Association of specific allergen sensitization with socioeconomic factors and allergic disease in a population of Boston women

doi:10.1067/mai.2001.113523

Journal of Allergy and Clinical Immunology

Volume 107, Issue 4, April 2001, Pages 615-622

https://doi.org/10.1067/mai.2001.113523 Get rights and content

Abstract

Background: Socioeconomic differences in allergic disease prevalence have been reported; asthma has been associated with poverty in the United States and hay fever and eczema with relative affluence elsewhere. It is not yet established to what degree such differences in disease prevalence reflect patterns of sensitization and specific allergen sensitivities. Objective: We analyzed specific and total IgE measurements in a sample of 458 women, enriched for allergic disease, from the metropolitan Boston area to establish the relation of allergen sensitization to markers of socioeconomic status (SES) and to the prevalence and socioeconomic pattern of allergic disease in this community. Methods: Total and specific IgE antibodies were measured with the UNICAP System; self-reported allergic disease, household income, education, and race-ethnicity were ascertained with a questionnaire; and a further marker of poverty (percentage living below the poverty level) in the women’s area of residence was established on the basis of zip codes. Analysis was performed with SAS statistical software. Results: Markers of low SES were univariately associated with increases in total IgE, number of allergen sensitizations, and levels of specific IgE. Socioeconomic differences in sensitization to cockroach (35% vs 6% in the highest and lowest poverty areas), animal (44% vs 26%), and ragweed (49% vs 23%) allergens were most marked. Sensitization primarily to indoor inhalant allergens (not ragweed or ryegrass) were associated with an increased risk of asthma, even after adjustment for SES. Conclusion: We have demonstrated a socioeconomic gradient in sensitization that concords with increased rates of asthma in less affluent communities in this population. (J Allergy Clin Immunol 2001;107:615-22.)

Section snippets

Subjects

This study involves the mothers of children in the Epidemiology of Home Allergens and Asthma Study, an ongoing longitudinal birth and family cohort study, which has been described in detail elsewhere.1, 10, 18 In summary, all women met the following criteria; delivery of a child on a weekday between September 1994 and June 1996 at a hospital in Boston, Massachusetts; age of 18 years or older; ability to speak English or Spanish; and residence within Route 128 (the highway encircling the

Results

The characteristics of the 458 women for whom specific IgE levels were assessed are given in Table I.

. General characteristics of all 458 women with assessment of IgE to at least one allergen and the subset of 300 women with doctor-diagnosed allergic disease, asthma, or both

Characteristics	Whole sample		Subset with doctor-diagnosed allergic disease, asthma, or both
Characteristics	No.	%	No.	%
Age group (y)
18-30	112	24.5	84	28.0
30-33	116	25.3	70	23.3
33-36	113	24.7	76	25.3
36-46	117	25.5	70	23.3
Race
White	363	79.3	234	78.0
Black	51	11.1	34	11.3

Discussion

We previously reported that asthma was associated with low SES in this study of mothers from the greater Boston area. We have now demonstrated a socioeconomic gradient in sensitization, in which the poorest have increased total IgE levels, increased numbers of allergen sensitizations, and increased levels of specific IgE to many of the allergens to which they are sensitized. Socioeconomic differences in sensitization to cockroach, household pets, and ragweed were most marked. Cockroach and

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^☆: Supported by the National Institutes of Health grants RO1 A1/EHS35786 and A1 20565 and the UK Medical Research Council (Fellowship, S. A. Lewis).

^☆☆: Reprint requests: Sarah Lewis, PhD, Division of Respiratory Medicine, City Hospital, Hucknall Rd, Nottingham, UK, NG5 1PB.

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Original Articles: Asthma, Rhinitis, Other Respiratory DiseasesAssociation of specific allergen sensitization with socioeconomic factors and allergic disease in a population of Boston women☆,☆☆

Abstract

Section snippets

Subjects

Results

Discussion

Respir Med

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Pediatr

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

Ann Allergy Asthma Immunol

Race, socioeconomic factors, and area of residence are associated with asthma prevalence

Pediatr Pulmonol

Asthma in schoolchildren

Br J Prev Soc Med

Original Articles: Asthma, Rhinitis, Other Respiratory Diseases
Association of specific allergen sensitization with socioeconomic factors and allergic disease in a population of Boston women☆,☆☆