Tuesday, January 13, 2009

Vicks VapoRub® may be dangerous for children

Growing up, whenever I had problems breathing I'd end up with my head over a bowl of steaming hot water poured over Vicks Vaporub -- breathing deeply of fumes that my parents insisted would help me clear my lungs.

Today, clinicians out of Wake Forest University Baptist Medical Center have discovered that Vicks VapoRub®, the popular menthol compound used to relieve symptoms of cough and congestion, may instead create respiratory distress in infants and small children. This doesn't bode well for the nation's old-fashioned Moms, who rely on the product's abilities as mine did.

The study appears in this month’s issue of Chest, the journal of the American College of Chest Physicians, and reports that the product may stimulate mucus production and airway inflammation, which can have severe effects on breathing infants or young children because of the small size of their airways.

Bruce K. Rubin, M.D., lead author of the study and a professor in the department of pediatrics at Brenner Children’s Hospital (part of Wake Forest Baptist says that “The ingredients in Vicks can be irritants, causing the body to produce more mucus to protect the airway. Infants and young children have airways that are much narrower than those of adults, so any increase in mucus or inflammation can narrow them more severely.”

Vicks VapoRub® has a long history in USA healthcare. It was first compounded in 1891, in Greensboro, NC. It was introduced in 1905 with the name Vick’s Magic Croup Salve. The flu epidemic of 1918 increased sales from $900,000 to $2.9 million in just one year and Procter & Gamble has since marketed the product as “The only thing more powerful than a mother’s touch.”

Now it seems as if this mother's touch can be dangerous. The salve is widely used to relieve symptoms of colds and congestion, but there are few data supporting an actual clinical benefit, according to Rubin. Some of the concerns these scientists and others have expressed include: Inflammation in the eyes, mental status changes, lung inflammation, liver damage, constriction of airways and allergic reactions.

Rubin and colleagues treated an infant who was taken to the emergency room after developing severe respiratory distress following the application of Vicks directly under her nose. Researchers sought to determine the effect of the product on the respiratory system using ferrets, which have an airway anatomy and cellular composition similar to humans. The team conducted tests on healthy ferrets and ferrets that had tracheal inflammation (simulating a person with a chest infection) that measured the effects of Vicks on mucus secretion and buildup in the airways, and fluid buildup in the lungs.

Results showed that Vicks exposure increased mucus secretion in both normal and inflamed airways, directly in opposition to the product's historical use. In addition, the studies showed that exposure to the product decreased the rate by which mucus was cleared from the trachea.

The product's label does indicate the product should not be used on children under 2 years of age. However, many parents continue to use Vicks on their sick children, often rubbing the salve on the feet or chest, Rubin said.

“I recommend never putting Vicks in, or under, the nose of anybody—adult or child,” Rubin said. “I also would follow the directions and never use it at all on children under age 2.”


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