From The Times
September 19, 2008
Calpol generation may be vulnerable to asthma and hay fever,
study says
David Rose http://www.timesonline.co.uk/tol/life_and_style/health/article4783572.ece
Giving paracetamol-based medicines such as Calpol to babies can increase
their chances of developing asthma in later life, a large international study
suggests.
Researchers who analysed data on more than 200,000 children found strong links
between their exposure to paracetamol as infants and the development of asthma
and other allergic conditions.
Mothers are advised that after two months, in babies weighing over 4kg (9lb),
they can treat fevers with medicines or suspensions that contain paracetamol.
But the study raises questions about the long-term effects of using medicines
such as junior paracetamol and Calpol at such a young age.
Children under 12 months who were given a paracetamol-based medicine at least
once a month more than tripled the chances of suffering wheezing attacks by the
age of 6 or 7, the researchers found. The painkiller was also associated with an
increased risk of rhinoconjunctivitis – or hay fever – and eczema. The
researchers add that increased use of paracetamol – because of earlier fears
about giving children aspirin – could be a factor in causing rising rates of
asthma in many countries.
Previous research had already suggested a link between paracetamol and asthma,
and scientists believe that the painkiller may cause changes in the body that
leave a child more vulnerable to inflammation and allergies.
The authors of the study, published in The Lancetmedical journal, empha-sise
that the findings do not constitute a reason to stop using paracetamol for
relief of pain and fever in children. Instead, they support existing guidelines
of the World Health Organisation that paracetamol-based medicines should not be
used routinely, but should be reserved for those with a high fever (38.5C or
above). Experts point out that in these cases, giving children medication
outweighs the risks of not doing so.
Paracetamol is not licensed for use in infants under 2 months old by mouth and
is only recommended after that in “junior” doses or medicines that contain less
than the standard adult dose.
More than one million children in the UK – equivalent to one in ten – now have
asthma and the number of cases has trebled since the 1960s. The rise has in part
coincided with paracetamol becoming the preferred drug to treat fevers and pain
in children.
The study, part of a worldwide investigation called the International Study of
Asthma and Allergies in Childhood, spanned 73 centres in 31 countries. It found
that giving children paracetamol in the first year of life increased the risk of
later asthma symptoms in children aged 6 and 7 by 46 per cent.
Taking paracetamol at least once a month – classified as “high use” – increased
the symptoms risk 3.23 times.
Using the drug in the first year of life increased the risk of hay fever and
eczema at the age of 6 and 7 by 48 per cent and 35 per cent respectively.
The researchers had to rely on written answers from parents who filled in
questionnaires about their children’s health and use of paracetamol, which may
be subject to error.
Professor Richard Beasley, who led the study at the Medical Research Institute
of New Zealand, said that there were good reasons to suggest that paracetamol
was a factor in causing health problems, rather than merely being associated
with them.
The research highlights a “dose-dependent” response, with more exposure to the
drug resulting in more asthma attacks, pointing to a cause-and-effect
relationship, he said.
The researchers said that more research, in the form of randomised controlled
trials, was needed urgently.