This Article Full Text Full Text (PDF) Online Supplement All Versions of this Article: 200304-596OCv1 169/7/836    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Barr, R. G. Articles by Camargo, C. A. Search for Related Content PubMed PubMed Citation Articles by Barr, R. G. Articles by Camargo, C. A., Jr.

Prospective Study of Acetaminophen Use and Newly Diagnosed Asthma among Women

Division of General Medicine, Department of Medicine, College of Physicians & Surgeons, and Division of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York; Channing Laboratory, Department of Medicine, Brigham & Women's Hospital; Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School; Departments of Epidemiology and Environmental Health, Harvard School of Public Health, Boston, Massachusetts

Correspondence and requests for reprints should be addressed to R. Graham Barr, M.D., Dr.P.H., Division of General Medicine, PH-9E 105 Columbia Presbyterian Medical Center, 622 West 168th Street, New York, NY 10032. E-mail: rgb9{at}columbia.edu

Acetaminophen decreases glutathione levels in the lung, which may predispose to oxidative injury and bronchospasm. Acetaminophen use has been associated with asthma in cross-sectional studies and a birth cohort. We hypothesized that acetaminophen use would be associated with newly diagnosed adult-onset asthma in the Nurses' Health Study, a prospective cohort study of 121,700 women. Participants were first asked about frequency of acetaminophen use in 1990. Cases with asthma were defined as those with a new physician diagnosis of asthma between 1990 and 1996 plus reiteration of the diagnosis and controller medication use. Proportional hazard models included age, race, socioeconomic status, body mass index, smoking, other analgesic use, and postmenopausal hormone use. During 352,719 person-years of follow-up, 346 participants reported a new physician diagnosis of asthma meeting diagnostic criteria. Increasing frequency of acetaminophen use was positively associated with newly diagnosed asthma (p for trend = 0.006). The multivariate rate ratio for asthma for participants who received acetaminophen for more than 14 days per month was 1.63 (95% confidence interval, 1.11–2.39) compared with nonusers. It would be premature to recommend acetaminophen avoidance for patients with asthma, but further research on pulmonary responses to acetaminophen is necessary to confirm or refute these findings and to identify subgroups whose asthma may be modified by acetaminophen.

Key Words: analgesics • paracetamol • aspirin • analgesic drugs, nonsteriodal

This article has been cited by other articles:

				S. Shaheen, J. Potts, L. Gnatiuc, J. Makowska, M. L. Kowalski, G. Joos, T. van Zele, Y. van Durme, I. De Rudder, S. Wohrl, et al. The relation between paracetamol use and asthma: a GA2LEN European case-control study Eur. Respir. J., November 1, 2008; 32(5): 1231 - 1236. [Abstract] [Full Text] [PDF]

				A. A Clayton, D. L Forrester, and A. J Knox Aspirin and asthma: barking up the right tree? Thorax, June 1, 2008; 63(6): 485 - 486. [Full Text] [PDF]

				C. Rebordosa, M. Kogevinas, H. T Sorensen, and J. Olsen Pre-natal exposure to paracetamol and risk of wheezing and asthma in children: A birth cohort study Int. J. Epidemiol., June 1, 2008; 37(3): 583 - 590. [Abstract] [Full Text] [PDF]

				T Kurth, R G Barr, J M Gaziano, and J E Buring Randomised aspirin assignment and risk of adult-onset asthma in the Women's Health Study Thorax, June 1, 2008; 63(6): 514 - 518. [Abstract] [Full Text] [PDF]

				R. G. Barr, T. Kurth, M. J. Stampfer, J. E. Buring, C. H. Hennekens, and J. M. Gaziano Aspirin and Decreased Adult-Onset Asthma: Randomized Comparisons from the Physicians' Health Study Am. J. Respir. Crit. Care Med., January 15, 2007; 175(2): 120 - 125. [Abstract] [Full Text] [PDF]

				T. M. McKeever, S. A. Lewis, H. A. Smit, P. Burney, J. R. Britton, and P. A. Cassano The Association of Acetaminophen, Aspirin, and Ibuprofen with Respiratory Disease and Lung Function Am. J. Respir. Crit. Care Med., May 1, 2005; 171(9): 966 - 971. [Abstract] [Full Text] [PDF]

				L. Fabbri, S. P. Peters, I. Pavord, S. E. Wenzel, S. C. Lazarus, W. MacNee, F. Lemaire, and E. Abraham Allergic Rhinitis, Asthma, Airway Biology, and Chronic Obstructive Pulmonary Disease in AJRCCM in 2004 Am. J. Respir. Crit. Care Med., April 1, 2005; 171(7): 686 - 698. [Full Text] [PDF]

				I. Eneli, K. Sadri, C. Camargo Jr, and R. G. Barr Acetaminophen and the Risk of Asthma: The Epidemiologic and Pathophysiologic Evidence Chest, February 1, 2005; 127(2): 604 - 612. [Abstract] [Full Text] [PDF]