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

• Published in: Journal of allergy and clinical immunology 2003-12, Vol.112 (6), p.1203-1207
• Main Authors: Sicherer, Scott H, Muñoz-Furlong, Anne, Sampson, Hugh A
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Age Distribution; Allergies; anaphylaxis; Arachis hypogaea; Censuses; Child; Child, Preschool; Cross-Sectional Studies; Data processing; Ethnicity; Female; Food allergies; food allergy; Health Surveys; Households; Humans; hypersensitivity; Interviews; Male; Middle Aged; Nut Hypersensitivity - epidemiology; peanut; Peanut Hypersensitivity - epidemiology; Peanuts; Prevalence; Random Allocation; Telephone; telephone survey; tree nut; United States - epidemiology
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/S0091-6749(03)02026-8

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. 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. We performed a nationwide, cross-sectional, random telephone survey by using a standardized questionnaire. 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). 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.