Personal care product use and risk of adult-onset asthma: Prospective cohort analyses of U.S. Women from the Sister Study

Abstract

Background: Population studies have found associations between prenatal exposure to endocrine-disrupting chemicals (EDCs) in personal care products (PCPs) and childhood asthma; however, few have examined adult-onset asthma. We investigated the associations between commonly used PCPs and the risk of adult-onset asthma in a prospective cohort study of U.S. women.

Methods: We analyzed 39,408 participants from the Sister Study who self-reported their usage frequency of 41 PCPs in the 12-month period before baseline (2003-2009). In our combined PCP analyses, we used Least Absolute Shrinkage and Selection Operator (LASSO) to select key PCPs that predict the risk of adult-onset asthma. In group-specific analyses, PCPs were aggregated into four product groups (i.e., beauty, everyday hair, hygiene, and skincare products). Subsequently, we conducted latent class analysis to identify groups of participants with similar patterns of PCP use (e.g., infrequent (reference), moderate, and frequent). Multivariable Cox regression models were used to assess the associations between PCP use and incident adult-onset asthma.

Results: Over an average 12.5-year follow-up, 1,774 incident asthma cases were identified. We found a positive association between combined PCP use and adult-onset asthma risk (moderate users, hazard ratio [HR] = 1.19 (95% confidence interval (CI):1.05,1.33) and frequent users, HR = 1.19 (95% CI:1.06,1.34)). In group-specific analyses, moderate (HR = 1.21 (95% CI:1.07,1.37)) and frequent (HR = 1.22 (95% CI:1.08,1.38)) users of beauty products had higher asthma risk compared to infrequent users. Similar associations were observed for hygiene (moderate: HR = 1.14 (95% CI:1.01,1.29) and frequent: HR = 1.20 (95% CI:1.06,1.36)) and skincare products (moderate: HR = 1.21 (95% CI:1.06,1.38) and frequent: HR = 1.20 (95% CI:1.06,1.35)).

Conclusions: Our findings suggest that PCP use potentially contributes to future risk of adult-onset asthma among women.

Keywords: Asthma; Endocrine disruptors; Personal care products; Prospective cohort study.