Personal care product use and risk of adult-onset asthma: findings from the Sister Study

BACKGROUND Personal care products (PCPs) contain endocrine-disrupting chemicals (EDCs) linked to hormonally-sensitive diseases. Population studies have found associations between prenatal EDC exposure and childhood asthma; however, few have investigated 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.

We analyzed 39,408 participants from the Sister Study (2003-2009). The participants self-reported their usage frequency of 41 PCPs in the 12-month period before baseline. Latent classes were used to identify groups with similar usage patterns (‘infrequent’, ‘moderate’, ‘frequent’) within types of products (‘beauty’, ‘everyday hair’, ‘hygiene’, and ‘skincare’). Multivariable Cox regression models were used to assess the associations between PCP use and incident adult-onset asthma.

Over an average 12.5-year follow-up, 1,774 incident asthma cases were identified. Compared to infrequent users, moderate (hazard ratio [HR]=1.21 (95% confidence interval (CI):1.07,1.37)) and frequent (HR=1.22 (95%CI:1.08,1.38)) users of beauty products had significantly higher asthma risk. 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)). Several individual everyday hair products (hair spray, hair styling gel/mousse, and pomade or hair grease) were positively associated with asthma risk, but associations were not detected for everyday hair latent classes.

Our findings suggest that PCP use potentially contributes to future risk of adult-onset asthma among women. These novel findings reinforce the need for regulation of PCPs and their components to reduce the burden of asthma. Competing Interest Statement The authors have declared no competing interest. Funding Statement This work was supported by intramural funding from the National Heart and Lung and Blood Institute, and Intramural Research Program of the National Institute of Health, National Institute of Environmental Health Sciences (grant number Z01ES044005). Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The institutional review boards of the National Institute Health gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Footnotes Conflicts of interest statement: The authors declare they have nothing to disclose. Data Availability All data necessary to reproduce the current analysis are publicly available upon request as described on the Sister Study website (https://sisterstudy.niehs.nih.gov/English/data-requests.htm).