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

BACKGROUNDPersonal 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. OBJECTIVESWe investigated the associations between commonly used PCPs and the risk of adult-onset asthma in a prospective cohort study of U.S. women. METHODSWe 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. RESULTSOver 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. DISCUSSIONOur 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.