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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
Open accessAbstract
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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“In fact, our rates of sensitization in teens were higher than those described in the recent analysis of the US population in the Third National Health and Nutrition and Examination Survey, in which 10 allergens were evaluated.(19) Furthermore, our analysis considered only specific IgE levels and not coexisting allergi…”
ResultAllergen immunotherapy (AIT) for the multiple-pollen sensitive patient
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“The overall prevalence of atopy was 52% (16 of 31 patients) in our cohort, similar to the prevalence in the general US population (12) of 54% (56% for teenagers 10- to 19-yr old) (p 1⁄4 0.”
BackgroundMethodInfluentialSensitization and allergic histories differ between black and white pregnant women
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BackgroundGOING TOO FAR? EXPLORING THE LIMITS OF SMOKING REGULATIONS
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“Arbes et al had found that test responses to allergen were more likely to be positive in men.(25) Male gender was found to be a risk factor for allergen sensitizations in a cross-sectional survey performed in 6,304 patients with asthma and/or rhinitis in China.”
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“Worldwide the prevalence for ragweed allergy has doubled in 20 years from 15% to 30% (Arbes et al. 2005).”
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Ragweed allergy immunotherapy tablet MK-3641 (Ragwitek®) for the treatment of allergic rhinitis
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“66 Allergic asthma (%) 100 (32) 13 (22) 66 (34) 21 (34) .”
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“According to epidemiological studies, polysensitization is more common than monosensitization [29, 30].”
BackgroundImmunotherapy in polysensitized patients: new chances for the allergists?
Ciprandi, G., Melioli, G., Passalacqua, G., & Canonica, G. W. (2012) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2012.09.006 · Cited by 11
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Kuperstock, J. E., Brook, C. D., Ryan, M. W., & Platt, M. P. (2016) · International Forum of Allergy & Rhinology · doi:10.1002/alr.21890 · Cited by 11
“Of the monosensitized patients, 47% (74) were sensitized to dust mite(s); 15% to cat (10), dog (1), or both cat and dog (13); 11% (17) to cockroach; 17% to a tree (17) or related trees (10); 3% (4) to a mold; 6% to ragweed (7) or ragweed and related weeds (3); 1 to grasses; and 1 to goose feather (Fig.”
BackgroundWojciechowska, M., Żbikowska-Götz, M., Marek‐Józefowicz, L., Przybyszewski, M., Gocki, J., & Bartuzi, Z. (2018) · Advances in Dermatology and Allergology · doi:10.5114/ada.2018.77664 · Cited by 11
“8%, respectively, and up to 90% of these cases may be associated with hypersensitivity to Fel d 1 [21, 22].”
BackgroundCox, J., Ryan, P., Burkle, J. W., Jandarov, R., Mendell, M. J., Hershey, G. K. K., LeMasters, G. K., & Reponen, T. A. (2020) · Environmental Epidemiology · doi:10.1097/ee9.0000000000000101 · Cited by 14
Component-Resolved Diagnosis for Phleum Allergy: The Role of Recombinants
AMICI, M. D., Alesina, R., Moratti, R., & Ciprandi, G. (2010) · Journal of Asthma · doi:10.3109/02770903.2010.489247 · Cited by 11
“Polysensitization has been well documented in several studies (4, 5).”
BackgroundChang, K., Jeon, J., Kim, G.-H., Jang, C., Jeong, S.-J., Ju, Y.-R., & Ahn, Y. (2017) · Scientific Reports · doi:10.1038/s41598-017-16099-6 · Cited by 11
High prevalence of rhinitis symptoms without allergic sensitization in Estonia and Finland
Pallasaho, P., Kainu, A., Juusela, M., Meren, M., & Sovijärvi, A. (2015) · European Clinical Respiratory Journal · doi:10.3402/ecrj.v2.25401 · Cited by 10
“Sensitization to house dust mites or cockroaches was also common among the general population in the US, and a high prevalence of storage mite sensitization has been reported in the Spanish general population (23, 24).”
BackgroundPrevalence of Fungal Allergens in Respiratory Allergic Patients in Ahvaz City, Southwest Iran
Shakurnia, A., Assarehzadegan, M., Amini, A., & Shakerinejad, G. (2013) · Jundishapur Journal of Microbiology · doi:10.5812/jjm.4864 · Cited by 10
“Due to diverse distribution and pattern of aeroallergens in different regions, identification and determination of common allergens is essential (1, 2, 17, 18), and lack of data on prevalence of sensitization to fungal allergens in our region, the current study was conducted to evaluate the prevalence of positive skin…”
Ragweed Sublingual Tablet Immunotherapy: Part I – Evidence-Based Clinical Efficacy and Safety
Creticos, P. S., & Pfaar, O. (2018) · Immunotherapy · doi:10.2217/imt-2017-0186 · Cited by 10
Pattern of allergic sensitization in chronic rhinitis: A 19-year retrospective study
Tantilipikorn, P., Pinkaew, B., Talek, K., Assanasen, P., Suwanwech, T. S. T., & Bunnag, C. (2020) · Asian Pacific Journal of Allergy and Immunology · doi:10.12932/ap-080719-0597 · Cited by 10
Climate Change Factors and the Aerobiology Effect
Rorie, A. C. (2022) · Immunology and Allergy Clinics of North America · doi:10.1016/j.iac.2022.05.007 · Cited by 10
Park, S., Fowler, S. J., Shaw, D. E., Adcock, I. M., Sousa, A. R., Djukanović, R., Dahlén, S., Sterk, P. J., Kermani, N. Z., Calhoun, W. J., et al. (2024) · Allergy Asthma and Immunology Research · doi:10.4168/aair.2024.16.4.338 · Cited by 10
Food for Thought on Prevention and Treatment of Atopic Disease Through Diet
Sicherer, S. H. (2007) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2007.07.017 · Cited by 10
Nam, Y., Jeon, D. S., & Lee, S.-K. (2015) · Allergy Asthma & Respiratory Disease · doi:10.4168/aard.2015.3.1.47 · Cited by 10
Systemic reactions to subcutaneous immunotherapy
Mustafa, S. S., Bingemann, T. A., Blue, H., Conn, K. M., Hanley, T., & Ramsey, A. C. (2019) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2019.06.021 · Cited by 10
The burden of chronic upper airway disorders in Australia: a population-based cross-sectional study
Habib, A.-R. R., Campbell, R. G., Kalish, L. H., Wong, E. H., Grayson, J. W., Alvarado, R., Sacks, R., & Harvey, R. J. (2019) · Australian Journal of Otolaryngology · doi:10.21037/ajo.2019.11.02 · Cited by 10
“Methods used in the current study are similar to those from previously published studies using National Health Surveys in other countries (8-13).”
BackgroundMaternal positive skin prick test results and asthma prediction after early childhood wheezing
Elizur, A., Pollack, N., Boslaugh, S., Kannai, Y., & Katz, Y. (2007) · Annals of Allergy Asthma & Immunology · doi:10.1016/s1081-1206(10)60732-6 · Cited by 10
Der p 1 IgE measurement for distinguishing between sensitization and allergy
Comite, P., Minale, P., Ferrero, F., Mussap, M., & Ciprandi, G. (2015) · Immunology Letters · doi:10.1016/j.imlet.2015.06.004 · Cited by 10
Population growth and allergen accumulation of Dermatophagoides farinae cultured at 20 and 25 °C
Yella, L., Morgan, M. S., & Arlian, L. G. (2012) · Experimental and Applied Acarology · doi:10.1007/s10493-012-9626-x · Cited by 10
“The latest National Health and Nutrition Examination Survey (NHANES III) showed that 27.7 % of 18–59 year olds in the United States were sensitive to these house dust mites (Arbes et al. 2005).”
BackgroundInfluentialAtopic Dermatitis Nomenclature Variants Can Impede Harmonization
Hanifin, J. M. (2011) · Journal of Investigative Dermatology · doi:10.1038/jid.2011.292 · Cited by 10
2023 Consensus Korean Diagnostic Criteria for Atopic Dermatitis
Lee, J. H., Lee, S. H., Bae, Y., Lee, Y. B., Jang, Y. H., Ahn, J., Ko, J. Y., Ko, H., Kim, H. O., Na, C. H., et al. (2024) · Annals of Dermatology · doi:10.5021/ad.24.049 · Cited by 9
“Furthermore, elevated allergen specific IgE level is not specific to AD since it also can be found in a significant portion of the general population 37 .”
Huang, C., Chu, C., Wu, C., Chang, Z.-N., Chue, F.-L., & Peng, H. (2012) · International Archives of Allergy and Immunology · doi:10.1159/000331140 · Cited by 9
Selection of Patients for Sublingual Versus Subcutaneous Immunotherapy
Larenas‐Linnemann, D. E., & Blaiss, M. S. (2014) · Immunotherapy · doi:10.2217/imt.14.55 · Cited by 9
Peptide Immunotherapy; Short but Long Lasting?
Simms, E., Syed, I., Rudulier, C. D., & Larché, M. (2015) · Current Treatment Options in Allergy · doi:10.1007/s40521-014-0043-8 · Cited by 9
Kennedy, J. L., Robinson, D., Christophel, J. J., Borish, L., & Payne, S. C. (2014) · American Journal of Rhinology and Allergy · doi:10.2500/ajra.2014.28.3998 · Cited by 9
Meteran, H., & Backer, V. (2019) · Expert Review of Clinical Immunology · doi:10.1080/1744666x.2020.1676731 · Cited by 9
Sensibilización a aeroalérgenos en una población pediátrica peruana con enfermedades alérgicas
García‐Gomero, D., López-Talledo, M. D. C., Galván, C. A., Muñoz-León, R., Matos‐Benavides, E., Dionicio, C. T., & Córdova‐Calderón, W. (2020) · Revista Peruana de Medicina Experimental y Salud Pública · doi:10.17843/rpmesp.2020.371.4460 · Cited by 9
To mix or not to mix in allergy immunotherapy vaccines
Nelson, H. S. (2021) · Current Opinion in Allergy and Clinical Immunology · doi:10.1097/aci.0000000000000784 · Cited by 9
“This is a critical issue, because polysensitization is more common than monosensitization (Table 1) [1,2].”
BackgroundCost‐effectiveness Analysis of Inferior Turbinate Reduction and Immunotherapy in Allergic Rhinitis
Yong, M., Aravinthan, K. A., Kirubalingam, K., Thamboo, A. V., Hwang, P. H., Nadeau, K. C., & Walgama, E. S. (2023) · The Laryngoscope · doi:10.1002/lary.31003 · Cited by 9
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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