Asthma in Children Linked with Common Pain and Fever Drugs

Asthma rates throughout the world have risen alarmingly in the 40 years since the 1970s. Rates for children under the age of five rising by more than 160% in the period from 1980-1994. In 2010, about 300 million people were estimated to be affected throughout the world. Bronchial asthma cases in Japan have increased sixfold. In the 1960s, only 1% of children suffered from bronchial asthma in Japan, but by the 1990s between 4-8% of children were affected. Japanese children are being affected by asthma at younger ages with 80 percent of sufferers now developing symptoms by the age of three years. Why has the incidence of asthma in children risen?

Medical experts have been trying to establish a cause for the increase. It is known that most asthma attacks are triggered by common allergens such as house dust, mites (by far the worst), cockroach faeces, cat and dog hair, pollen, dairy products, fungi, hen eggs, buckwheat and wheat. Many researches have looked to the various lifestyle changes and housing developments that may have encouraged house mites and the allergen triggers to proliferate. This includes modern draft-free house designs, the proliferation of heaters and other developments in housing.

How increased drug use is linked to increased in wheeze rates
How increased drug use is linked to increased in wheeze rates. Source: Public Domain

However, recent research has 'pointed the finger' at common pain and fever treatment drugs such as acetaminophen (paracetamol) which were not widely used until the 1970s. By the1980s, sales of paracetamol had risen above those of aspirin in many countries.

The rise in the asthma epidemic in the 1980s coincided with the increase popularity of acetaminophen and the decline in aspirin use for treatment of fevers in children. Aspirin was linked to Reye’s syndrome in children, and many doctors stopped recommending aspirin for children in favour of acetaminophen. The switch to acetaminophen as a possible cause for increases in asthma prevalence was first proposed in 1998.

Since then more than twenty studies have been conducted that support this theory, including a very large study of than 200,000 children that showed an association between the taking of acetaminophen and increased risk of asthma.

The review study published by John McBride from the Akron Children’s Hospital in Ohio, summarises the information:

Counter Arguments

Randomized and Properly Controlled Trial Studies

So far there is only a single properly controlled, randomized trial. Researchers in Boston in 2002, randomly assigned about 1,900 children suffering from asthma, to take either acetaminophen or ibuprofen when they developed fever symptoms. The study concluded that children who were given acetaminophen were twice as likely to be taken to a doctor for asthma symptoms than those who took ibuprofen. There is a desperate need for more randomised controls.

There is a lot of uncertainty about how doctors should respond to the data and research findings. Many authorities urge caution.

References

Outdoor air pollution and asthma in children

All studies reviewed in this work indicate that outdoor air pollution affects the appearance and exacerbation of asthma in children.

Pharmacogenetics of asthma in children

The clinical features of patients and causes of diseases vary. Therefore, personalized medicine (tailor-made medicine) is necessary for the improvement of quality of life (QOL) and for asthma cure.

The role of paracetamol in the pathogenesis of asthma

Paracetamol use represents a putative risk factor for the development of asthma.There is convincing epidemiological evidence that the risk of asthma may be increased with exposure to paracetamol in the intrauterine environment, infancy, later childhood and adult life. A dose-dependent association has also been observed in these different age groups in different populations world-wide.


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Asthma rates are increasing and may be linked to use of common pain drugs
Asthma rates are increasing and may be linked to use of common pain drugs. Source: Public Domain
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