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. 2018 Sep 3:14:33.
doi: 10.1186/s13223-018-0260-y. eCollection 2018.

Common allergies in urban adolescents and their relationships with asthma control and healthcare utilization

Hyekyun Rhee  1 , Tanzy Love  2 , Donald Harrington  2 , Annette Grape  1
Affiliations

Common allergies in urban adolescents and their relationships with asthma control and healthcare utilization

Hyekyun Rhee et al. Allergy Asthma Clin Immunol. .

Abstract

Background: Urban adolescents suffer a disproportionate burden of asthma morbidity, often in association with allergies. Literature is limited on comparing various types of allergies regarding prevalence and associations with asthma morbidity in urban dwelling adolescents. The purpose of this study was to examine the prevalence of common allergies reported by urban adolescents and to assess their relationships to healthcare utilization and asthma control.

Methods: Study participants included 313 urban adolescents (12-20 years of age) with persistent asthma who were recruited from three states in the United States. Self-report data were collected on nine indoor and outdoor allergies, healthcare utilization, and asthma exacerbation. Logistic regressions and zero-inflated Poisson regressions were conducted to examine the relationships between allergies and asthma morbidity.

Results: The mean age of participants was 14.58 (± 1.97) and 52% were female, and 79% were black. Seventy-three percent (n = 229) reported one or more allergies. Dust mite and grass allergies were most common, each reported by 50%. The prevalence of pest allergies (cockroach and mouse) was 27.5% and 19%, respectively. Those with pest allergies were more likely to report ED visits (cockroach- Odds Ratio (OR) = 2.16, 95% CI 1.18-3.94, p = .01; mouse- OR = 2.13, 95% CI 1.09-4.07, p = .02), specialist visits (cockroach-OR = 2.69, 95% CI 1.60-4.54, p < .001; mouse- OR = 2.06, 95% CI 1.15-3.68, p = .01) and asthma exacerbation (cockroach-OR = 2.17, 95% CI 1.26-3.74, p < .001; mouse- OR = 2.30, 95% CI 1.26-4.18, p = .01). Cockroach allergies were associated with 2.2 times as many nights in the hospital (95% CI 1.053-3.398, p = 0.036) and 2.2 times as many specialist visits (95% CI 1.489-3.110, p < 0.001), and mouse allergy was associated with 1.6 times as many ED visits (95% CI 1.092-2.257, p = 0.015) compared to those without pest allergies.

Conclusions: Concomitant occurrence of allergies is ubiquitous among urban adolescents with asthma. Only pest allergies, of those examined, appear to have implications for poorly controlled asthma, exacerbation and acute healthcare utilization. To reduce asthma burden in urban adolescents, identification and management of high-risk adolescents with pest allergen sensitization and exposure are warranted.

Keywords: Allergies; Asthma; Cockroach; Healthcare utilization; Mouse; Urban adolescents.

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Figures

Fig. 1
Fig. 1
Self-reported common allergies in inner-city adolescents
Fig. 2
Fig. 2
Healthcare utilization, exacerbation, and uncontrolled asthma associated with each type of allergy. Odds ratio (95% CIs) for dichotomous outcome measures after adjusting for age and sex. Odds ratios greater than 1 indicate an increased chance of healthcare utilization, exacerbation, or uncontrolled asthma control predicted by each allergy
Fig. 3
Fig. 3
Average number of health care utilizations by each self-reported allergy. The bars represent standard deviations. The asterisks indicate significance of the allergy in the model for counts of utilization from the ZIP model, * for p < 0.05, ** for p < 0.01, and *** for p < 0.001
See this image and copyright information in PMC

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