Chest
Original ResearchAsthmaAcetaminophen Use and the Risk of Asthma in Children and Adults: A Systematic Review and Metaanalysis
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Materials and Methods
We conducted a systematic review and metaanalysis based on Quality of Reporting of Metaanalyses9 criteria for reporting the results of systematic reviews of randomized controlled trials (RCTs) and the Metaanalysis of Observational Studies in Epidemiology10 criteria for reporting results of systematic reviews of observational studies.
Results
Twenty-four studies7, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37 met our inclusion criteria. After carefully reviewing the articles, four studies15, 16, 17, 18 were found to be duplicates and part of the larger International Study of Asthma and Allergies in Childhood (ISAAC).26 One study19 was excluded because it was part of the same study published at a later date.33 Thirteen cross-sectional studies,7, 21, 22, 25, 26, 27, 28, 29, 30, 31, 32, 36,
Discussion
The results of our systematic review indicate an increase in the risk of asthma with acetaminophen use in both adults and children. We also found an increase in the risk of asthma in children with a history of prenatal exposure to acetaminophen. The strength of our review is mainly in the large sample size, the multinational nature of the study participants, and the consistency of the effect in both children and adults.
Confounding bias has been deemed to be one of the reasons for the positive
Acknowledgments
Author contributions: Dr. Etminan contributed to all aspects of this study in addition to providing administrative, technical, and material support and study supervision. Dr. Etminan also has full access to all of the data and has taken responsibility for the integrity and accuracy of the data. Dr. Sadatsafavi contributed to the study concept and design, analysis and interpretation of the data, statistical analysis, and critical revision of the manuscript. Dr. Jafari contributed to the
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Funding/Support: The study was funded by the Vancouver Coastal Health Research Institute.
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