Original
articles
The association of individual allergen reactivity with respiratory disease in a national sample: Data from the second National Health and Nutrition Examination Survey, 1976-80 (NHANES II) Peter J. Gergen,
MD, MPH,” and Paul C. Turkeltaub,
MDb Rethrsdu,
Md.
The independent association of individual allergen reactiL,itv with re.spirato~ disease was evaluated with use of the second National Health and Nutrition Examination Survey, a .sample .*.it the U.S. w.hite civilian population, ages 6 to 24 years (n = 4295). Eight, I :2O wtlvol, .CO’% glycerol, unstandardized extracts were administered by psick puncture. Allergen reactivir\ was reported as the percent with a mean ervthema diumeter IO.5 mm or greater at 20 minute.\ Oni\ the prevalence of asthma and allergic rhinitis increased with the increasing number o]’ po.sc:rvc allergen .skin tests. The independent association of individual allergen reactivity with respiratory disease wtas yuantijied with logistic models thut included other allerSqen reactivity. age, XI, smoking, and region. Asthma was associated with reactivifl to house dust (odds ratio, 2.9: c)!c,; confidence interval (CL] I, 7 to 5) and Alternaria (odds ratio, 5. I: 9.5VcCl: 2.9 to 8.Y). Allrt.,~;~ rhinitis was associated with reactivity to ragweed lodd.s ratio, 2.3: Y-T%Cl: I .S to 3..3) rvegrass (odds ratio. 2.8: 95% CI: I.8 to 4.3): house dust (0dd.s ratio, 2.5: 9.57~CI. i.6 to X9); Alternaria (odds ratio, 2.3; 95% Cl: I.5 to 3.4). Asthma onlx (without allergic rhinttis) was assoc$ated with dust and .4lternaria. Allergic rhinitis only frtithout asthma) wa.s aSsociated with ~egrass, ragweed. und house dust. When both asthma and ullergic rhiniti.s were pre.sent. onlv house dust and Alternaria remained associated. These jindinys highlight the ussociaticm o! .spec$ic allergens with upper ond lower respiratory diseases and the interactions trmony coe.xisting respirator? diseases. I J ALLERGY CLI‘V IMMLNOL /992:9~~:.~770-88. i Key words: Asthma. allergic rhinitis. chronic rhinitis, sinusttis. rrllere\, .YHA.VES I1
With the recent increase among the U.S. population of asthma prevalence,’ morbidity,’ and mortality,” attention has been focused on improving asthma treatment. Newly released treatment guidelines highlight the use of antiinflammatory agents to reduce airway inflammation.’
“”
From the Division of Allergy. Immunology. and Transplantation. National Institute of Allergy and Infectious Diseases, Bethesda,’ and the Laboratory of Allergy and Immunochemistry, Center for Biologics Evaluation and Research. Food and Drug Administration. Bethesda.” Received for publication Sept. 4, 1991. Revised April 21, 1992. Accepted for publication May 12, 1992. Based on a presentation by the authors at the Forty-seventh Annual Meeting of the American Academy of Allergy and Immunology in San Francisco, Calif., March l-6. 1991. Reprint requests: Peter .I. Gergen, MD. MPH, DAIT, NIAID, Solar Room 4A29. 9000 Rockville Pike. Bethesda, MD 20892. 111139471
To further reduce the burden of asthma, greater emphasis will need to be placed on prevention. One aspect of prevention involves identifying and avoiding environmental exposures associated with airway inflammation. One important cause of respiratory inflammation is exposure to aeroallergens. When population surveys are carried out. allergic responses to important aeroallergens (e.g., pollens. molds. animal. and insects) are consistently associated with the prevalence and severity of upper and lower anwa\: respiratory diseases.
articles
The association of individual allergen reactivity with respiratory disease in a national sample: Data from the second National Health and Nutrition Examination Survey, 1976-80 (NHANES II) Peter J. Gergen,
MD, MPH,” and Paul C. Turkeltaub,
MDb Rethrsdu,
Md.
The independent association of individual allergen reactiL,itv with re.spirato~ disease was evaluated with use of the second National Health and Nutrition Examination Survey, a .sample .*.it the U.S. w.hite civilian population, ages 6 to 24 years (n = 4295). Eight, I :2O wtlvol, .CO’% glycerol, unstandardized extracts were administered by psick puncture. Allergen reactivir\ was reported as the percent with a mean ervthema diumeter IO.5 mm or greater at 20 minute.\ Oni\ the prevalence of asthma and allergic rhinitis increased with the increasing number o]’ po.sc:rvc allergen .skin tests. The independent association of individual allergen reactivity with respiratory disease wtas yuantijied with logistic models thut included other allerSqen reactivity. age, XI, smoking, and region. Asthma was associated with reactivifl to house dust (odds ratio, 2.9: c)!c,; confidence interval (CL] I, 7 to 5) and Alternaria (odds ratio, 5. I: 9.5VcCl: 2.9 to 8.Y). Allrt.,~;~ rhinitis was associated with reactivity to ragweed lodd.s ratio, 2.3: Y-T%Cl: I .S to 3..3) rvegrass (odds ratio. 2.8: 95% CI: I.8 to 4.3): house dust (0dd.s ratio, 2.5: 9.57~CI. i.6 to X9); Alternaria (odds ratio, 2.3; 95% Cl: I.5 to 3.4). Asthma onlx (without allergic rhinttis) was assoc$ated with dust and .4lternaria. Allergic rhinitis only frtithout asthma) wa.s aSsociated with ~egrass, ragweed. und house dust. When both asthma and ullergic rhiniti.s were pre.sent. onlv house dust and Alternaria remained associated. These jindinys highlight the ussociaticm o! .spec$ic allergens with upper ond lower respiratory diseases and the interactions trmony coe.xisting respirator? diseases. I J ALLERGY CLI‘V IMMLNOL /992:9~~:.~770-88. i Key words: Asthma. allergic rhinitis. chronic rhinitis, sinusttis. rrllere\, .YHA.VES I1
With the recent increase among the U.S. population of asthma prevalence,’ morbidity,’ and mortality,” attention has been focused on improving asthma treatment. Newly released treatment guidelines highlight the use of antiinflammatory agents to reduce airway inflammation.’
“”
From the Division of Allergy. Immunology. and Transplantation. National Institute of Allergy and Infectious Diseases, Bethesda,’ and the Laboratory of Allergy and Immunochemistry, Center for Biologics Evaluation and Research. Food and Drug Administration. Bethesda.” Received for publication Sept. 4, 1991. Revised April 21, 1992. Accepted for publication May 12, 1992. Based on a presentation by the authors at the Forty-seventh Annual Meeting of the American Academy of Allergy and Immunology in San Francisco, Calif., March l-6. 1991. Reprint requests: Peter .I. Gergen, MD. MPH, DAIT, NIAID, Solar Room 4A29. 9000 Rockville Pike. Bethesda, MD 20892. 111139471
To further reduce the burden of asthma, greater emphasis will need to be placed on prevention. One aspect of prevention involves identifying and avoiding environmental exposures associated with airway inflammation. One important cause of respiratory inflammation is exposure to aeroallergens. When population surveys are carried out. allergic responses to important aeroallergens (e.g., pollens. molds. animal. and insects) are consistently associated with the prevalence and severity of upper and lower anwa\: respiratory diseases.
