Should the popular drug Paracetamol be banned applying the Precautionary Principle?

Before you raise your eyebrows wondering why discussion on Paracetamol appears in Agropages, let me assure you this has lots of relevance to pesticides. Therefore, read till the end keeping curiosity.

Precautionary Principle

The precautionary principle is the most nebulous regulatory policy indiscriminately advocated by activists to ban chemicals in the guise of protecting our health and environment.

The Principle 15 of the Rio Declaration of the United Nation Conference on Environment 1992 defined the precautionary principle as follows:

″where there are threats of serious or irreversible damage, lack of full scientific certainty shall not be used as reason for postponing cost-effective measures to prevent environmental degradation″.

Precautionary principle is an emotionally appealing concept. Experience shows that environmental activists in fact abuse this principle to attempt to eliminate certain cost – effective pesticides which served the farming community for long. 

Here is an analogy that would help understanding the gravity of the problem associated with the precautionary principle:

Paracetamol

Paracetamol (N-acetyl-p-aminophenol) is the common drug used globally to relieve pain and reduce fever.

Paracetamol is an over the counter (OTC) drug therefore accessible to all.

The worldwide sale of Paracetamol is estimated to be around $1.6 bn. It is absolutely impossible to find a person who would not have taken Paracetamol in his/her lifetime. Paracetamol played a valuable role in managing the COVID pandemic.

Paracetamol and Precautionary Principle

Recent reports bring out some health risks linked to Paracetamol.

• In the year 2022, scientists from the Cambridge University found that intrauterine Paracetamol exposure may be associated with certain congenital/reproductive disorders in the offspring.

  
  

• One study has described a relationship between maternal Paracetamol consumption and earlier puberty in females.

• Three epidemiological studies have reported association between Paracetamol intake and increased cryptorchidism. This is a disorder in which one or both the testes fail to descend in male infants.

  
  

• Gevin et al.  found difference in DNA metalation in cord blood from children with attention deficit and hyperactivity disorder (ADHD) linked to long term maternal Paracetamol use compared to children unexposed to Paracetamol.

  
  

• There are other studies that found levels of Paracetamol metabolites in umbilical cord to be associated with increased risk of autism spectrum disorder. 

  
  

• Zeyan Liew et al. found that Paracetamol use during pregnancy was associated with subnormal attention and executive function in the offspring at age 5.

  
  

• Dr. Kevin Christensen from the University of Copenhagen found that the use of Paracetamol during pregnancy affects the mental ability of the children and affects their ability to learn.

  
  

• Agnieszka Baranska et al. confirmed that maternal Paracetamol use in pregnancy is associated with an increased risk of asthma or wheezing in their children.

The Question: 

Should Paracetamol be banned applying the precautionary principle?

NO, would be the obvious response. Rightly so. Afterall the usefulness of Paracetamol is well established. The drug use follows risk-benefit analysis. The risks associated with Paracetamol are few, probably one in a million whereas the benefits are substantial. The benefits outweigh the risks. Besides, neurodevelopmental disorders are multi-factorial and cannot be completely linked to a singular cause.

Remember, risk free life is a utopian concept, an impossible ideal in the real world.

Final Message

The rationale that applies to Paracetamol should apply to pesticides too. It is irrational to seek to ban well-known, cost-effective and time-tested pesticides citing the precautionary principle on the basis of some stray scientific reports ignoring the weight of evidence.

While medicines provide health security, pesticides provide food security. Both are important. There must not be discriminatory approach towards pesticides.

Remember, medicines and pesticides undergo rigorous tests to assess their impact on health and environment before being allowed for marketing.

References:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047911/    

2. https://pubmed.ncbi.nlm.nih.gov/28785368/ 

3. https://academic.oup.com/ije/article/45/6/2009/2724482 

4. https://www.news18.com/news/lifestyle/why-pregnant-women-should-avoid-paracetamol-know-its-side-effects-7143553.html   

5. https://www.mdpi.com/2077-0383/12/5/1832