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J Allergy Clin Immunol Pract. 2019 Mar 18. pii: S2213-2198(19)30269-7. doi: 10.1016/j.jaip.2019.02.044. [Epub ahead of print]

Food allergy in adults: substantial variation in prevalence and causative foods across Europe.

Author information

1
Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: s.a.lyons-2@umcutrecht.nl.
2
Population Health & Occupational Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom.
3
Allergy Unit, Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland; Faculty of Medicine, University of Zürich, Zürich, Switzerland; Clinic for Dermatology and Allergology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
4
Allergy Department, Hospital Clinico San Carlos, IdISSC, ARADyAL, RD16/0006/0009, Madrid, Spain.
5
Servicio de Medicina Preventiva, Epidemiology Unit, Hospital Clinico San Carlos, IdISSC, Madrid, Spain.
6
Children's Hospital, Landspitali University Hospital, Reykjavik, Iceland.
7
Medical Faculty, Vilnius University, Vilnius, Lithuania.
8
Allergy Unit, Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland.
9
Department of Allergy and Immunology, Medical University of Lodz, Lodz, Poland.
10
Clinical Centre of Allergology of the Alexandrovska Hospital, Medical University of Sofia, Sofia, Bulgaria.
11
Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.
12
Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece; Division of infection, Immunity and Respiratory Medicine, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom.
13
University Hospital Sv. Ivan Rilski, Sofia, Bulgaria.
14
Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
15
Division of Internal Medicine and Dermatology, University Medical Center Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
16
Division of Infection, Immunity and Respiratory Medicine, Manchester Institute of Biotechnology & Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom.
17
Department of Experimental Immunology and Department of Otorhinolaryngology, Amsterdam University Medical Center, Amsterdam, The Netherlands.

Abstract

BACKGROUND:

The EuroPrevall study showed that prevalence of self-reported food allergy (FA) in adults across Europe ranged from 2-37% for any food and 1-19% for 24 selected foods.

OBJECTIVE:

To determine prevalence of probable FA (symptoms plus sIgE-sensitisation) and challenge-confirmed FA in European adults, along with symptoms and causative foods.

METHODS:

In phase I of the EuroPrevall project, a screening questionnaire was sent to a random sample of the general adult population in eight European centres. Phase II consisted of an extensive questionnaire on reactions to 24 pre-selected commonly implicated foods, and measurement of sIgE. Multiple imputation was performed performed to estimate missing symptom and serology information for non-responders. In the final phase, subjects with probable FA were invited for double-blind placebo-controlled food challenge.

RESULTS:

Prevalence of probable FA in adults in Athens, Reykjavik, Utrecht, Lodz, Madrid and Zurich was respectively 0.3%, 1.4%, 2.1%, 2.8%, 3.3% and 5.6%. Oral allergy symptoms were reported most frequently (81.6%), followed by skin symptoms (38.2%) and rhino-conjunctivitis (29.5%). Hazelnut, peach and apple were the most common causative foods in Lodz, Utrecht and Zurich. Peach was also among the top three causative foods in Athens and Madrid. Shrimp and fish allergies were relatively common in Madrid and Reykjavik. Of the 55 food challenges performed, 72.8% was classified as positive.

CONCLUSION:

Food allergy shows substantial geographical variation in prevalence and causative foods across Europe. Although probable FA is less common than self-reported FA, prevalence still reaches 6% in parts of Europe.

KEYWORDS:

Europe; Food allergy; adults; causative foods; prevalence

PMID:
30898689
DOI:
10.1016/j.jaip.2019.02.044

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