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Products: Peanuts
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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
Authors: Sicherer SH, Munoz-Furlong A, Sampson HA.
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- Journals: J Allergy Clin Immunol
- Pages: 1203-7.
- Volume: 112(6)
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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% CI; 1.0%-1.4%) individuals in 155 (3.2%; 95% CI; 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% CI; 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.