Food, drug, insect sting allergy, and anaphylaxis
US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up

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Background

Allergy to peanuts and tree nuts (TNs) is the leading cause of fatal allergic reactions in the United States, and the prevalence appears to be increasing.

Objectives

We sought to determine the US prevalence of self-reported peanut, TN, and sesame allergy in 2008 and compare results with comparable surveys conducted in 1997 and 2002.

Methods

A nationwide, cross-sectional, random telephone survey for peanut and TN allergy was conducted with a previously used questionnaire, with additional questions about sesame.

Results

A total of 5,300 households (13,534 subjects) were surveyed (participation rate, 42% vs 52% in 2002 and 67% in 1997). Peanut allergy, TN allergy, or both was reported by 1.4% of subjects (95% CI, 1.2% to 1.6%) compared with 1.2% in 2002 and 1.4% in 1997. For adults, the prevalence was 1.3% (95% CI, 1.1% to 1.6%), which was not significantly different from prior surveys. However, the prevalence of peanut or TN allergy for children younger than 18 years was 2.1% (95% CI, 1.6% to 2.7%) compared with 1.2% in 2002 (P = .007) and 0.6% in 1997 (P < .001). The prevalence of peanut allergy in children in 2008 was 1.4% (95% CI, 1.0% to 1.9%) compared with 0.8% in 2002 (P = not significant) and 0.4% in 1997 (P < .0001). The prevalence of childhood TN allergy increased significantly across the survey waves (1.1% in 2008, 0.5% in 2002, and 0.2% in 1997). Sesame allergy was reported by 0.1% (95% CI, 0.0% to 0.2%).

Conclusions

Although caution is required in comparing surveys, peanut allergy, TN allergy, or both continue to be reported by more than 1% of the US population (eg, >3 million subjects) and appear to be increasingly reported among children over the past decade. Sesame allergy is reported much less commonly.

Section snippets

Survey methods

The survey was a nationwide, cross-sectional, computer-assisted telephone interview performed by TMR, Inc, OpinionMD Division (Broomall, Pa). The survey was administered through the same computer-assisted survey technology and the same sampling system as the 2 previous surveys; the company performing the interviews was different but specializes in the same approach as the previously used vendor. The current survey was conducted from September 27, 2008, to December 22, 2008; the first survey was

Participation rate

A total of 12,683 households were contacted: 6,578 (51.8%) refused to participate, and an additional 807 (6.4%) were ineligible (age <18 years, n = 32; language barrier, n = 775). The total of 5,300 participating households represented a census of 13,534 subjects. The overall participation rate of 5,300 (42%) from the 12,658 households contacted was lower than that for the 2002 survey (52%, P < .001) and the 1997 survey (67%, P < .001).

Demographic characteristics of participants and reported rates of peanut and TN allergy

A total of 188 households (3.6%; 95% CI, 3.1% to 4.1%)

Discussion

We have focused on peanut and TN allergies during each of 3 periodic US telephone surveys because allergies to these foods are often severe and rarely outgrown.2 Our study is particularly unique because we determined peanut and TN allergy prevalence in the general US population using the same methods over time. Except for our national seafood allergy survey,17 we are not aware of US food allergy prevalence studies that incorporate all age groups with a national sample. In our current study,

References (27)

  • G. Lack

    Epidemiologic risks for food allergy

    J Allergy Clin Immunol

    (2008)
  • A.T. Fox et al.

    Household peanut consumption as a risk factor for the development of peanut allergy

    J Allergy Clin Immunol

    (2009)
  • I. Dalal et al.

    The pattern of sesame sensitivity among infants and children

    Pediatr Allergy Immunol

    (2003)
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    Supported by the Food Allergy Initiative, New York, NY, and National Institutes of Health grant UL 1 RR 029887.

    Disclosure of potential conflict of interest: S. H. Sicherer receives research support from the Food Allergy Initiative, the Food Allergy & Anaphylaxis Network, and the National Institutes of Health (NIH) and is a consultant for the Food Allergy Initiative and a medical advisor for the Food Allergy & Anaphylaxis Network. H. A. Sampson is a consultant for and a 4% shareholder in Allertein Pharmaceuticals, LLC; receives research support from the Food Allergy Initiative and the National Institutes of Allergy and Infectious Diseases/NIH; is a consultant/scientific advisor for the Food Allergy Initiative; is a former president of the American Academy of Allergy, Asthma & Immunology; and is a 45% owner of Herbal Springs, LLC. The rest of the authors have declared that they have no conflict of interest.

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