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Self-reported adverse food reactions and anaphylaxis in the SchoolNuts study: A population-based study of adolescents - 07/03/18

Doi : 10.1016/j.jaci.2017.09.012 
Vicki L. McWilliam, MND a, b, c, Jennifer J. Koplin, PhD a, Michael J. Field, MD a, Mari Sasaki, MD a, Shyamali C. Dharmage, MD, PhD a, e, Mimi L.K. Tang, MD, PhD a, b, c, Susan M. Sawyer, MD a, b, d, Rachel L. Peters, PhD a, Katrina J. Allen, MD, PhD a, b, c, f,
for the

SchoolNuts investigators

a Murdoch Children's Research Institute, Royal Children's Hospital Melbourne, Melbourne, Australia 
c Department of Allergy and Immunology, Royal Children's Hospital Melbourne, Melbourne, Australia 
d Centre for Adolescent Health, Royal Children's Hospital Melbourne, Melbourne, Australia 
b Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, Australia 
e Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Australia 
f Institute of Inflammation and Repair, University of Manchester, Manchester, United Kingdom 

Corresponding author: Katrina J. Allen, MD, PhD, Murdoch Childrens Research Institute, Royal Children's Hospital, Flemington Rd, Parkville 3052, Victoria, Australia.Murdoch Childrens Research InstituteRoyal Children's HospitalFlemington RdParkvilleVictoria3052Australia

Abstract

Background

Adolescents are at the highest risk of death from anaphylaxis, yet few population-based studies have described the frequencies and risk factors for allergic reactions caused by accidental allergen ingestion in this group.

Methods

We describe the prevalence, frequency, and associated risk factors for recent adverse food reactions in 10- to 14-year-olds in Melbourne, Australia, recruited from a stratified, random, population-based sample of schools (SchoolNuts, n = 9663; 48% response rate). Self-reported food allergy and adverse reaction details, including anaphylaxis, were identified by using a student questionnaire over the past year.

Results

Of 547 students with possible IgE-mediated food allergy, 243 (44.4%; 95% CI, 40.3% to 48.7%) reported a reaction to a food. Fifty-three (9.7%; 95% CI, 7.2% to 12.2%) students reported 93 anaphylaxis episodes. Peanut and tree nuts were the most common food triggers. Among students with current IgE-mediated food allergy, those with resolved or current asthma (adjusted odds ratio [aOR], 1.9 [95% CI, 1.1-1.3] and 1.7 [95% CI, 1.1-2.6]) and those with more than 2 food allergies (aOR, 1.9 [95% CI, 1.1-3.1]) were at greatest risk of any adverse food reaction, and those with nut allergy were most at risk of severe reactions (aOR, 2.9 [95% CI, 1.1-4.4]). Resolved or current asthma was not associated with increased risk of severe reactions (aOR, 0.8 [95% CI, 0.3-2.2] and 1.6 [95% CI, 0.7-3.7]).

Conclusions

Adolescents with food allergy are frequently exposed to food allergens. Those with asthma and more than 2 food allergies were at the greatest risk for adverse food reactions. Those with nut allergies were most at risk of severe reactions.

Le texte complet de cet article est disponible en PDF.

Key words : Food allergy, anaphylaxis, adolescents, schools, peanut allergy, asthma

Abbreviations used : aOR, OR


Plan


 Supported by the National Health and Medical Research Council of Australia (NHMRC grant APP1047396). J.J.K., S.C.D., and K.J.A. hold NHMRC fellowships. V.L.M.'s PhD scholarship was funded by NHMRC funded Centre for Food and Allergy Research (CFAR).
 Disclosure of potential conflict of interest: V. L. McWilliam's institution received a grant from National Health Medical Research Council (NHMRC) for this study and consultancy fees from Nutricia, and she was personally paid lecture fees from Nutricia, Nestle, and Abbot. J. J. Koplin's, M. J. Field's, S. M. Sawyer's, R. L. Peters's institutions received a grant from the NHMRC for this study. M. Sasaki's institution received a grant from the NHMRC, and Dr Sasaki personally received support for travel from the Center for Clinical Epidemiology, St Luke's International University, Tokyo, Japan, for this work. M. L. K. Tang received board membership from the Nestle Nutrition Institute and Danone Nutricia; received consultancy fees from Deerfield Consulting, GLG consulting, and Bayer; is employed by ProTA Therapeutics; received payment for lectures from Danone Nutricia; received royalties from Wilkinson Publishing; received payment for development of educational presentations from MD Linx; and holds stock options from ProTA Therapeutics, and her institution received patents and grants from ProTA Therapeutics for other works. K. J. Allen received speakers' honoraria from Nestle, Thermo Fisher, and AspenCare for this work and received consultancy fees from Before Brands for other works. S. C. Dharmage declares that he has no relevant conflicts of interest.


© 2017  American Academy of Allergy, Asthma & Immunology. Tous droits réservés.
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Vol 141 - N° 3

P. 982-990 - mars 2018 Retour au numéro
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