Paracetamol increases the risk of asthma in children
paracetamol, sold under brand names such as Metacin, Crocin and Calpol in India, is considered a safe bet
against fever and body ache. But it may pose problems for children, a new study revealed. It found that if a child was given paracetamol within the
first year of birth, it increased the risk of asthma by 46 per cent five or six years later. It also made children prone to repetitive sneezing, nasal
congestion, hay fever and eczema. Despite these findings, the researchers said that paracetamol should remain the preferred drug against fever
in children because its alternatives were more harmful.
Researchers across the world studied more than 200,000 children in the age group of six to seven in 31 countries. If paracetamol was
administered once or more than once a month, the risk doubled, said their paper published in Lancet (Vol 372, No 9643). The analysis
was part of phase three of the International Study of Asthma and Allergies in Childhood. Researchers said that earlier phases of the study had
found increased incidents of asthma along with a simultaneous rise in use of paracetamol.
The researchers reviewed other related studies, the European respiratory health survey for instance, which began in the 1980s. This study said
that the risk of asthma increased due to paracetamol use during pregnancy, infancy and adult life. This study was carried out in 22 countries
including India and involved about 150,000 individuals. Another study published in the Journal of Investigational Allergology and Clinical
Immunology (Vol 16, No 4), studied more than 3,000 children in Mexico and established a link between paracetamol and asthma and
eczema. A similar study published in European Respiratory Journal (Vol 18, No 3) also said that paracetamol increased the risk of
asthma and not environmental allergens such as dust. But there are few alternatives to the drug. Aspirin, also prescribed for fever and body ache,
is known to cause Reye's syndrome, a metabolic disorder of the brain and liver. "The findings do lend support to the current guidelines of the
World Health Organization, which recommend that paracetamol should not be used routinely, but should be reserved for children with a high fever
(more than 101 Fahrenheit)," the paper said.
Critics said that though the study gave an insight into the causes of asthma, it suffered from problems such as recall bias. "The findings do not
definitively show that early exposure to paracetamol increases the risk of childhood asthma. The researchers asked for parents to recall the use
of paracetamol in early years of the child. Parents of kids who have asthma might remember giving them paracetamol more readily than parents
whose children are free of asthma," said Adrian Lowe, research fellow at University of Melbourne's Centre for Molecular, Environmental, Genetic
and Analytic Epidemiology. The authors too did not rule out recall bias in their analysis. Praveen Khaduja, a pediatrician in Delhi said that
paracetamol was very useful to treat high fevers and that the findings should not stop parents giving and pediatricians referring the drug.
An expert on molecular biology working in a Bangalore-based private biotech company had doubts about the link. "Paracetamol is given against
fever, which represents certain kind of infection. There are a number of early life infections that have been linked to increased risk of asthma.
Giving paracetamol more frequently means more frequent infection. It could be underlying infection which increases the asthma risk rather use of
paracetamol," she explained.
However, a study published in the journal Thorax (Vol 55) showed how paracetamol causes asthma. It said frequent use of paracetamol
decreases an antioxidant called glutathione, found in high levels in the lining of the airways and the nose. Glutathione protects lungs from air
pollutants and free radicals. Abundance of oxygen in airways causes more free radical production. Free radicals are also high in the lungs of
asthmatics. "Paracetamol has shown to cause liver damage in rats. This could be because paracetamol reduces antioxidants in the body.
Antioxidants are important as they can lower the risk of certain diseases by stopping free radicals in the body," said B N Dhawan, former
scientist at the Central Drug Research Institute, Lucknow.
We are a voice to you; you have been a support to us. Together we build journalism that is independent, credible and fearless. You can further help us by making a donation. This will mean a lot for our ability to bring you news, perspectives and analysis from the ground so that we can make change together.
.png)
Comments are moderated and will be published only after the site moderator’s approval. Please use a genuine email ID and provide your name. Selected comments may also be used in the ‘Letters’ section of the Down To Earth print edition.