Does Acetaminophen Cause Asthma? Some Thoughts On The Science
By now you have probably heard about the accumulating scientific evidence showing a link between acetaminophen use and asthma. And if you haven’t seen it, there was a terrific review of the studies done – and clinical issues raised – in the New York Times. As a parent, I (like you) wonder what this means for my child – especially since I am not a pediatrician. What I can offer, though, is some perspective on the science, and how as a scientist I sort through these issues to see if they impact what I do at home as a parent.
The first thing I consider is the type of research done to date. For the most part, these have been epidemiological studies that have looked statistically at the probability of developing asthma after taking acetaminophen. Even before learning about the findings, I remind myself of a very old principle – correlation does not imply causation. So even though a strong statistical link has been reported, this does not – in and of itself – prove that acetaminophen causes asthma. That emerges as a hypothesis, however, especially since some studies suggest that the association is very strong.
The second thing I think about is the extent to which other factors have been accounted for in the research. For example, in the report in the Times you will see that other variables may be important – for example, viral infections may be the link between the statistical association between acetaminophen and risk for asthma. My read is that, to date, the impact of other factors has not been fully addressed and will require more research – so this puts me on the fence.
The third thing that crosses my mind is to think about which kids are at risk. For example, does the link hold up when all kinds of kids are studied, or is it the case that kids who are prone to asthma may be especially sensitive? The answer to this question is not yet clear – some of the studies show the risk most strongly when kids with asthma are studied (taking acetaminophen rather than ibuprofen increases their asthma symptoms).
So where does this leave me as a parent? Well, I’m concerned, but not yet convinced. So what I will do in this case is share the thoughts I just described with my pediatrician, who knows my child well, and have a pointed discussion to see if I should factor this research into my decision making at home. It very well may be that the tipping point is the extent to which you think your child is at risk for asthma (or has shown signs of asthma).
In my experience, your pediatrician can be a very important translator between the world of research and the real decisions you have to make about your own child’s care. But it can be very helpful to learn a bit about the science being reported to help you have an informed discussion with your child’s doctor – especially since we are all flooded with this type of information these days!Add a Comment