effect of annual income on parental/family burden of food allergy
TRANSCRIPT
J ALLERGY CLIN IMMUNOL
FEBRUARY 2014
AB206 Abstracts
MONDAY
712 Prenatal and Postnatal Factors Associated With IgE-Mediated Wheat Allergy In Infants: A Study In AsianPopulation
Dr. Suparat Sirivimonpan, MD; Chulalongkorn University, Bangkok,
Thailand.
RATIONALE: Wheat allergy is a growing problem in Asian countries.
Factors associated the diseases from western studies may not apply to the
population because of genetic, geographical and dietary differences. Early
life circumstances may affect development of sensitization and food
allergy. We aimed to determine prenatal and postnatal factors associated
with wheat allergy.
METHODS: Using case-control design, 47 infants with IgE-mediated
wheat allergy and 188 gender and age matched controls were enrolled.
Personal histories and associated factors were analysed.
RESULTS: Ninety-two percent of wheat-allergic infants had symptoms
on first exposure, suggested the role of sensitization intrauterine or via
breast milk. Anaphylaxis occurred in 19% of subjects. Parental atopic
histories and high socioeconomic status significantly increased the risk of
wheat allergy. IgE-mediated wheat allergy was independently associated
with maternal wheat consumption during pregnancy (bread>3 pieces per
week, adjusted odds ratio, 3.7; 95% confidence interval, 1.8 to
7.5;P50.001), and breast feeding beyond 6 months (adjusted odds ratio,
2.3; 95 % confidence interval, 1.1 to 4.8;P50.03). Delayed wheat
introduction after 6 months of age had trend toward the association with
IgE positivity to wheat (adjusted odds ratio 1.8; 95 % confidence interval,
0.9 to 3.9;P50.09).
CONCLUSIONS: Several factors during prenatal and early life period
associated with the risk of IgE-mediated wheat allergy. Our findings
demonstrated that genetic predisposition and socioeconomic status
strongly increased risk of wheat allergy. Maternal consumption of wheat
during pregnancy and prolonged breast feeding were significantly
associated with the disease. Developing the strategies to prevent wheat
allergy requires consideration of all these factors.
713 Maternal Healthy Diet and Development Of Allergic DiseaseDr. Carina Venter, PhD, RD1, Ms. Harriet R. Moonesinghe2,
Prof. Hasan Arshad3,4, Prof. Taraneh Dean2,5, Mrs. Jane Grundy3,
Mrs. Gill Glasbey3, Dr. Veeresh Patil3,4; 1The David Hide Asthma and Al-
lergy Research Center, Isle of Wight, United Kingdom, 2University of
Portsmouth, School of Health Sci, Portsmouth, United Kingdom, 3The
David Hide Asthma and Allergy Centre, Newport, United Kingdom, 4Uni-
versity of Southampton, Southampton, United Kingdom, 5The David Hide
Asthma and Allergy Centre, Newport.
RATIONALE: Maternal healthy diet may play a role in the development
of allergic diseases and need further investigation.
METHODS: Pregnant women (n5 969) were recruited at 12 weeks
gestation; a FFQ was completed at 36 weeks. Reported symptoms of
allergic disease were obtained during infants first three years, and at 10
years. Children were skin prick tested to a panel of food and aero-allergens
and food challenges conducted. Healthy Eating Index (HEI) was calculated
as: multivitamin/mineral intake (2) + folic acid (1) + omega-3 fatty acids
(1) + regular white fish(1)/ fatty fish intake (2) +citrus fruit (1) + >_ 5/day
fruit and vegetables (2) 5 10
RESULTS: Maternal diets scored low on HEI: 949/969 (97.9%) scored
0-5 and 20/969 (2.1%) scored 6-10. Using this binary HEI factors, no
association with atopy (+ SPT) (3 years; p50.589 and 10 years; p5 0.519),
reported allergic diseases (3 years; p50.489 and 10 years; p50.636) and
food allergy (FA) (3 years; p50.450 and 10 years; p50.365) was seen. HEI
as continuous variable was associated with FA by 3 years (p5 0.010; OR
1.244 [95% CI: 1.055 – 1.468]) even after adjusting for maternal allergic
history and smoking, pet exposure and sibship. FA at 10 years showed no
association (p50.128, OR 0.723 [0.475 – 1.099]). Fatty fish intake was
associated with increased risk of atopy by 3 years (p50.023).
CONCLUSIONS: The role of healthy diet on development of allergic
disease need more investigation using a robust method measuring food
intake and sufficient numbers of healthy eating mothers.
714 Effect Of Annual Income On Parental/Family Burden Of FoodAllergy
Dr. David A. Petty, DO1, Jay A. Lieberman, MD2, Nhu Quynh Tran,
PhD3; 1University of Tennessee Allergy fellowship program, Memphis,
TN, 2University of Tennessee, Memphis, TN, 3University of Tennessee
Department of Preventative Medicine.
RATIONALE: Having a child with food allergies can cause a significant
burden for families. We hypothesized the effect that a child’s food allergy
would have on the family’s quality of life would be different among
different socio-economic classes.
METHODS: Parents of pediatric patients with physician-diagnosed food
allergies were recruited from both a university and a private allergy clinic.
Participants completed the Food Allergy Quality of Life-Parental Burden
(FAQL-PB) questionnaire. Background and demographic data were also
collected, family incomes were reported in quintiles (<$25,000, $25,000-
50,000, $50,000-75,000, $75,000-100,000, and >$100,000). Wilcoxon
rank sum tests were used for univariate analyses. Multiple linear regression
was used to model the relationship between exploratory variables and the
FAQL-PB scores.
RESULTS: Data from 77 respondents were analyzed. Themean age of the
food-allergic child was 6.69 years (range 1-17). 86% of respondents were
mothers. The majority of respondents were either black (46%) or white
(42%). In the univariate analysis, there was a significant difference in the
FAQL-PB scores among different family income levels (P50.01), with the
lowest scores seen in the $75,000-100,000 income quintile. This signif-
icance held in the multivariable analysis (P50.02). Factors associated with
a decreased quality of life in the univariate analysis included if the
respondent was the child’s mother (P50.03) and if the child was allergic to
milk (P50.01) or wheat (P50.04).
CONCLUSIONS: In this survey study, there was a statistically significant
variance in FAQL-PB scores among different family income levels, with
the least perceived family burden seen in families reporting income levels
between $75,000-100,000.
715 Food Allergy and Anaphylaxis Educational NeedsAssessment, Training Curriculum and Assessment OfKnowledge Of Urban Child Care Center Workers
Dr. Bruce J. Lanser, MD1, Dr. Ronina A. Covar, MD1, David Mark
Fleischer, MD, FAAAAI1, Dr. J. Andrew Bird, MD, FAAAAI2; 1National
Jewish Health, Denver, CO, 2UT Southwestern Medical Center, Dallas, TX.
RATIONALE: More than half of preschool aged children are enrolled in
child care, and nearly 10% between ages 3 and 5 have a food allergy. The
need exists for food allergy and anaphylaxis educational needs assessment
and training curriculum for child care center workers.
METHODS: An online educational needs assessment and live training
curriculum with pre and post-test were created, reviewed by experts and
piloted with a focus group of child care workers to obtain content and face
validity. A SurveyMonkey link to the needs assessment was sent to email
addresses from the state licensing agency to centers in Dallas and Tarrant
Counties. The curriculum and eighteen question test addressed the areas of
understanding labeling and the definition of food allergy, recognizing a
reaction and treatment.
RESULTS: Seventy-three workers responded to the online needs assess-
ment, with 43% having food allergy training. They identified their sources
as parents (73%), self-taught (54%), educational curricula (21%) and
conferences (19%). The majority felt they have a high or moderately high
proficiency in food allergy management. Forty-five workers participated in
the training curriculum, presented at regional child care conferences. Total
scores improved from 54% correct on pre-test to 83% on post-test,
(p<0.0001). Categorical sub-analysis reveals similar results, with statisti-
cally significant improvement in all areas.
CONCLUSIONS: Child care center workers have diverse educational
backgrounds and infrequently experience standardized training about food
allergies. There is a significant lack of knowledge regarding food allergies
and anaphylaxis. The curriculum was successful at educating workers to
more safely care for children with food allergies.