Asthma cases attributable to atopy: results from the Third National Health and Nutrition Examination Survey.
BACKGROUND
The percentage of asthma cases attributable to atopy is the subject of debate.


OBJECTIVE
The objectives were to estimate the percentage of asthma cases in the US population attributable to atopy and to examine associations between allergen-specific skin tests and asthma.


METHODS
Data were obtained from the Third National Health and Nutrition Examination Survey, in which subjects age 6 to 59 years were skin tested with 10 allergens. Atopy was defined as at least 1 positive allergen-specific test. Doctor-diagnosed current asthma was assessed by questionnaire.


RESULTS
In the United States, 56.3% of the asthma cases were attributable to atopy, and that percentage was greater among males than females, among persons in the highest education category than in lower education categories, and among persons living in highly populated metropolitan areas than in all other areas. Each allergen-specific test was strongly associated with asthma before adjustment (odds ratios varied from 2.1 to 4.5); however, after adjustment by all the allergens, only tests to cat, Alternaria, white oak, and perennial rye were independently associated with asthma. Perennial rye was inversely associated with asthma. Of the 10 allergens, a positive response to cat accounted for the highest percentage of asthma cases (29.3%).


CONCLUSIONS
About half of the current asthma cases in the US population represented by the Third National Health and Nutrition Examination Survey were attributable to atopy. Some allergen-specific skin tests were not independently associated with asthma.


CONCLUSIONS
If atopy could be prevented or reversed, or its effect on asthma blocked, then a large percentage of asthma cases in the US population could be prevented.
Arbes
Samuel J
SJ
Laboratory of Respiratory Biology, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA.
Gergen
Peter J
PJ
Vaughn
Ben
B
Zeldin
Darryl C
DC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000276:immunology; D000818:Animals; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology*; D002415:Cats; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D012130:Respiratory Hypersensitivity / Q000150:complications*; D012882:Skin Tests; D014481:United States / Q000453:epidemiology
D000485:Allergens