Accidental exposures to peanut in a large cohort of Canadian children with peanut allergy

Clinical and Translational Allergy

Ann Clarke^1,10  Mary Allen⁹  Laurie Harada¹  Yvan St-Pierre⁸  Greg Shand⁸  Stephen Cheuk⁴  Edmond Chan²  Yuka Asai⁵  Reza Alizadehfar⁷  Moshe Ben-Shoshan⁶  Sabrine Cherkaoui³ 

[1] Anaphylaxis Canada, Toronto, ON, Canada;Division of Allergy and Immunology, Department of Pediatrics, British Columbia Children’s Hospital, University of British Columbia, Vancouver, BC, Canada;Division of Allergy and Clinical Immunology, Department of Medicine, University of Montreal, Montreal, QC, Canada;Allergist/Clinical Immunologist, Calgary, AB, Canada;Division of Dermatology, Department of Medicine, Queen’s University, Kingston, ON, Canada;Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, McGill University Health Centre, Montreal, QC, Canada;Division of Allergy and Clinical Immunology, Department of Pediatrics, McGill University Health Centre, Montreal, QC, Canada;Division of Clinical Epidemiology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada;Allergy/Asthma Information Association, Toronto, ON, Canada;Division of Rheumatology, Department of Medicine, University of Calgary, Calgary, AB, Canada

关键词: Treatment;    Food allergy;    Epidemiology;    Accidental exposure;    Peanut allergy;   

Others  :  1160703
DOI  :  10.1186/s13601-015-0055-x

 received in 2014-11-14, accepted in 2015-02-28,  发布年份 2015

【 摘 要 】

Background

We previously estimated that the annual rate of accidental exposure to peanut in 1411 children with peanut allergy, followed for 2227 patient-years, was 11.9% (95% CI, 10.6, 13.5). This cohort has increased to 1941 children, contributing 4589 patient-years, and we determined the annual incidence of accidental exposure, described the severity, management, location, and identified associated factors.

Findings

Children with physician-confirmed peanut allergy were recruited from Canadian allergy clinics and allergy advocacy organizations from 2004 to May 2014. Parents completed questionnaires regarding accidental exposure to peanut over the preceding year. Five hundred and sixty-seven accidental exposures occurred in 429 children over 4589 patient-years, yielding an annual incidence rate of 12.4% (95% CI, 11.4, 13.4). Of 377 accidental exposures that were moderate or severe, only 109 (28.9%) sought medical attention and of these 109, only 40 (36.7%) received epinephrine. Of the 181 moderate/severe accidental exposures treated outside a health care facility, only 11.6% received epinephrine. Thirty-seven percent of accidental exposures occurred at home. In multivariate analyses, longer disease duration, recruitment through an allergy advocacy association, and having other food allergies decreased the likelihood of accidental exposures. Age ≥ 13 years at study entry and living with a single parent increased the risk.

Conclusion

Despite increased awareness, accidental exposures continue to occur, mainly at home, and most are managed inappropriately by both health care professionals and caregivers. Consequently, more education is required on the importance of strict allergen avoidance and the need for prompt and correct management of anaphylaxis.

【 授权许可】

   
2015 Cherkaoui et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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