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The Epidemiology of Allergy

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (1 October 2018) | Viewed by 67724

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Special Issue Editor

Dr. Nicholas Osborne

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Guest Editor

1. School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
2. School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
3. European Centre for Environment and Human Health (ECEHH), University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro TR1 3HD, Cornwall, UK
Interests: food allergy and environmental determinants; pollen and health; uncertain chronic kidney disease

Special Issue Information

Dear Colleagues,

We are organizing a Special Issue on the epidemiology of allergy in the International Journal of Environmental Research and Public Health. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://www.mdpi.com/journal/ijerph.

The academic study of the epidemiology of allergy has undergone a transformation over the last 20 years, from around 150 citations of "epidemiology and allergy" in 1995 to over 8500 in 2016. Epidemiological studies have laid the ground work for examining a range of exciting theories, as well as acting as hypothesis generating tools. Highlights have included probing the ubiquitousness of the hygiene hypothesis, exploring the nexus with gut and skin flora, examining the timing of introduction of allergens to diet, genetic factors and exposure to greenspace/more natural environments altering risk of allergy.

These have been performed in the context of increased access to wide ranging digital datasets of exposures and populations, and with appropriate linkage providing new tools for the epidemiologist to explore this global phenomenon. The epidemiology of allergy is increasing flagged as important in the large populations of developing economies, with increasing urbanisation seeing a fundamental shift in exposures. Clinical medicine is also using knowledge derived from epidemiology, moving away from guidelines based on historic practice, to those emphasising evidence-based medicine, to aid patients and prevent disease onset.

This Special Issue is open to any subject area related to the epidemiology of allergy. The listed keywords suggest just a few of the many possibilities.

Dr. Nicholas J. Osborne
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Atopy
Public health
Pollen
Air pollution
Occupational
Rhinitis
Pollinosis
Microbiome
Sensitization
Allergen
Hay fever
Food allergy
Gut microbiology
Health geography
Quality of life
Stress
Genetics
Physical activity
Environmental exposure
Emissions
Hygiene hypothesis
Vitamin D
Drug allergy
IgE
Non-IgE
Filaggrin
Anaphylaxis

Published Papers (10 papers)

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Research

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8 pages, 884 KiB

Open AccessArticle

Food Allergy Prevalence in Salvadoran Schoolchildren Estimated by Parent-Report

by Francisco Cabrera-Chávez, Cecilia Ivonne Rodríguez-Bellegarrigue, Oscar Gerardo Figueroa-Salcido, Jesús Aristeo Lopez-Gallardo, Jesús Gilberto Arámburo-Gálvez, Marcela de Jesús Vergara-Jiménez, Mónica Lizzette Castro-Acosta, Norberto Sotelo-Cruz, Martina Hilda Gracia-Valenzuela and Noé Ontiveros

Int. J. Environ. Res. Public Health 2018, 15(11), 2446; https://doi.org/10.3390/ijerph15112446 - 02 Nov 2018

Cited by 17 | Viewed by 3722

Abstract

The prevalence of food allergy (FA) has not been estimated at a population level in Central American countries and, consequently, the magnitude and relevance of the problem in the Central American region remains unknown. Thus, our aim was to evaluate the parent-reported prevalence of FA in a population of schoolchildren from the Central American country El Salvador. A Spanish version of a structured questionnaire was utilized. Five hundred and eight (508) parents returned the questionnaire with valid responses (response rate, 32%). The estimated prevalence rates (95% CI) were: adverse food reactions 15.9 (13.0–19.3), “perceived FA, ever” 11.6 (9.1–14.6), “physician-diagnosed FA, ever” 5.7% (4.0–8.0), “immediate-type FA, ever” 8.8% (6.6–11.6), “immediate-type FA, current” 5.3% (3.6–7.6), and anaphylaxis 2.5% (1.5–4.3). The most common food allergens were milk (1.7%), shrimp (1.3), chili (0.7%), chocolate (0.7%), and nuts (0.3%). Most of the “food-dependent anaphylaxis” cases (60.5%) sought medical attention, but only one case reported the prescription of an epinephrine autoinjector. Mild and severe FA cases are not uncommon among Salvadoran schoolchildren and both the prescription of epinephrine autoinjectors by healthcare personnel and the use of the autoinjectors by anaphylactic individuals should be encouraged. Full article

(This article belongs to the Special Issue The Epidemiology of Allergy)

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8 pages, 272 KiB

Open AccessArticle

The Epidemiology of Food Allergy in the Global Context

by Wenyin Loh and Mimi L. K. Tang

Int. J. Environ. Res. Public Health 2018, 15(9), 2043; https://doi.org/10.3390/ijerph15092043 - 18 Sep 2018

Cited by 306 | Viewed by 19215

Abstract

There is a lack of high-quality evidence based on the gold standard of oral food challenges to determine food allergy prevalence. Nevertheless, studies using surrogate measures of food allergy, such as health service utilization and clinical history, together with allergen-specific immunoglobulin E (sIgE), provide compelling data that the prevalence of food allergy is increasing in both Western and developing countries. In Western countries, challenge-diagnosed food allergy has been reported to be as high as 10%, with the greatest prevalence noted among younger children. There is also growing evidence of increasing prevalence in developing countries, with rates of challenge-diagnosed food allergy in China and Africa reported to be similar to that in Western countries. An interesting observation is that children of East Asian or African descent born in a Western environment are at higher risk of food allergy compared to Caucasian children; this intriguing finding emphasizes the importance of genome-environment interactions and forecasts future increases in food allergy in Asia and Africa as economic growth continues in these regions. While cow’s milk and egg allergy are two of the most common food allergies in most countries, diverse patterns of food allergy can be observed in individual geographic regions determined by each country’s feeding patterns. More robust studies investigating food allergy prevalence, particularly in Asia and the developing world, are necessary to understand the extent of the food allergy problem and identify preventive strategies to cope with the potential increase in these regions. Full article

(This article belongs to the Special Issue The Epidemiology of Allergy)

10 pages, 1192 KiB

Open AccessArticle

How Accurate Are the ISAAC Questions for Diagnosis of Allergic Rhinitis in Korean Children?

by Dong Hyun Kim, Dae Hyun Lim, Mona Samra, Eun Hye Kim and Jeong Hee Kim

Int. J. Environ. Res. Public Health 2018, 15(7), 1527; https://doi.org/10.3390/ijerph15071527 - 19 Jul 2018

Cited by 19 | Viewed by 4268

Abstract

Background: The aims of this study were to investigate the prevalence of allergic rhinitis (AR) and the accuracy of the International Study of Asthma and Allergies in Childhood (ISAAC) questions for diagnosis of AR, in Korean children. Methods: Students that participated in an allergic disease prevalence survey in 2010–2017 were evaluated (n = 18,425) using questionnaires and a skin prick test (SPT). Age−stratified (5−7, 8−10, 11−13, 14−16 years) prevalence of four rhinitis questions, accuracy of the questions for AR, and proportion of comorbidities in the AR and non-AR (NAR) groups were evaluated. Results: The proportion of students responding to the questionnaire that ever had symptoms of AR since birth, that is, the prevalence of “symptom, ever” was 47.6%. Based on the questionnaire and SPT, overall prevalence of AR and NAR were 21% and 26.5%, respectively. The sensitivity, specificity, and accuracy of “symptom, ever” were 57.5%, 58.4%, and 58.1%, respectively, and those of “diagnosis, ever”, who had ever been diagnosed with AR, were 39.8%, 76.9%, and 63.4%, respectively. Questionnaire−based asthma, atopic dermatitis, and food allergy were significantly associated with the AR group compared to the NAR group. Conclusions: Since the AR accuracy of the questionnaire is about 60%, it should be considered that the questionnaire based survey overestimates the true prevalence of AR in Korean children. Full article

(This article belongs to the Special Issue The Epidemiology of Allergy)

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13 pages, 353 KiB

Open AccessArticle

2-Naphthol Levels and Allergic Disorders in Children

by Tien-Jen Lin, Yueliang Leon Guo, Jiin-Chyr Hsu and I-Jen Wang

Int. J. Environ. Res. Public Health 2018, 15(7), 1449; https://doi.org/10.3390/ijerph15071449 - 09 Jul 2018

Cited by 4 | Viewed by 2929

Abstract

Background: The measurement of polycyclic aromatic hydrocarbons (PAH) in ambient air is quite difficult to perform. Using urine biomarkers of PAH such as 2-naphthol is one approach to this problem. This study explored the association between urine 2-naphthol levels and allergic diseases. The associations between 2-naphthol levels and oxidative stress biomarkers for the possible disease pathogenesis were also investigated. Method: A total of 453 kindergarten children from the (Childhood Environment and Allergic Diseases Study) CEAS cohort with urine samples were recruited. Urine 2-naphthol levels were measured by high-performance liquid chromatography mass spectrometry (HPLC-MS/MS) and markers of oxidative stress (8OHdG) were measured by enzyme-linked immunosorbent assays (ELISA). Information on environmental risk factors and allergic diseases were also collected. The association between 2-naphthol levels, 8OHdG levels, IgE, and allergic diseases were evaluated by multivariate linear regression and logistic regression. Results: Levels of 2-naphthol were positively correlated with 8OHdG levels. A one ln-unit increase in the 2-naphthol level was positively associated to 8OHdG levels (per ln-unit: β = 100.61, p < 0.001). When dividing 2-naphthol levels into quartiles, asthma was significantly associated with 2-naphthol levels at a concentration of >1.60 ng/mL (adjusted OR: 3.14, 95% CI 1.34–7.35). Conclusion: Urine 2-naphthol levels are associated with markers of oxidative stress and the risk of allergic diseases in young children. Full article

(This article belongs to the Special Issue The Epidemiology of Allergy)

13 pages, 1324 KiB

Open AccessFeature PaperArticle

Association of Infant Eczema with Childhood and Adult Asthma: Analysis of Data from the 1958 Birth Cohort Study

by Ghada Abo-Zaid, Richard A. Sharpe, Lora E. Fleming, Michael Depledge and Nicholas J. Osborne

Int. J. Environ. Res. Public Health 2018, 15(7), 1415; https://doi.org/10.3390/ijerph15071415 - 05 Jul 2018

Cited by 16 | Viewed by 3941

Abstract

The influence of early life exposures on later life disease has for some time provided clues to modifiable risk factors of disease. The “atopic march” is thought to play a role in the progression of allergic diseases and may offer an opportunity to lower asthma’s health and socioeconomic burden, although evidence remains controversial. We aimed to examine the relationship between early life eczema and asthma later in life. Using the National Child Development Study, we examined infant eczema and childhood and adult asthma. Data related to asthma or wheezing bronchitis were available for 13,503 (73%; 95% CI 72–74), 11,503 (61%; 95% CI 60–61), 12,524 (68%; 95% CI 67–69), 11,194 (60%; 95% CI 60–60), 9377 (51%; 95% CI 51–51), and 9760 (53%; 95% CI 52–53) subjects at ages 11, 16, 23, 33, 44, and 50 years, respectively. Logistic regression models were fitted to examine each wave separately before and after adjusting for a range of potential confounders. Generalised estimating equation (GEE) methods were undertaken to examine the associations after pooling all data from questionnaires. The prevalence of self-reported asthma in those that had previously reported infant eczema ranged from 1.0%; 95% CI 0.9–1.4 (age 44 years) to 2.2%; 95% CI 2.1–2.3 (age 33 years). Participants with infant eczema had a 2–3-fold increased risk of reporting asthma in childhood and adulthood; this was 1.6 times at age 44 years when using spirometry measures. Similar effect sizes were observed in the GEE models when considering all participants (OR 2.9; 95% CI 2.6–3.2). Childhood and adult asthma were consistently associated with infant eczema both by using the self-reported data and lung measures. Full article

(This article belongs to the Special Issue The Epidemiology of Allergy)

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12 pages, 322 KiB

Open AccessArticle

Modifiable Risk Factors for Common Ragweed (Ambrosia artemisiifolia) Allergy and Disease in Children: A Case-Control Study

by Maureen Agnew, Ivana Banic, Iain R. Lake, Clare Goodess, Carlota M. Grossi, Natalia R. Jones, Davor Plavec, Michelle Epstein and Mirjana Turkalj

Int. J. Environ. Res. Public Health 2018, 15(7), 1339; https://doi.org/10.3390/ijerph15071339 - 26 Jun 2018

Cited by 6 | Viewed by 4098

Abstract

Ragweed allergy is a major public health concern. Within Europe, ragweed is an introduced species and research has indicated that the amounts of ragweed pollen are likely to increase over Europe due to climate change, with corresponding increases in ragweed allergy. To address this threat, improving our understanding of predisposing factors for allergic sensitisation to ragweed and disease is necessary, specifically focusing upon factors that are potentially modifiable (i.e., environmental). In this study, a total of 4013 children aged 2–13 years were recruited across Croatia to undergo skin prick tests to determine sensitisation to ragweed and other aeroallergens. A parental questionnaire collected home environment, lifestyle, family and personal medical history, and socioeconomic information. Environmental variables were obtained using Geographical Information Systems and data from nearby pollen, weather, and air pollution stations. Logistic regression was performed (clustered on school) focusing on risk factors for allergic sensitisation and disease. Ragweed sensitisation was strongly associated with ragweed pollen at levels over 5000 grains m^–3 year⁻¹ and, above these levels, the risk of sensitisation was 12–16 times greater than in low pollen areas with about 400 grains m^–3 year⁻¹. Genetic factors were strongly associated with sensitisation but nearly all potentially modifiable factors were insignificant. This included measures of local land use and proximity to potential sources of ragweed pollen. Rural residence was protective (odds ratio (OR) 0.73, 95% confidence interval (CI) 0.55–0.98), but the factors underlying this association were unclear. Being sensitised to ragweed doubled (OR 2.17, 95% CI 1.59–2.96) the risk of rhinoconjunctivitis. No other potentially modifiable risk factors were associated with rhinoconjunctivitis. Ragweed sensitisation was strongly associated with ragweed pollen, and sensitisation was significantly associated with rhinoconjunctivitis. Apart from ragweed pollen levels, few other potentially modifiable factors were significantly associated with ragweed sensitisation. Hence, strategies to lower the risk of sensitisation should focus upon ragweed control. Full article

(This article belongs to the Special Issue The Epidemiology of Allergy)

12 pages, 1052 KiB

Open AccessArticle

Association between Serum 25-Hydroxy Vitamin D Levels and the Prevalence of Adult-Onset Asthma

by Mark P. C. Cherrie, Christophe Sarran and Nicholas J. Osborne

Int. J. Environ. Res. Public Health 2018, 15(6), 1103; https://doi.org/10.3390/ijerph15061103 - 29 May 2018

Cited by 6 | Viewed by 4108

Abstract

The major circulating metabolite of vitamin D (25(OH)D) has been implicated in the pathogenesis for atopic dermatitis, asthma and other allergic diseases due to downstream immunomodulatory effects. However, a consistent association between 25(OH)D and asthma during adulthood has yet to be found in observational studies. We aimed to test the association between 25(OH)D and asthma during adulthood and hypothesised that this association would be stronger in non-atopic participants. Using information collected on the participants of the 1958 birth cohort, we developed a novel measure of atopic status using total and specific IgE values and reported history of eczema and allergic rhinitis. We designed a nested case-control analysis, stratified by atopic status, and using logistic regression models investigated the association between 25(OH)D measured at age 46 years with the prevalence of asthma and wheezy bronchitis at age 50 years, excluding participants who reported ever having asthma or wheezy bronchitis before the age of 42. In the fully adjusted models, a 10 nmol/L increase in serum 25(OH)D prevalence had a significant association with asthma (aOR 0.94; 95% CI 0.88–1.00). There was some evidence of an atopic dependent trend in the association between 25(OH)D levels and asthma. Further analytical work on the operationalisation of atopy status would prove useful to uncover whether there is a role for 25(OH)D and other risk factors for asthma. Full article

(This article belongs to the Special Issue The Epidemiology of Allergy)

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Review

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12 pages, 468 KiB

Open AccessReview

Greenspace and Atopic Sensitization in Children and Adolescents—A Systematic Review

by Katrina A. Lambert, Gayan Bowatte, Rachel Tham, Caroline J. Lodge, Luke A. Prendergast, Joachim Heinrich, Michael J. Abramson, Shyamali C. Dharmage and Bircan Erbas

Int. J. Environ. Res. Public Health 2018, 15(11), 2539; https://doi.org/10.3390/ijerph15112539 - 13 Nov 2018

Cited by 32 | Viewed by 4186

Abstract

In the last decade, studies investigating greenspace have highlighted several benefits to human health. However, the effect of greenspace on allergies and atopic sensitization in children was not clear. While several studies have investigated this link, the evidence has not been systematically synthesized. We conducted a systematic search of eight databases. Study characteristics and findings were extracted from five articles covering 11 cohorts published between 2012 and 2016, and study quality assessments were performed. Due to significant heterogeneity, meta-analysis was not conducted. Findings were not consistent, possibly due to variations in exposure measurements, study populations and location, the specific allergens tested, and inclusion of confounders. Protective effects from greenspace were reported in four cohorts, while two cohorts showed an increase in sensitization related to greenspace. The other five cohorts found no significant effect of greenspace on atopic sensitization. There is limited understanding of the contributions of greenspace to specific allergens. Future research should consider amount and type of greenspace, as well as the specific allergens tested. Full article

(This article belongs to the Special Issue The Epidemiology of Allergy)

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23 pages, 1872 KiB

Open AccessReview

Aeroallergens in Canada: Distribution, Public Health Impacts, and Opportunities for Prevention

by Cecilia Sierra-Heredia, Michelle North, Jeff Brook, Christina Daly, Anne K. Ellis, Dave Henderson, Sarah B. Henderson, Éric Lavigne and Tim K. Takaro

Int. J. Environ. Res. Public Health 2018, 15(8), 1577; https://doi.org/10.3390/ijerph15081577 - 25 Jul 2018

Cited by 20 | Viewed by 8410

Abstract

Aeroallergens occur naturally in the environment and are widely dispersed across Canada, yet their public health implications are not well-understood. This review intends to provide a scientific and public health-oriented perspective on aeroallergens in Canada: their distribution, health impacts, and new developments including the effects of climate change and the potential role of aeroallergens in the development of allergies and asthma. The review also describes anthropogenic effects on plant distribution and diversity, and how aeroallergens interact with other environmental elements, such as air pollution and weather events. Increased understanding of the relationships between aeroallergens and health will enhance our ability to provide accurate information, improve preventive measures and provide timely treatments for affected populations. Full article

(This article belongs to the Special Issue The Epidemiology of Allergy)

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39 pages, 466 KiB

Open AccessReview

Contact Allergy: A Review of Current Problems from a Clinical Perspective

by Wolfgang Uter, Thomas Werfel, Ian R. White and Jeanne D. Johansen

Int. J. Environ. Res. Public Health 2018, 15(6), 1108; https://doi.org/10.3390/ijerph15061108 - 29 May 2018

Cited by 48 | Viewed by 11570

Abstract

Contact allergy is common, affecting 27% of the general population in Europe. Original publications, including case reports, published since 2016 (inclusive) were identified with the aim of collating a full review of current problems in the field. To this end, a literature search employing methods of systematic reviewing was performed in the Medline^® and Web of Science™ databases on 28 January 2018, using the search terms (“contact sensitization” or “contact allergy”). Of 446 non-duplicate publications identified by above search, 147 were excluded based on scrutiny of title, abstract and key words. Of the remaining 299 examined in full text, 291 were deemed appropriate for inclusion, and main findings were summarised in topic sections. In conclusion, diverse sources of exposures to chemicals of widely-differing types and structures, continue to induce sensitisation in man and may result in allergic contact dermatitis. Many of the chemicals are “evergreen” but others are “newcomers”. Vigilance and proper investigation (patch testing) are required to detect and inform of the presence of these haptens to which our populations remain exposed. Full article

(This article belongs to the Special Issue The Epidemiology of Allergy)

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