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Prevalences of positive skin test responses to 10 common allergens in the US population: Results from the Third National Health and Nutrition Examination Survey
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Background Allergy skin tests were administered in the second and third National Health and Nutrition Examination Surveys (NHANES II and III) conducted in the United States from 1976 through 1980 and 1988 through 1994, respectively.Objectives This study estimated positive skin test response rates in NHANES III and identified predictors of one or more positive test responses. Comparisons with NHANES II were also made.Methods In NHANES III, 10 allergens and 2 controls were tested in all subjects aged 6 to 19 years and a random half-sample of subjects aged 20 to 59 years. A wheal-based definition of a positive test response was used.Results In NHANES III, 54.3% of the population had positive test responses to 1 or more allergens. Prevalences were 27.5% for dust mite, 26.9% for perennial rye, 26.2% for short ragweed, 26.1% for German cockroach, 18.1% for Bermuda grass, 17.0% for cat, 15.2% for Russian thistle, 13.2% for white oak, 12.9% for Alternaria alternata, and 8.6% for peanut. Among those with positive test responses, the median number of positive responses was 3.0. Adjusted odds of a positive test response were higher for the following variables: age of 20 to 29 years, male sex, minority race, western region, old homes, and lower serum cotinine levels. For the 6 allergens common to NHANES II and III, prevalences were 2.1 to 5.5 times higher in NHANES III.Conclusions The majority of the US population represented in NHANES III was sensitized to 1 or more allergens. Whether the higher prevalences observed in NHANES III reflect true changes in prevalence or methodological differences between the surveys cannot be determined with certainty.
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“While positive testing does indicate evidence of sensitization, this does not necessarily correlate with allergic nasal disease.1843”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [1843]
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National Prevalence and Exposure Risk for Cockroach Allergen in U.S. Households
Cohn, R. D., Arbes, S. J., Jaramillo, R., Reid, L., & Zeldin, D. C. (2005) · Environmental Health Perspectives · doi:10.1289/ehp.8561 · Cited by 112
“The estimated prevalence of detectable Bla g 1 concentrations in 63% of homes is consistent with other research that found 52% prevalence in a regional sample of child care facilities (Arbes et al. 2005b).”
BackgroundResultInfluentialSelf-citationHouse dust (1–3)‐β‐ d ‐glucan and wheezing in infants
Iossifova, Y. Y., Reponen, T. A., Bernstein, D. I., Levin, L., Kalra, H. K., Campo, P., Villareal, M., Lockey, J. E., Hershey, G. K. K., & LeMasters, G. K. (2007) · Allergy · doi:10.1111/j.1398-9995.2007.01340.x · Cited by 111
“However, the Third National Health and Nutrition Examination Survey (NHANES III [53]), 1988–94, designed to obtain nationally representative information on the health of the population of the United States, showed that 54.”
BackgroundEnvironmental Issues in Managing Asthma
Diette, G. B., McCormack, M. C., Hansel, N. N., Breysse, P. N., & Matsui, E. C. (2008) · Respiratory Care · doi:10.4187/respcare.08530602 · Cited by 111
Atopic profile of patients failing medical therapy for chronic rhinosinusitis
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Advances in Diagnosing Peanut Allergy
Sicherer, S. H., & Wood, R. A. (2012) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2012.10.004 · Cited by 106
Efficacy and safety of immunotherapy for allergies to Alternaria alternata in children
Kuna, P., Kaczmarek, J., & Kupczyk, M. (2011) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2010.11.036 · Cited by 106
Creticos, P. S., Esch, R. E., Couroux, P. R., Gentile, D. A., D’Angelo, P., Whitlow, B., Alexander, M., & COYNE, T. C. (2013) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2013.10.041 · Cited by 104
Regulatory T Cells Enhance Mast Cell Production of IL-6 via Surface-Bound TGF-β
Ganeshan, K., & Bryce, P. J. (2011) · The Journal of Immunology · doi:10.4049/jimmunol.1102389 · Cited by 107
“Clinically, it is well described that the majority of individuals who possess food Ag-specific IgE show no clinical reactivity (45).”
BackgroundHigher serum folate levels are associated with a lower risk of atopy and wheeze
Matsui, E. C., & Matsui, W. H. (2009) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2009.03.007 · Cited by 103
“We found a lower prevalence of atopy in this NHANES population than reported in the NHANES III.(47) Skin testing was performed in the NHANES III, but specific IgE testing was performed in the NHANES 2005-2006.”
Peanut allergy diagnosis: A 2020 practice parameter update, systematic review, and GRADE analysis
Greenhawt, M., Shaker, M. S., Wang, J., Oppenheimer, J., Sicherer, S. H., Keet, C. A., Swaggart, K., Rank, M. A., Portnoy, J. M., Bernstein, J., et al. (2020) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2020.07.031 · Cited by 104
“24 Interpreting peanut allergy sensitization.”
BackgroundMonosensitization and polysensitization in allergic rhinitis
Ciprandi, G., & Cirillo, I. (2011) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2011.05.009 · Cited by 102
“Polysensitization is an immunological phenomenon that is clinically significant and relevant from an epidemiological point of view, as recently reported in recent surveys [5–13].”
ResultGeography of house dust mite allergens
Thomas, W. R. (2010) · Asian Pacific Journal of Allergy and Immunology · doi:10.12932/2010-28-211 · Cited by 101
“GA(2)LEN skin test study I: GA(2)LEN harmonization of skin prick testing: novel sensitization patterns for inhalant allergens in Europe.”
BackgroundChen, K., Marusciac, L., Tamaș, T.-P., Valenta, R., & Panaitescu, C. B. (2018) · International Archives of Allergy and Immunology · doi:10.1159/000487997 · Cited by 101
Nolte, H., Hébert, J., Berman, G., Gawchik, S. M., White, M. V., Kaur, A., Liu, N., Lumry, W. R., & Maloney, J. M. (2013) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2013.03.013 · Cited by 97
Davies, J. M. (2014) · Clinical & Experimental Allergy · doi:10.1111/cea.12317 · Cited by 96
Amish children living in northern Indiana have a very low prevalence of allergic sensitization
Holbreich, M., Genuneit, J., Weber, J., Braun‐Fahrländer, C., Waser, M., & von Mutius, E. (2012) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2012.03.016 · Cited by 96
Novel approaches and perspectives in allergen immunotherapy
Hoffmann, H. J., Valovirta, E. J., Pfaar, O., Moingeon, P. E., Schmid, J. M., Skaarup, S. H., Cardell, L., Simonsen, K., Larché, M., Durham, S. R., et al. (2017) · Allergy · doi:10.1111/all.13135 · Cited by 95
Marcus, S., Schertzer, J. S., Roland, L. T., Wise, S. K., Levy, J. M., & DelGaudio, J. M. (2019) · International Forum of Allergy & Rhinology · doi:10.1002/alr.22454 · Cited by 94
Management of the polyallergic patient with allergy immunotherapy: a practice-based approach
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“8 % of the participants were polysensitized [8].”
BackgroundClimate Change and Allergic Disease
Bielory, L., Lyons, K. J., & Goldberg, R. (2012) · Current Allergy and Asthma Reports · doi:10.1007/s11882-012-0314-z · Cited by 93
“2008) to 16 % in the 1976−1980 survey (the NHANES II study) (Gergen, Turkeltaub and Kovar 1987 [39]) to 28 % in the 1988−1994 survey (NHANES III) [3] to 30 % in 2000 [40].”
BackgroundRauer, D., Gilles, S., Wimmer, M., Frank, U., Mueller, C., Musiol, S., Vafadari, B., Aglas, L., Ferreira, F., Schmitt‐Kopplin, P., et al. (2020) · Allergy · doi:10.1111/all.14618 · Cited by 90
Aldakheel, F. M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182212105 · Cited by 98
“African Americans suffering disproportionately more than white people [28,29].”
BackgroundThe Innate Immune Response in House Dust Mite-Induced Allergic Inflammation
Wang, J. (2013) · Allergy Asthma and Immunology Research · doi:10.4168/aair.2013.5.2.68 · Cited by 87
Clinical reviews in allergy and immunology
Leung, D. Y. M., Ledford, D. K., Wechsler, M. E., Fulkerson, P. C., Bochner, B. S., Gauvreau, G. M., Gleich, G. J., Henkel, T., Kolbeck, R., Mathur, S. K., et al. (2012) · Cited by 87
A new therapy (MP29-02) is effective for the long-term treatment of chronic rhinitis.
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Impact of Fungal Spores on Asthma Prevalence and Hospitalization
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“are usually present in lower atmospheric concentrations compared to other allergenic airborne spores, they sport the highest rate of sensitization amongst atopic patients, which is estimated to range from 13–17% [29,42,43], and account for 60% of positive skin prick tests gathered from fungal sensitized patients [8].”
BackgroundThe effect of air pollution on asthma and allergy
Riedl, M. A. (2008) · Current Allergy and Asthma Reports · doi:10.1007/s11882-008-0024-8 · Cited by 84
“Though it is ethically prohibitive to replicate such human experiments with “real-world” allergens, this effect may be a significant factor in the growing prevalence of allergic sensitization as demonstrated in recent longitudinal surveys [ 24 ].”
BackgroundContribution of dust mite and cat specific IgE to total IgE: Relevance to asthma prevalence
Erwin, E. A., Rönmark, E., Wickens, K. L., Perzanowski, M. S., Barry, D., Lundbäck, B., Crane, J., & Platts‐Mills, T. A. E. (2007) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2006.12.648 · Cited by 82
Microarrayed recombinant allergens for diagnostic testing
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Allergies, obesity, other risk factors and survival from pancreatic cancer
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“In a study conducted within the framework of the third National Health and Nutrition Examination Survey in the US, 26.2% of the population had a skin prick test positive to short ragweed ( Arbes et al. 2005 ).”
Influential
Metadata
- Authors
- Arbes Jr., S. J., Gergen, P. J., Elliott, L., & Zeldin, D. C.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Zeldin, Darryl C.
- ORCID
- Zeldin, Darryl C.
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2005-08
- Volume
- 116
- Issue
- 2
- Pages
- 377-383
- ISSN
- 0091-6749 (ISSN-L)
- OpenAlex
- W2017199648
- Cited by
- 639
- References
- 23
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 16 · 2023: 24 · 2022: 20 · 2021: 27 · 2020: 24 · 2019: 29 · 2018: 27 · 2017: 29 · 2016: 50 · 2015: 45 · 2014: 35 · 2013: 34 · 2012: 46
- FWCI
- 18.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases
- Topics
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Keywords
- allergen sensitization, skin test reactivity, allergen prevalence, dust mites, Blattella germanica, Cynodon dactylon, cat allergen, Russian thistle, Quercus alba, Alternaria alternata, peanut allergens, NHANES III, NHANES II, serum cotinine
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Allergens, Child, Child, Preschool, Female, Health Surveys, Humans, Infant, Male, Middle Aged, Nutrition Surveys, Skin Tests, United States, Prevalence
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