Paraben exposures and asthma-related outcomes among children from the US general population

doi:10.1016/j.jaci.2018.08.021

Journal of Allergy and Clinical Immunology

Volume 143, Issue 3, March 2019, Pages 948-956.e4

https://doi.org/10.1016/j.jaci.2018.08.021 Get rights and content

Background

Parabens are synthetic preservatives present in many consumer products. Their antimicrobial and endocrine-disrupting properties have raised concerns that they might play a role in respiratory and allergic diseases; however, studies exploring these associations are scarce.

Objective

We examined the cross-sectional association between parabens and asthma morbidity among 450 children with asthma and with asthma prevalence among 4023 children in the US general population participating in the National Health and Nutrition Examination Survey (2005-2014).

Methods

We conducted multivariable logistic regression to examine associations between urinary paraben biomarker concentrations (butyl paraben, ethyl paraben, methyl paraben [MP], and propyl paraben [PP]) and asthma attacks and emergency department visits among children with asthma and with a current asthma diagnosis among all children. We also examined heterogeneity of associations by sex.

Results

We observed an increased prevalence odds of reporting emergency department visits for every 10-fold increase in MP and PP concentrations among boys with asthma (adjusted prevalence odds ratio, 2.61 [95% CI, 1.40-4.85] and 2.18 [95% CI, 1.22-3.89, respectively; P_{interaction-MP} = .002 and P_{interaction-PP} = .003); associations remained after adjusting for other phenolic compounds previously linked to respiratory outcomes. No other dimorphic effects of exposure by sex were observed. Among children in the general population, no overall associations with current asthma were observed, although there was a positive trend with PP and a current asthma diagnosis.

Conclusion

We identified differential effects of exposure to select parabens by sex on asthma morbidity. Further studies are needed to replicate these findings and elucidate mechanisms by which parabens could affect respiratory health and elicit dimorphic effects by sex.

Section snippets

Data source for the study population

Our study population consisted of children between the ages of 6 and 19 years participating in NHANES, a population-based, cross-sectional survey assessing the general health and nutritional status of the US noninstitutionalized population. NHANES uses a complex, stratified, multistage probability sample design to be representative of the general population. All study activities were approved by the National Center for Health Statistics (NCHS) institutional review board, and proper consenting

Study population characteristics

Of the 4465 children with data on current asthma diagnosis, 4023 had data available on parabens and covariates included in our analyses. Weighted demographic characteristics for the 4023 children with complete data were similar to those of the larger population of children with available data on current asthma diagnosis (n = 4465; Table I). The mean age of children included in our analyses was 13.0 (SD, 4.0) years, and approximately 52% were male. More than half of the children were

Discussion

In this study, we examined cross-sectional associations between exposure to parabens and asthma-related outcomes in a sample of children from the US general population. We did not observe associations between any paraben and asthma prevalence or asthma morbidity in the population as a whole. However, we identified dimorphic effects of paraben exposure by sex among children with asthma. We found that exposure to both MP and PP was associated with increased prevalence odds of reporting ED visits

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: L.Q.-A. was supported by a National Heart, Lung, and Blood Institute (NHLBI) Career Development Award (K01HL138124); N.N.H. was supported by the National Institute of Environmental Health Sciences (NIEHS; P50 ES018176, R01ES022607, and R01ES023500), the National Institute on Minority Health and Health Disparities (NIMHD; (P50MD010431), and the US Environmental Protection Agency (EPA; agreements 83615201, 83451001, and 83615001); M.C.M. was supported by the NIEHS (P50 ES018176 and R21 ES025840), NIMHD (P50MD010431), and EPA (agreement 83615201); and E.C.M. was supported by the National Institute of Allergy and Infectious Diseases (NIAID; K24AI114769) and NIEHS (R01ES023447 and R01ES026170). The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the official position or views of the National Institutes of Health or the EPA.

: Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest.

View full text

Asthma and lower airway diseaseParaben exposures and asthma-related outcomes among children from the US general population

Background

Objective

Methods

Results

Conclusion

Section snippets

Data source for the study population

Study population characteristics

Discussion

Food Chem Toxicol

Food Chem Toxicol

Toxicol Appl Pharmacol

Food Chem Toxicol

Toxicol Appl Pharmacol

Reprod Toxicol

Med Hypotheses

Lancet

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

World Allergy Organ J

J Allergy Clin Immunol

J Chromatogr B Analyt Technol Biomed Life Sci

Int J Hyg Environ Health

Ann Allergy Asthma Immunol

Ann Allergy Asthma Immunol

Reprod Toxicol

J Allergy Clin Immunol

Ann Allergy Asthma Immunol

Acad Pediatr

Environ Int

Environ Res

Kaohsiung J Med Sci

J Allergy Clin Immunol

J Allergy Clin Immunol

Environ Res

Environ Res

Parabens factsheet 2013

Final amended report on the safety assessment of methylparaben, ethylparaben, propylparaben, isopropylparaben, butylparaben, isobutylparaben, and benzylparaben as used in cosmetic products

Int J Toxicol

Urinary concentrations of four parabens in the U.S. population: NHANES 2005-2006

Environ Health Perspect

Assessment of principal parabens used in cosmetics after their passage through human epidermis-dermis layers (ex-vivo study)

Exp Dermatol

Paraben concentrations in maternal urine and breast milk and its association with personal care product use

Environ Sci Technol

Endocrine disrupters—potential modulators of the immune system and allergic response

Allergy

Asthma and lower airway disease
Paraben exposures and asthma-related outcomes among children from the US general population