The Associations among Food Allergy History, Food-Induced Anaphylactic Shock, and Health Outcomes

The prevalence of food allergies doubled between 1985 and 2005 and allergies to peanuts among children tripled between 1997 and 2008. Allergen labeling laws and food safety programs focus on the presence of the "Big Eight" allergenic food types: egg, dairy, fish, wheat, shellfish, tree-nuts, soy, and peanuts, even though no studies have compared different allergenic foods in terms of risk of adverse outcomes after food-induced anaphylactic shock (FIAS). Within a multivariate risk assessment framework, odds ratios were used to compare the differences in the effects of different allergenic food types on extended length of hospital stays, respiratory distress or failure, and FIAS, as well as to better understand the association between food allergy history (FAH) and FIAS. The logistic regression analysis of 2525 patient records from a 2008 hospital discharge dataset revealed a tendency for males to suffer more severe outcomes after FIAS compared to females, a finding that is contrary to current understanding of gender responses to food allergens. In addition, patients in this dataset with the highest risk of FIAS were those without a documented FAH. There were no statistically significant differences in the odds ratios of adverse outcomes after peanut-induced FIAS compared to other forms of FIAS, in part due to the small number of patients who experienced FIAS. This study was among the first to use population-based data to assess the public health impacts of different allergenic food types. Future studies should continue to use large datasets to explore these relationships. A risk-based prioritization of food allergen control strategies serves positive social change by helping to relieve the stress, anxiety, and other psychosocial effects that are experienced by people with food allergies through more accurate identification of dangerous antigens in processed foods.