and related cases of asthma, McBride sees a trend. In the most telling, an international research project, headed by Richard Beasley, data from over 500,000 children in nearly 60 countries was gathered and analyzed. In these studies, observed children displayed increased chances of asthma attacks and/or developing asthma at fairly high rates. These included:
- 13-14 year olds who took acetaminophen more than once per year but less than once a month saw their risk for developing asthma jump by 40%
- 6-7 year olds who took acetaminophen more than once per year but less than once a month saw their risk for developing asthma jump by 60%
- Regardless of geography, culture or economic levels of the countries, when acetaminophen was used, the results were almost always the same
Other studies that were analyzed focused on the effect acetaminophen usage had upon adults. One in particular showed a near 50% increase in the risk of developing asthma with weekly use of the drug.
While there are multiple layers and details within each study, the broad trend that Dr. McBride observed in relation to acetaminophen use and asthma was enough for him to advise against the use of popular children's medicines that contain the compound.
McBride agrees with others that further research is needed. Where he differs is that for him the evidence of risk involved with the use of acetaminophen is so great that he believes at this point, research to prove the SAFETY of the drug needs to be done, not more research further proving adverse effects on asthmatics and children. Ultimately, if time proves Dr. McBride to be correct in his warnings, it will not be the first time that a popular children's medicine has fallen out of favor for health concerns.
Pain Relievers and Health Concerns
The questions surrounding the use of acetaminophen and asthma are not the first time a major children's pain reliever has been called into question. Children's aspirin used to be very common. Most of us who are in our 30's or older can remember Bayer's tiny orange flavored dissolvable aspirin that we would sometimes take as children.
Use of aspirin for children began falling as soon as acetaminophen and ibuprofen were introduced in 1956 and 1969, respectively. But then in 1967, the FDA began limiting the potency of children's aspirin
in an effort to reduce potential overdoses and other related issues with the use of aspirin by children. By the late 1970's statistics were beginning to show a significant link between the use of children's aspirin and Reye's Syndrome. Just a few years later, the CDC would begin advising against the use of aspirin for children under the age of 12 who were experiencing cold or flu symptoms. Consequently, the instances of Reye's Syndrome began to wane shortly thereafter.
This historical data somewhat matches a very interesting trend line. As aspirin declined, acetaminophen quickly became one of the most popular children's medicines for colds, aches and pains. As use of acetaminophen-based products like Tylenol has increased since 1980, so has the prevalence of asthma amongst children. As the graph indicates, the prevalence of asthma in children has steadily grown since 1980.**
For children with asthma or a family history of asthma, the amount data compiled over the last decade likely warrants, at a minimum, a serious discussion with your pediatrician or family physician. For those who share the same concern as Dr. McBride, ibuprofen has shown to be nearly as effective in pain relief and swelling as well as in treating cough and cold symptoms. Regardless of your stance, as medical and pharmacological research advances so too will our understanding of asthma.
To read the full text of Dr. McBride's study, download or view the PDF.
For full text of the Beasley study, Acetaminophen Use and Risk of Asthma, Rhinoconjunctivitis, and Eczema in Adolescents.
* CDC Asthma Infographic -
** For current asthma prevalence statistics in the U.S. -