Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA; Department of Pediatrics, Harbor-UCLA Medical Center and the David Geffen School of Medicine, University of California at Los Angeles, Torrance, CA, USA.
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA.
Allergol Int. 2019 Jul;68(3):316-320. doi: 10.1016/j.alit.2018.12.007. Epub 2019 Feb 5.
Anaphylaxis is a severe and potentially fatal allergic response. Early-life exposure to rural environments may help protect against allergic reaction. This study assesses urban/rural differences by age and race/ethnicity in emergency department (ED) pediatric visit rates for food-induced anaphylaxis.
This observational study examined 2009-2014 inpatient and ED data from New York and Florida, using ICD-9-CM diagnostic code (995.6) to identify food-induced anaphylaxis cases <18 y/o. Primary predictor of interest was urban/rural setting, with race/ethnicity and age also evaluated. Associations between ED visit rates and urban/rural setting were evaluated by multivariable hierarchical negative binomial regression with state and year fixed effects.
ED visit rates (per 100,000) for food-induced anaphylaxis were 12.31 and 4.60 in urban and rural settings, respectively. Rates were highest among Blacks (15.26) younger urban children (17.29) and older rural children (6.99). Compared to rural, urban children had significantly higher anaphalaxis ED visit rates (IRR 2.77).
Food-induced anaphylaxis ED visit rates were highest among younger urban children and Black children, with a notable contrast in age distribution between urban and rural rates. Higher urban rates may be attributed to Hygiene Hypothesis, though racial, economic and emergency care access disparities may also influence these outcomes.
过敏反应是一种严重且可能致命的过敏反应。儿童早期接触农村环境可能有助于预防过敏反应。本研究通过年龄和种族/民族评估了急诊室（ED）儿科就诊率因食物引起的过敏反应的城乡差异。
本观察性研究使用 ICD-9-CM 诊断代码（995.6），对 2009-2014 年纽约和佛罗里达州的住院和 ED 数据进行了检查，以确定 18 岁以下的食物诱发过敏反应病例。主要预测因素是城乡环境，同时还评估了种族/民族和年龄。通过具有州和年份固定效应的多变量分层负二项式回归评估 ED 就诊率与城乡环境之间的关联。
ED 就诊率（每 10 万人）因食物引起的过敏反应分别为城市和农村地区的 12.31 和 4.60。在黑人（15.26）、城市儿童（17.29）和农村儿童（6.99）中，发病率最高。与农村地区相比，城市儿童的过敏反应 ED 就诊率明显更高（IRR 2.77）。
在年轻的城市儿童和黑人儿童中，食物引起的过敏反应 ED 就诊率最高，城乡就诊率的年龄分布存在明显差异。城市地区较高的发病率可能归因于卫生假设，但种族、经济和紧急护理获得方面的差异也可能影响这些结果。
