Prevalence and Severity of Food Allergies Among US Adults
Prevalence and Severity of Food Allergies Among US Adults
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DOI：
10.1001/jamanetworkopen.2018.5630
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发表时间：
2019-01-01
影响因子：
13.8
通讯作者：
Nadeau, Kari C.
中科院分区：
文献类型：
--
作者：
Gupta, Ruchi S.;Warren, Christopher M.;Nadeau, Kari C.
食物过敏是一种代价高昂、可能危及生命的疾病。虽然有研究调查了儿童食物过敏的患病率，但对美国成年人食物过敏的患病率、严重程度或医疗保健利用情况知之甚少。目的：对成人食物过敏的分布、严重程度和相关因素提供具有全国代表性的估计。在这项针对美国成年人的横断面调查研究中，调查于2015年10月9日至2016年9月18日通过互联网和电话进行。参与者首先从芝加哥大学以概率为基础的AmeriSpeak小组的NORC中招募，然后从非概率为基础的国际抽样调查（SSI）小组中招募额外的参与者。暴露人口统计学和过敏参与者特征。自我报告的食物过敏是主要结果，如果报告的特定过敏原症状与ige介导的反应一致，则被认为是令人信服的。对特定过敏原的诊断史和食物过敏相关的医疗保健使用也是主要结果。估计是基于这个具有全国代表性的样本，使用小面积估计和迭代比例拟合方法。为了提高精度，AmeriSpeak的数据通过SSI的校准加权非概率响应来增强。结果：40443名成年人（平均[SD]年龄46.6[20.2]岁）完成了调查，AmeriSpeak小组成员（n = 7210）的调查完成率为51.2%，SSI小组成员（n = 33 233）的调查完成率为5.5%。据估计，美国成年人中令人信服的食物过敏患病率为10.8% (95% CI, 10.4%-11.1%)，尽管19.0%（95% CI, 18.5%-19.5%）的成年人自我报告有食物过敏。最常见的过敏是贝类(2.9%;95%可信区间,2.7% -3.1%),牛奶(1.9%;95%可信区间,1.8% -2.1%)、花生(1.8%;95%可信区间,1.7% -1.9%),树坚果(1.2%;95%可信区间,1.1% -1.3%),和鳍鱼(0.9%;95%可信区间,0.8% -1.0%)。在食物过敏的成年人中，51.1% （95% CI, 49.3%-52.9%）经历过严重的食物过敏反应，45.3%（95% CI, 43.6%-47.1%）对多种食物过敏，48.0%（95% CI, 46.2%-49.7%）在成年后发生食物过敏。关于医疗保健的使用，24.0% （95% CI, 22.6%-25.4%）报告了当前的肾上腺素处方，38.3%（95% CI, 36.7%-40.0%）报告了至少一次与食物过敏相关的终身急诊就诊。结论和相关性这些数据表明，至少10.8%（约2600万）的美国成年人对食物过敏，而近19%的成年人认为他们有食物过敏。因此，这些发现表明，对疑似食物过敏的成年人进行适当的确证性测试和咨询是至关重要的，以确保食物不会不必要地避免，生活质量不会受到过度损害。
IMPORTANCE Food allergy is a costly, potentially life-threatening condition. Although studies have examined the prevalence of childhood food allergy, little is known about prevalence, severity, or health care utilization related to food allergies among US adults.OBJECTIVE To provide nationally representative estimates of the distribution, severity, and factors associated with adult food allergies.DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional survey study of US adults, surveys were administered via the internet and telephone from October 9, 2015, to September 18, 2016. Participants were first recruited from NORC at the University of Chicago's probability-based AmeriSpeak panel, and additional participantswere recruited from the non-probability-based Survey Sampling International (SSI) panel.EXPOSURES Demographic and allergic participant characteristics.MAIN OUTCOMES AND MEASURES Self-reported food allergies were the main outcome and were considered convincing if reported symptoms to specific allergenswere consistent with IgE-mediated reactions. Diagnosis history to specific allergens and food allergy-related health care use were also primary outcomes. Estimates were based on this nationally representative sample using small-area estimation and iterative proportional fitting methods. To increase precision, AmeriSpeak data were augmented by calibration-weighted, non-probability-based responses from SSI.RESULTS Surveys were completed by 40 443 adults (mean [SD] age, 46.6 [20.2] years), with a survey completion rate of 51.2% observed among AmeriSpeak panelists (n = 7210) and 5.5% among SSI panelists (n = 33 233). Estimated convincing food allergy prevalence among US adultswas 10.8% (95% CI, 10.4%-11.1%), although 19.0%(95% CI, 18.5%-19.5%) of adults self-reported a food allergy. The most common allergies were shellfish (2.9%; 95% CI, 2.7%-3.1%), milk (1.9%; 95% CI, 1.8%-2.1%), peanut (1.8%; 95% CI, 1.7%-1.9%), tree nut (1.2%; 95% CI, 1.1%-1.3%), and fin fish (0.9%; 95% CI, 0.8%-1.0%). Among food-allergic adults, 51.1% (95% CI, 49.3%-52.9%) experienced a severe food allergy reaction, 45.3%(95% CI, 43.6%-47.1%) were allergic to multiple foods, and 48.0%(95% CI, 46.2%-49.7%) developed food allergies as an adult. Regarding health care utilization, 24.0% (95% CI, 22.6%-25.4%) reported a current epinephrine prescription, and 38.3%(95% CI, 36.7%-40.0%) reported at least 1 food allergy-related lifetime emergency department visit.CONCLUSIONS AND RELEVANCE These data suggest that at least 10.8%(> 26 million) of US adults are food allergic, whereas nearly 19% of adults believe that they have a food allergy. Consequently, these findings suggest that it is crucial that adults with suspected food allergy receive appropriate confirmatory testing and counseling to ensure food is not unnecessarily avoided and quality of life is not unduly impaired.