Perceived Versus Actual Aeroallergen Sensitization in Urban Children.

BACKGROUND: Individuals often report allergy to specific aeroallergens, but allergy testing can reveal disparate sensitization.

OBJECTIVE: To characterize the agreement between perceived and actual sensitization to individual aeroallergens in an urban pediatric population.

METHODS: 253 children were enrolled from pediatric clinics in New York, NY. Detailed questionnaires regarding perceived sensitization and serum specific IgE measurements to ten common aeroallergens were completed. Agreement between perceived and actual sensitization (sIgE ≥ 0.35 kUA /L) to individual aeroallergens was assessed by Cohen's Kappa. Multivariable logistic regression models adjusted for potential confounders were used to test for associations between perceived and actual sensitization.

RESULTS: 161 (63.6%) of the 253 children reported perceived sensitization to ≥1 aeroallergen, and 203 (80.2%) were actually sensitized to ≥1 aeroallergen. Agreement between perceived and actual aeroallergen sensitization was fair for most aeroallergens, with greatest agreement for cat dander (Kappa 0.42, 95% CI 0.32-0.53) and dust (Kappa 0.32, 95% CI 0.20-0.44). Models adjusted for potential confounders showed nearly 6-fold odds of sensitization to cat dander given perceived cat allergy (aOR 5.82, 95%CI 2.91-11.64), and over 2-fold odds of sensitization to D. pteronyssinus, D. farinae, dog dander, or grass pollen given perceived sensitization to their respective allergens. Among children with no perceived sensitization, actual sensitization ranged from 5.4% to 30.4%, and was more common for indoor vs. outdoor allergens, including cockroach.

CONCLUSION: Children who perceive allergen sensitization to cat, dog, dust or grass are likely to demonstrate actual sensitization to these individual allergens. Children with no perceived sensitization to allergens are nonetheless frequently sensitized.