The relation between paracetamol use and asthma: a GA²LEN European case-control study

¹ National Heart Lung Institute Imperial College, London UK
² Medical University, Lodz, Poland
³ Ghent University, Ghent, Belgium
⁴ Medical University of Vienna, Vienna, Austria
⁵ Odense University Hospital, Odense, Denmark
⁶ Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Germany
⁷ Consiglio Nazionale delle Ricerche, Palermo, Italy
⁸ Consiglio Nazionale delle Ricerche, Rome, Italy
⁹ Academic Medical Centre, Amsterdam, Netherlands
¹⁰ Universitad de Coimbra, Coimbra, Portugal
¹¹ Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; and CIBER Epidemiología y Salud Pública (CIBERESP), Spain
¹² Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; and Servei de Pneumologia, Hospital del Mar, Barcelona, Spain
¹³ Uppsala University, Uppsala, Sweden

^* To whom correspondence should be addressed. E-mail: s.shaheen{at}imperial.ac.uk.

	Abstract

Studies from the UK and the USA suggest that frequent use of paracetamol (acetaminophen) may increase the risk of asthma, but data across Europe are lacking.

As part of a multi-centre case-control study organised by the GA²LEN network we have examined whether frequent paracetamol use is associated with adult asthma across Europe. The network compared 521 cases with a diagnosis of asthma and reporting asthma symptoms in the last 12 months with 507 controls with no diagnosis of asthma and no asthmatic symptoms in the last 12 months across 12 European centres. All cases and controls were selected from the same population defined by age (20–45 years) and place of residence.

In a random effects meta-analysis, after controlling for confounders, the adjusted odds ratio for asthma associated with weekly use of paracetamol, compared with less frequent use, was 2.87 (95% CI: 1.49 to 5.37), P=0.002. There was no evidence for heterogeneity across centres. No association was seen between use of other analgesics and asthma.

These data add to the increasing and consistent epidemiological evidence implicating frequent paracetamol use in asthma in diverse populations.