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

Richard Beasley, Tadd Clayton, Julian Crane, Erika von Mutius, Christopher KW Lai, Stephen Montefort, Alistair Stewart, N. Aït-Khaled, H. R. Anderson, M. I. Asher, R. Beasley, B. Björkstén, B. Brunekreef, J. Crane, P. Ellwood, L. García-Marcos, S. Foliaki, U. Keil, C. K W Lai, J. Mallol & 82 others C. F. Robertson, E. A. Mitchell, S. Montefort, J. Odhiambo, N. Pearce, J. Shah, A. W. Stewart, D. Strachan, E. von Mutius, S. K. Weiland, G. Weinmayr, H. Williams, G. Wong, M. E. Howitt, J. Weyler, L. de Freitas Souza, D. Rennie, L. Amarales, P. Aguilar, A. M. Cepeda, G. Aristizábal, G. A. Ordoñez, M. A, Riikjärv, G. Zsigmond, S. Rego, P. S. Suresh Babu, V. Singh, K. C. Jain, T. U. Sukumaran, S. Awasthi, M. K. Joshi, A. V. Pherwani, S. N. Mantri, S. Salvi, S. K. Sharma, N. M. Hanumante, S. Bhave, C. B. Kartasasmita, M. R. Masjedi, A. Steriu, H. Odajima, C. Imanalieva, J. Kudzyte, K. H. Teh, B. S. Quah, B. E. Del-Río-Navarro, M. Barragán-Meijueiro, R. García-Almaraz, M. Baeza-Bacab, J. V. Merida-Palacio, S. N. González-Díaz, F. J. Linares-Zapién, S. Romero-Tapia, C. Moyes, P. Pattemore, R. MacKay, B. O. Onadeko, G. Cukier, G. Lis, A. Brêborowicz, R. Câmara, J. E. Rosado Pinto, C. Nunes, J. M. Lopes dos Santos, D. Y T Goh, H. B. Lee, Omar AL-Rawas, I. Carvajal-Uruẽa, R. M. Busquets, C. González Díaz, L. García-Marcos, G. Garcia-Hernández, M. M M Suárez-Varela, O. Al-Rawas, Y. Mohammad, S. Mohammad, J. L. Huang, C. C. Kao, P. Vichyanond, M. Trakultivakorn, M. C. Lapides, O. Aldrey

Research output: Contribution to journalArticle

255 Citations (Scopus)

Abstract

Background: Exposure to paracetamol during intrauterine life, childhood, and adult life may increase the risk of developing asthma. We studied 6-7-year-old children from Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC) programme to investigate the association between paracetamol consumption and asthma. Methods: As part of Phase Three of ISAAC, parents or guardians of children aged 6-7 years completed written questionnaires about symptoms of asthma, rhinoconjunctivitis, and eczema, and several risk factors, including the use of paracetamol for fever in the child's first year of life and the frequency of paracetamol use in the past 12 months. The primary outcome variable was the odds ratio (OR) of asthma symptoms in these children associated with the use of paracetamol for fever in the first year of life, as calculated by logistic regression. Findings: 205 487 children aged 6-7 years from 73 centres in 31 countries were included in the analysis. In the multivariate analyses, use of paracetamol for fever in the first year of life was associated with an increased risk of asthma symptoms when aged 6-7 years (OR 1·46 [95% CI 1·36-1·56]). Current use of paracetamol was associated with a dose-dependent increased risk of asthma symptoms (1·61 [1·46-1·77] and 3·23 [2·91-3·60] for medium and high use vs no use, respectively). Use of paracetamol was similarly associated with the risk of severe asthma symptoms, with population-attributable risks between 22% and 38%. Paracetamol use, both in the first year of life and in children aged 6-7 years, was also associated with an increased risk of symptoms of rhinoconjunctivitis and eczema. Interpretation: Use of paracetamol in the first year of life and in later childhood, is associated with risk of asthma, rhinoconjunctivitis, and eczema at age 6 to 7 years. We suggest that exposure to paracetamol might be a risk factor for the development of asthma in childhood. Funding: The BUPA Foundation, the Health Research Council of New Zealand, the Asthma and Respiratory Foundation of New Zealand, the Hawke's Bay Medical Research Foundation, the Waikato Medical Research Foundation, Glaxo Wellcome New Zealand, the New Zealand Lottery Board, Astra Zeneca New Zealand, and Glaxo Wellcome International Medical Affairs.

Original languageEnglish
Pages (from-to)1039-1048
Number of pages10
JournalThe Lancet
Volume372
Issue number9643
DOIs
Publication statusPublished - 2008

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Eczema
Acetaminophen
Hypersensitivity
Asthma
New Zealand
Fever
Biomedical Research
Odds Ratio
Multivariate Analysis
Parents
Logistic Models

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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. / Beasley, Richard; Clayton, Tadd; Crane, Julian; von Mutius, Erika; Lai, Christopher KW; Montefort, Stephen; Stewart, Alistair; Aït-Khaled, N.; Anderson, H. R.; Asher, M. I.; Beasley, R.; Björkstén, B.; Brunekreef, B.; Crane, J.; Ellwood, P.; García-Marcos, L.; Foliaki, S.; Keil, U.; Lai, C. K W; Mallol, J.; Robertson, C. F.; Mitchell, E. A.; Montefort, S.; Odhiambo, J.; Pearce, N.; Shah, J.; Stewart, A. W.; Strachan, D.; von Mutius, E.; Weiland, S. K.; Weinmayr, G.; Williams, H.; Wong, G.; Howitt, M. E.; Weyler, J.; de Freitas Souza, L.; Rennie, D.; Amarales, L.; Aguilar, P.; Cepeda, A. M.; Aristizábal, G.; Ordoñez, G. A.; Riikjärv, M. A,; Zsigmond, G.; Rego, S.; Suresh Babu, P. S.; Singh, V.; Jain, K. C.; Sukumaran, T. U.; Awasthi, S.; Joshi, M. K.; Pherwani, A. V.; Mantri, S. N.; Salvi, S.; Sharma, S. K.; Hanumante, N. M.; Bhave, S.; Kartasasmita, C. B.; Masjedi, M. R.; Steriu, A.; Odajima, H.; Imanalieva, C.; Kudzyte, J.; Teh, K. H.; Quah, B. S.; Del-Río-Navarro, B. E.; Barragán-Meijueiro, M.; García-Almaraz, R.; Baeza-Bacab, M.; Merida-Palacio, J. V.; González-Díaz, S. N.; Linares-Zapién, F. J.; Romero-Tapia, S.; Moyes, C.; Pattemore, P.; MacKay, R.; Onadeko, B. O.; Cukier, G.; Lis, G.; Brêborowicz, A.; Câmara, R.; Rosado Pinto, J. E.; Nunes, C.; Lopes dos Santos, J. M.; Goh, D. Y T; Lee, H. B.; AL-Rawas, Omar; Carvajal-Uruẽa, I.; Busquets, R. M.; González Díaz, C.; García-Marcos, L.; Garcia-Hernández, G.; Suárez-Varela, M. M M; Al-Rawas, O.; Mohammad, Y.; Mohammad, S.; Huang, J. L.; Kao, C. C.; Vichyanond, P.; Trakultivakorn, M.; Lapides, M. C.; Aldrey, O.

In: The Lancet, Vol. 372, No. 9643, 2008, p. 1039-1048.

Research output: Contribution to journalArticle

Beasley, R, Clayton, T, Crane, J, von Mutius, E, Lai, CKW, Montefort, S, Stewart, A, Aït-Khaled, N, Anderson, HR, Asher, MI, Beasley, R, Björkstén, B, Brunekreef, B, Crane, J, Ellwood, P, García-Marcos, L, Foliaki, S, Keil, U, Lai, CKW, Mallol, J, Robertson, CF, Mitchell, EA, Montefort, S, Odhiambo, J, Pearce, N, Shah, J, Stewart, AW, Strachan, D, von Mutius, E, Weiland, SK, Weinmayr, G, Williams, H, Wong, G, Howitt, ME, Weyler, J, de Freitas Souza, L, Rennie, D, Amarales, L, Aguilar, P, Cepeda, AM, Aristizábal, G, Ordoñez, GA, Riikjärv, MA, Zsigmond, G, Rego, S, Suresh Babu, PS, Singh, V, Jain, KC, Sukumaran, TU, Awasthi, S, Joshi, MK, Pherwani, AV, Mantri, SN, Salvi, S, Sharma, SK, Hanumante, NM, Bhave, S, Kartasasmita, CB, Masjedi, MR, Steriu, A, Odajima, H, Imanalieva, C, Kudzyte, J, Teh, KH, Quah, BS, Del-Río-Navarro, BE, Barragán-Meijueiro, M, García-Almaraz, R, Baeza-Bacab, M, Merida-Palacio, JV, González-Díaz, SN, Linares-Zapién, FJ, Romero-Tapia, S, Moyes, C, Pattemore, P, MacKay, R, Onadeko, BO, Cukier, G, Lis, G, Brêborowicz, A, Câmara, R, Rosado Pinto, JE, Nunes, C, Lopes dos Santos, JM, Goh, DYT, Lee, HB, AL-Rawas, O, Carvajal-Uruẽa, I, Busquets, RM, González Díaz, C, García-Marcos, L, Garcia-Hernández, G, Suárez-Varela, MMM, Al-Rawas, O, Mohammad, Y, Mohammad, S, Huang, JL, Kao, CC, Vichyanond, P, Trakultivakorn, M, Lapides, MC & Aldrey, O 2008, '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, vol. 372, no. 9643, pp. 1039-1048. https://doi.org/10.1016/S0140-6736(08)61445-2
Beasley, Richard ; Clayton, Tadd ; Crane, Julian ; von Mutius, Erika ; Lai, Christopher KW ; Montefort, Stephen ; Stewart, Alistair ; Aït-Khaled, N. ; Anderson, H. R. ; Asher, M. I. ; Beasley, R. ; Björkstén, B. ; Brunekreef, B. ; Crane, J. ; Ellwood, P. ; García-Marcos, L. ; Foliaki, S. ; Keil, U. ; Lai, C. K W ; Mallol, J. ; Robertson, C. F. ; Mitchell, E. A. ; Montefort, S. ; Odhiambo, J. ; Pearce, N. ; Shah, J. ; Stewart, A. W. ; Strachan, D. ; von Mutius, E. ; Weiland, S. K. ; Weinmayr, G. ; Williams, H. ; Wong, G. ; Howitt, M. E. ; Weyler, J. ; de Freitas Souza, L. ; Rennie, D. ; Amarales, L. ; Aguilar, P. ; Cepeda, A. M. ; Aristizábal, G. ; Ordoñez, G. A. ; Riikjärv, M. A, ; Zsigmond, G. ; Rego, S. ; Suresh Babu, P. S. ; Singh, V. ; Jain, K. C. ; Sukumaran, T. U. ; Awasthi, S. ; Joshi, M. K. ; Pherwani, A. V. ; Mantri, S. N. ; Salvi, S. ; Sharma, S. K. ; Hanumante, N. M. ; Bhave, S. ; Kartasasmita, C. B. ; Masjedi, M. R. ; Steriu, A. ; Odajima, H. ; Imanalieva, C. ; Kudzyte, J. ; Teh, K. H. ; Quah, B. S. ; Del-Río-Navarro, B. E. ; Barragán-Meijueiro, M. ; García-Almaraz, R. ; Baeza-Bacab, M. ; Merida-Palacio, J. V. ; González-Díaz, S. N. ; Linares-Zapién, F. J. ; Romero-Tapia, S. ; Moyes, C. ; Pattemore, P. ; MacKay, R. ; Onadeko, B. O. ; Cukier, G. ; Lis, G. ; Brêborowicz, A. ; Câmara, R. ; Rosado Pinto, J. E. ; Nunes, C. ; Lopes dos Santos, J. M. ; Goh, D. Y T ; Lee, H. B. ; AL-Rawas, Omar ; Carvajal-Uruẽa, I. ; Busquets, R. M. ; González Díaz, C. ; García-Marcos, L. ; Garcia-Hernández, G. ; Suárez-Varela, M. M M ; Al-Rawas, O. ; Mohammad, Y. ; Mohammad, S. ; Huang, J. L. ; Kao, C. C. ; Vichyanond, P. ; Trakultivakorn, M. ; Lapides, M. C. ; Aldrey, O. / 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. In: The Lancet. 2008 ; Vol. 372, No. 9643. pp. 1039-1048.
@article{a533db4a64244e4c896ba4c63a863281,
title = "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",
abstract = "Background: Exposure to paracetamol during intrauterine life, childhood, and adult life may increase the risk of developing asthma. We studied 6-7-year-old children from Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC) programme to investigate the association between paracetamol consumption and asthma. Methods: As part of Phase Three of ISAAC, parents or guardians of children aged 6-7 years completed written questionnaires about symptoms of asthma, rhinoconjunctivitis, and eczema, and several risk factors, including the use of paracetamol for fever in the child's first year of life and the frequency of paracetamol use in the past 12 months. The primary outcome variable was the odds ratio (OR) of asthma symptoms in these children associated with the use of paracetamol for fever in the first year of life, as calculated by logistic regression. Findings: 205 487 children aged 6-7 years from 73 centres in 31 countries were included in the analysis. In the multivariate analyses, use of paracetamol for fever in the first year of life was associated with an increased risk of asthma symptoms when aged 6-7 years (OR 1·46 [95{\%} CI 1·36-1·56]). Current use of paracetamol was associated with a dose-dependent increased risk of asthma symptoms (1·61 [1·46-1·77] and 3·23 [2·91-3·60] for medium and high use vs no use, respectively). Use of paracetamol was similarly associated with the risk of severe asthma symptoms, with population-attributable risks between 22{\%} and 38{\%}. Paracetamol use, both in the first year of life and in children aged 6-7 years, was also associated with an increased risk of symptoms of rhinoconjunctivitis and eczema. Interpretation: Use of paracetamol in the first year of life and in later childhood, is associated with risk of asthma, rhinoconjunctivitis, and eczema at age 6 to 7 years. We suggest that exposure to paracetamol might be a risk factor for the development of asthma in childhood. Funding: The BUPA Foundation, the Health Research Council of New Zealand, the Asthma and Respiratory Foundation of New Zealand, the Hawke's Bay Medical Research Foundation, the Waikato Medical Research Foundation, Glaxo Wellcome New Zealand, the New Zealand Lottery Board, Astra Zeneca New Zealand, and Glaxo Wellcome International Medical Affairs.",
author = "Richard Beasley and Tadd Clayton and Julian Crane and {von Mutius}, Erika and Lai, {Christopher KW} and Stephen Montefort and Alistair Stewart and N. A{\"i}t-Khaled and Anderson, {H. R.} and Asher, {M. I.} and R. Beasley and B. Bj{\"o}rkst{\'e}n and B. Brunekreef and J. Crane and P. Ellwood and L. Garc{\'i}a-Marcos and S. Foliaki and U. Keil and Lai, {C. K W} and J. Mallol and Robertson, {C. F.} and Mitchell, {E. A.} and S. Montefort and J. Odhiambo and N. Pearce and J. Shah and Stewart, {A. W.} and D. Strachan and {von Mutius}, E. and Weiland, {S. K.} and G. Weinmayr and H. Williams and G. Wong and Howitt, {M. E.} and J. Weyler and {de Freitas Souza}, L. and D. Rennie and L. Amarales and P. Aguilar and Cepeda, {A. M.} and G. Aristiz{\'a}bal and Ordo{\~n}ez, {G. A.} and Riikj{\"a}rv, {M. A,} and G. Zsigmond and S. Rego and {Suresh Babu}, {P. S.} and V. Singh and Jain, {K. C.} and Sukumaran, {T. U.} and S. Awasthi and Joshi, {M. K.} and Pherwani, {A. V.} and Mantri, {S. N.} and S. Salvi and Sharma, {S. K.} and Hanumante, {N. M.} and S. Bhave and Kartasasmita, {C. B.} and Masjedi, {M. R.} and A. Steriu and H. Odajima and C. Imanalieva and J. Kudzyte and Teh, {K. H.} and Quah, {B. S.} and Del-R{\'i}o-Navarro, {B. E.} and M. Barrag{\'a}n-Meijueiro and R. Garc{\'i}a-Almaraz and M. Baeza-Bacab and Merida-Palacio, {J. V.} and Gonz{\'a}lez-D{\'i}az, {S. N.} and Linares-Zapi{\'e}n, {F. J.} and S. Romero-Tapia and C. Moyes and P. Pattemore and R. MacKay and Onadeko, {B. O.} and G. Cukier and G. Lis and A. Br{\^e}borowicz and R. C{\^a}mara and {Rosado Pinto}, {J. E.} and C. Nunes and {Lopes dos Santos}, {J. M.} and Goh, {D. Y T} and Lee, {H. B.} and Omar AL-Rawas and I. Carvajal-Uruẽa and Busquets, {R. M.} and {Gonz{\'a}lez D{\'i}az}, C. and L. Garc{\'i}a-Marcos and G. Garcia-Hern{\'a}ndez and Su{\'a}rez-Varela, {M. M M} and O. Al-Rawas and Y. Mohammad and S. Mohammad and Huang, {J. L.} and Kao, {C. C.} and P. Vichyanond and M. Trakultivakorn and Lapides, {M. C.} and O. Aldrey",
year = "2008",
doi = "10.1016/S0140-6736(08)61445-2",
language = "English",
volume = "372",
pages = "1039--1048",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier Limited",
number = "9643",

}

TY - JOUR

T1 - Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6-7 years

T2 - analysis from Phase Three of the ISAAC programme

AU - Beasley, Richard

AU - Clayton, Tadd

AU - Crane, Julian

AU - von Mutius, Erika

AU - Lai, Christopher KW

AU - Montefort, Stephen

AU - Stewart, Alistair

AU - Aït-Khaled, N.

AU - Anderson, H. R.

AU - Asher, M. I.

AU - Beasley, R.

AU - Björkstén, B.

AU - Brunekreef, B.

AU - Crane, J.

AU - Ellwood, P.

AU - García-Marcos, L.

AU - Foliaki, S.

AU - Keil, U.

AU - Lai, C. K W

AU - Mallol, J.

AU - Robertson, C. F.

AU - Mitchell, E. A.

AU - Montefort, S.

AU - Odhiambo, J.

AU - Pearce, N.

AU - Shah, J.

AU - Stewart, A. W.

AU - Strachan, D.

AU - von Mutius, E.

AU - Weiland, S. K.

AU - Weinmayr, G.

AU - Williams, H.

AU - Wong, G.

AU - Howitt, M. E.

AU - Weyler, J.

AU - de Freitas Souza, L.

AU - Rennie, D.

AU - Amarales, L.

AU - Aguilar, P.

AU - Cepeda, A. M.

AU - Aristizábal, G.

AU - Ordoñez, G. A.

AU - Riikjärv, M. A,

AU - Zsigmond, G.

AU - Rego, S.

AU - Suresh Babu, P. S.

AU - Singh, V.

AU - Jain, K. C.

AU - Sukumaran, T. U.

AU - Awasthi, S.

AU - Joshi, M. K.

AU - Pherwani, A. V.

AU - Mantri, S. N.

AU - Salvi, S.

AU - Sharma, S. K.

AU - Hanumante, N. M.

AU - Bhave, S.

AU - Kartasasmita, C. B.

AU - Masjedi, M. R.

AU - Steriu, A.

AU - Odajima, H.

AU - Imanalieva, C.

AU - Kudzyte, J.

AU - Teh, K. H.

AU - Quah, B. S.

AU - Del-Río-Navarro, B. E.

AU - Barragán-Meijueiro, M.

AU - García-Almaraz, R.

AU - Baeza-Bacab, M.

AU - Merida-Palacio, J. V.

AU - González-Díaz, S. N.

AU - Linares-Zapién, F. J.

AU - Romero-Tapia, S.

AU - Moyes, C.

AU - Pattemore, P.

AU - MacKay, R.

AU - Onadeko, B. O.

AU - Cukier, G.

AU - Lis, G.

AU - Brêborowicz, A.

AU - Câmara, R.

AU - Rosado Pinto, J. E.

AU - Nunes, C.

AU - Lopes dos Santos, J. M.

AU - Goh, D. Y T

AU - Lee, H. B.

AU - AL-Rawas, Omar

AU - Carvajal-Uruẽa, I.

AU - Busquets, R. M.

AU - González Díaz, C.

AU - García-Marcos, L.

AU - Garcia-Hernández, G.

AU - Suárez-Varela, M. M M

AU - Al-Rawas, O.

AU - Mohammad, Y.

AU - Mohammad, S.

AU - Huang, J. L.

AU - Kao, C. C.

AU - Vichyanond, P.

AU - Trakultivakorn, M.

AU - Lapides, M. C.

AU - Aldrey, O.

PY - 2008

Y1 - 2008

N2 - Background: Exposure to paracetamol during intrauterine life, childhood, and adult life may increase the risk of developing asthma. We studied 6-7-year-old children from Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC) programme to investigate the association between paracetamol consumption and asthma. Methods: As part of Phase Three of ISAAC, parents or guardians of children aged 6-7 years completed written questionnaires about symptoms of asthma, rhinoconjunctivitis, and eczema, and several risk factors, including the use of paracetamol for fever in the child's first year of life and the frequency of paracetamol use in the past 12 months. The primary outcome variable was the odds ratio (OR) of asthma symptoms in these children associated with the use of paracetamol for fever in the first year of life, as calculated by logistic regression. Findings: 205 487 children aged 6-7 years from 73 centres in 31 countries were included in the analysis. In the multivariate analyses, use of paracetamol for fever in the first year of life was associated with an increased risk of asthma symptoms when aged 6-7 years (OR 1·46 [95% CI 1·36-1·56]). Current use of paracetamol was associated with a dose-dependent increased risk of asthma symptoms (1·61 [1·46-1·77] and 3·23 [2·91-3·60] for medium and high use vs no use, respectively). Use of paracetamol was similarly associated with the risk of severe asthma symptoms, with population-attributable risks between 22% and 38%. Paracetamol use, both in the first year of life and in children aged 6-7 years, was also associated with an increased risk of symptoms of rhinoconjunctivitis and eczema. Interpretation: Use of paracetamol in the first year of life and in later childhood, is associated with risk of asthma, rhinoconjunctivitis, and eczema at age 6 to 7 years. We suggest that exposure to paracetamol might be a risk factor for the development of asthma in childhood. Funding: The BUPA Foundation, the Health Research Council of New Zealand, the Asthma and Respiratory Foundation of New Zealand, the Hawke's Bay Medical Research Foundation, the Waikato Medical Research Foundation, Glaxo Wellcome New Zealand, the New Zealand Lottery Board, Astra Zeneca New Zealand, and Glaxo Wellcome International Medical Affairs.

AB - Background: Exposure to paracetamol during intrauterine life, childhood, and adult life may increase the risk of developing asthma. We studied 6-7-year-old children from Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC) programme to investigate the association between paracetamol consumption and asthma. Methods: As part of Phase Three of ISAAC, parents or guardians of children aged 6-7 years completed written questionnaires about symptoms of asthma, rhinoconjunctivitis, and eczema, and several risk factors, including the use of paracetamol for fever in the child's first year of life and the frequency of paracetamol use in the past 12 months. The primary outcome variable was the odds ratio (OR) of asthma symptoms in these children associated with the use of paracetamol for fever in the first year of life, as calculated by logistic regression. Findings: 205 487 children aged 6-7 years from 73 centres in 31 countries were included in the analysis. In the multivariate analyses, use of paracetamol for fever in the first year of life was associated with an increased risk of asthma symptoms when aged 6-7 years (OR 1·46 [95% CI 1·36-1·56]). Current use of paracetamol was associated with a dose-dependent increased risk of asthma symptoms (1·61 [1·46-1·77] and 3·23 [2·91-3·60] for medium and high use vs no use, respectively). Use of paracetamol was similarly associated with the risk of severe asthma symptoms, with population-attributable risks between 22% and 38%. Paracetamol use, both in the first year of life and in children aged 6-7 years, was also associated with an increased risk of symptoms of rhinoconjunctivitis and eczema. Interpretation: Use of paracetamol in the first year of life and in later childhood, is associated with risk of asthma, rhinoconjunctivitis, and eczema at age 6 to 7 years. We suggest that exposure to paracetamol might be a risk factor for the development of asthma in childhood. Funding: The BUPA Foundation, the Health Research Council of New Zealand, the Asthma and Respiratory Foundation of New Zealand, the Hawke's Bay Medical Research Foundation, the Waikato Medical Research Foundation, Glaxo Wellcome New Zealand, the New Zealand Lottery Board, Astra Zeneca New Zealand, and Glaxo Wellcome International Medical Affairs.

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U2 - 10.1016/S0140-6736(08)61445-2

DO - 10.1016/S0140-6736(08)61445-2

M3 - Article

VL - 372

SP - 1039

EP - 1048

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 9643

ER -