Researchers at the Medical Research Institute of New Zealand (Wellington) conducted a study at 113 centers in 50 countries participating in the International Study of Asthma and Allergies in Childhood (ISAAC), investigating the risk related to acetaminophen use in adolescents; 322,959 children (aged 13-14 years old) completed written and video questionnaires regarding their current symptoms of asthma, rhinoconjunctivitis, and eczema. They also completed a written environmental questionnaire regarding potential risk factors (including acetaminophen exposure) in the preceding 12 months. The primary outcome measure was the odds ratio (OR) of current asthma symptoms associated with acetaminophen use, calculated by logistic regression.

The results showed that recent use of acetaminophen was associated with an exposure-dependent OR risk of 1.43 for current asthma symptoms, and an OR risk of 2.51 for medium and high asthma development. Acetaminophen use was also associated with an exposure-dependent increased risk of current symptoms of rhinoconjunctivitis and eczema. The study was published early online on August 13, 2010, in the American Journal of Respiratory and Critical Care Medicine.

"The overall population attributable risks for current symptoms of severe asthma were around 40%, suggesting that if the associations were causal, they would be of major public health significance,” said lead author professor of medicine Richard Beasley, M.D., director of the Medical Research Institute of New Zealand. "Randomized controlled trials are now urgently required to investigate this relationship further and to guide the use of antipyretics, not only in children but in pregnancy and adult life.”

Acetaminophen, also known as Paracetamol, is a widely used over-the-counter (OTC) analgesic and antipyretic. It is commonly used for the relief of headaches and other minor aches and pains, and is a major ingredient in numerous cold remedies. While generally safe for use at recommended doses, acute overdoses of acetaminophen can cause potentially fatal liver damage and, in rare individuals, a normal dose can do the same; the risk is heightened by alcohol consumption.

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Medical Research Institute of New Zealand