Behavioral risks associated with food allergy management in an urban pediatric population

In the United States, the prevalence of food allergy (FA) amongst children and adolescents is estimated at 8%1 and 38.7% report a history of severe reactions.2 The mainstay of effective FA management includes allergen avoidance and emergency preparedness for allergic reactions.3 Despite these efforts, unexpected allergic reactions can still occur in children diagnosed with FA. Descriptive characteristics of the participants' children are presented in Table I. This predominantly minority population was highly atopic, with more than half reporting a diagnosis of asthma, atopic dermatitis, and/or allergic rhinitis. N = 100 Survey completed by Child's mother 85% Child's father 11% Other legal guardian 4% Reported household demographics Single-provider household 55% At least 1 additional child in the household 56% Additional household member with FA 49% Age, median (range) 5.3 y (2 mo to 19.8 y) Group 1: 0 mo to 5 y 48% Group 2: >5 y 52% Gender, male 59% Ethnicity Hispanic 39% Non-Hispanic 49% No response 12% Race White 20% Black 37% Asian 9% American Indian/Alaskan native 5% Other 6% Avoiding a single FA 20% Avoiding multiple FA 80% Median number of foods avoided 3 (1-10) Food allergens Tree nuts 69% Peanuts 68% Egg 51% Shellfish 41% Milk 34% Fish 33% Wheat 22% Soy 17% Other 16% Comorbid allergic disorders Asthma 57% Allergic rhinitis 58% Eczema/atopic dermatitis 78% Food allergic reactions in the past year? 17% Table II Food allergy management behaviors including reasons for noncompliance of food allergen avoidance, rates of epinephrine autoinjector (EAI) carriage, and reasons reported for not having an EAI available during the visit Reasons for noncompliance of food allergen avoidance Yes We give the allergic food to my child because I am not sure how to eliminate the allergic foods from his/her diet (N = 100) 10% We give the allergic food to my child because I get confused about what foods he/she should avoid (N = 100) 14% We give the allergic food to my child because I do not have time to check all the food ingredients (N = 100) 11% We give the allergic food to my child because it is too expensive to buy special food for my child (N = 100) 7% We give the allergic food to my child because he/she has never had a bad reaction (N = 99) 17% We give the allergic food to my child because the allergy medication will fix any problem (N = 100) 7% We give the allergic food to my child to see if he/she is still allergic (N = 100) 21% We give the allergic food to my ch