Epidemiologic Study of Abuse of Analgesics Containing Phenacetin

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Abstract
A study group of 623 working women 30 to 49 years old with objective evidence of intake of phenacetin-containing analgesics and a matched control group of 621 women without such intake in 1968 were assessed six times from 1969 to 1978 for laboratory evidence of urinary-tract disorders. The two groups did not differ in development of bacteriuria, hematuria, or proteinuria. However, a low specific gravity of urine (study group vs. control group, 23 vs. 7 per cent) and a raised level of serum creatinine (6.7 vs. 0.9 per cent) were significantly more frequent in the study group (P<0.001). Adjusted analyses of mortality over 11 years showed significant differences between the groups in overall mortality (study group vs. control group, 39 vs. 13 deaths; P<0.001), mortality due to urinary-tract disorders (P = 0.033), and cardiovascular diseases (P = 0.008). We conclude that heavy users of analgesic mixtures in the course of a decade have a higher incidence of both abnormal kidney function and kidney-related mortality than do casual users and nonusers, but the absolute incidences remain small even among heavy users. (N Engl J Med. 1983; 308:357–62.)