A population-based study on peanut, tree nut, fish, shellfish, and sesame allergy prevalence in Canada

Ben-Shoshan, Moshe; Harrington, Daniel W.; Soller, Lianne; Fragapane, Joseph; Joseph, Lawrence; St Pierre, Yvan; Godefroy, Samuel B.; Elliot, Susan J.; Clarke, Ann E.

doi:10.1016/j.jaci.2010.03.015

« Previous Next »The Journal of Allergy and Clinical Immunology
Volume 125, Issue 6 , Pages 1327-1335, June 2010

A population-based study on peanut, tree nut, fish, shellfish, and sesame allergy prevalence in Canada

Moshe Ben-Shoshan, MD
- Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, McGill University Health Center, Montreal, Quebec, Canada
- Reprint requests: Moshe Ben-Shoshan, MD, Montreal Children's Hospital, 2300 Tupper St, Montreal, QC H3H 1P3, Canada.
Daniel W. Harrington, MA
- School of Geography and Earth Sciences, McMaster University, Hamilton, Ontario, Canada
Lianne Soller, BSc
- Division of Clinical Epidemiology, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada
Joseph Fragapane, BSc
- Division of Clinical Epidemiology, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada
Lawrence Joseph, PhD
- Division of Clinical Epidemiology, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada
- Departments of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
Yvan St Pierre, MA
- Division of Clinical Epidemiology, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada
Samuel B. Godefroy, PhD
- Food Directorate, Health Canada, Ottawa, Ontario, Canada
Susan J. Elliot, PhD
- School of Geography and Earth Sciences, McMaster University, Hamilton, Ontario, Canada
Ann E. Clarke, MD, MSc
- Division of Clinical Epidemiology, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada
- Division of Allergy and Clinical Immunology, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada

Received 18 February 2010; received in revised form 11 March 2010; accepted 19 March 2010. published online 10 May 2010.

Background

Recent studies suggest an increased prevalence of food-induced allergy and an increased incidence of food-related anaphylaxis. However, prevalence estimates of food allergies vary considerably between studies.

Objectives

To determine the prevalence of peanut, tree nut, fish, shellfish, and sesame allergy in Canada.

Methods

Using comparable methodology to Sicherer et al in the United States in 2002, we performed a cross-Canada, random telephone survey. Food allergy was defined as perceived (based on self-report), probable (based on convincing history or self-report of physician diagnosis), or confirmed (based on history and evidence of confirmatory tests).

Results

Of 10,596 households surveyed in 2008 and 2009, 3666 responded (34.6% participation rate), of which 3613 completed the entire interview, representing 9667 individuals. The prevalence of perceived peanut allergy was 1.00% (95% CI, 0.80%-1.20%); tree nut, 1.22% (95% CI, 1.00%-1.44%); fish, 0.51% (95% CI, 0.37%-0.65%); shellfish, 1.60% (95% CI, 1.35%-1.86%); and sesame, 0.10% (95% CI, 0.04%-0.17%). The prevalence of probable allergy was 0.93% (95% CI, 0.74%-1.12%); 1.14% (95% CI, 0.92%-1.35%); 0.48% (95% CI, 0.34%-0.61%); 1.42% (95% CI, 1.18%-1.66%); and 0.09% (95% CI, 0.03%-0.15%), respectively. Because of the infrequency of confirmatory tests and the difficulty in obtaining results if performed, the prevalence of confirmed allergy was much lower.

Conclusion

This is the first nationwide Canadian study to determine the prevalence of severe food allergies. Our results indicate disparities between perceived and confirmed food allergy that might contribute to the wide range of published prevalence estimates.

Key words: Food allergy, peanut allergy, tree nut allergy, fish allergy, shellfish allergy, sesame allergy, perceived food allergy, probable food allergy, confirmed food allergy

Abbreviations used: IQR, Interquartile range, SPT, Skin prick test, UK, United Kingdom

Supported by the Allergy, Genes, and Environment (AllerGen) Network of Centres of Excellence, Health Canada. M.B.-S. was partially supported by the Ross Fellowship from the Research Institute of the Montreal Children's Hospital, and D.H. is supported by a Social Sciences and Humanities Research Council fellowship. L.J. and A.E.C. are National Scholars of the Fonds de la recherché en santé du Quebec.

Disclosure of potential conflict of interest: A. E. Clarke has received research support from AllerGen NCE and Health Canada. The rest of the authors have declared that they have no conflict of interest.

PII: S0091-6749(10)00537-3

doi:10.1016/j.jaci.2010.03.015