Prevalence of peanut and tree nut allergy in the United States determined by means of a random digit dial telephone survey:: A 5-year follow-up study
Prevalence of peanut and tree nut allergy in the United States determined by means of a random digit dial telephone survey:: A 5-year follow-up study
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DOI：
10.1016/s0091-6749(03)02026-8
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发表时间：
2003-12-01
影响因子：
14.2
通讯作者：
Sampson, HA
中科院分区：
文献类型：
--
作者：
Sicherer, SH;Muñoz-Furlong, A;Sampson, HA
背景：花生和坚果(TNS)过敏是致命性和近乎致命性食物过敏反应的主要原因。目的：调查2002年美国普通人群中花生过敏和TN过敏的患病率，并与5年前的估算结果进行比较。方法：采用标准化问卷，在全国范围内进行横断面随机电话调查。结果：共有4855户家庭(53%的参与率)参与了13493人的普查。在155户(3.2%；95%氯，2.7%-3.7%)家庭中，166人(1.2%；95%氯，1.0%-1.4%)有花生过敏或TN过敏，总体患病率与1997年报告的相似。同样与1997年的调查类似，严重程度很高，79%的人报告了呼吸道或多器官系统反应，66%的人经历了5次以上的终生反应。尽管过敏的严重程度和反应频率很高，但只有74%的儿童和44%的成年人寻求过敏评估，只有不到一半的人接受了自我注射肾上腺素的处方。应用保守规则对有不令人信服的反应和调查工具假阳性率(7%)的人进行调整，最终患病率估计为1.04%(95%CI，0.9%-1.24%)。花生-TN过敏在18岁以下的儿童中男性占优势(1.7%比0.7%，P=.02)，在成人中女性占优势(1.7%比0.9%，P=.0008)。虽然从1997年到2002年，成人中花生过敏和/或两者的发生率没有显著差异，但儿童中花生过敏的发生率从0.6%上升到1.2%，主要是由于报告的花生过敏增加(1997年为0.4%，2002年为0.8%，P=0.05)。结论：从1997年到2002年，儿童中自我报告的花生过敏增加了一倍，300多万美国人继续报告花生过敏和/或两者兼而有之。考虑到反应严重，过敏持续存在，这些过敏反应代表着越来越多的健康问题。
Background: Allergy to peanuts and tree nuts (TNs) is the leading cause of fatal and near-fatal food allergic reactions. Peanut allergy appears to be increasing in prevalence.Objectives: We sought to determine the prevalence of self-reported peanut and TN allergy among the general population of the United States in 2002 by sex and age and to compare the results with prevalence estimates obtained 5 years earlier.Methods: We performed a nationwide, cross-sectional, random telephone survey by using a standardized questionnaire.Results: A total of 4855 households participated (53% participation rate), representing a census of 13,493 individuals. Peanut allergy, TN allergy, or both was self-reported in 166 (1.2%; 95% Cl, 1.0% - 1.4%) individuals in 155 (3.2%; 95% Cl, 2.7%-3.7%) households, overall prevalence rates similar to those reported in 1997. Also similar to the 1997 survey, the severity level was high, with 79% reporting respiratory or multiple organ system reactions and 66% experiencing more than 5 lifetime reactions. Despite the severity and reaction frequency, only 74% of the children and 44% of the adults sought evaluation for the allergy, and fewer than half who did were prescribed self-injectable epinephrine. Applying conservative rules to adjust for persons with unconvincing reactions and a false-positive rate of the survey instrument (7%), a final prevalence estimate of 1.04% (95% Cl, 0.9% -1.24%) was obtained. A male predominance of peanut-TN allergy was reported in children younger than 18 years (1.7% vs 0.7%, P = .02), and a female predominance was reported among adults (1.7% vs 0.9%, P =.0008). Although the rate of peanut allergy, TN allergy, or both was not significantly different from 1997 to 2002 among adults, the rate increased from 0.6% to 1.2% among children, primarily as a result of an increase in reported allergy to peanut (0.4% in 1997 to 0.8% in 2002, P =.05).Conclusions: Self-reported peanut allergy has doubled among children from 1997 to 2002, and peanut allergies, TN allergies, or both continue to be reported by more than 3 million Americans. Considering that reactions are severe and the allergy is persistent, these allergies represent an increasing health concern.