Urban/rural residence effect on emergency department visits arising from food-induced anaphylaxis
Background: 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...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-07-01
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| Series: | Allergology International |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1323893019300048 |
| _version_ | 1829472911225782272 |
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| author | Rie Sakai-Bizmark Scott M.I. Friedlander Karin Oshima Eliza J. Webber Laurie A. Mena Emily H. Marr Yoshikazu Ohtsuka |
| author_facet | Rie Sakai-Bizmark Scott M.I. Friedlander Karin Oshima Eliza J. Webber Laurie A. Mena Emily H. Marr Yoshikazu Ohtsuka |
| author_sort | Rie Sakai-Bizmark |
| collection | DOAJ |
| description | Background: 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. Methods: 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. Results: 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). Conclusions: 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. Keywords: Anaphylactic reactions, Anaphylaxis, Environmental exposures, Food allergy, Immunology and allergy |
| first_indexed | 2024-12-14T02:21:07Z |
| format | Article |
| id | doaj.art-26050428bd6547f993f072f270d9c8fd |
| institution | Directory Open Access Journal |
| issn | 1323-8930 |
| language | English |
| last_indexed | 2024-12-14T02:21:07Z |
| publishDate | 2019-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Allergology International |
| spelling | doaj.art-26050428bd6547f993f072f270d9c8fd2022-12-21T23:20:29ZengElsevierAllergology International1323-89302019-07-01683316320Urban/rural residence effect on emergency department visits arising from food-induced anaphylaxisRie Sakai-Bizmark0Scott M.I. Friedlander1Karin Oshima2Eliza J. Webber3Laurie A. Mena4Emily H. Marr5Yoshikazu Ohtsuka6Los 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; Corresponding author. Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, Torrance, CA 90502, USA.Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USALos Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA; Department of Pediatrics and Adolescent Medicine, Juntendo University, School of Medicine, Tokyo, JapanLos Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USALos Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USALos Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USADepartment of Pediatrics and Adolescent Medicine, Juntendo University, School of Medicine, Tokyo, JapanBackground: 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. Methods: 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. Results: 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). Conclusions: 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. Keywords: Anaphylactic reactions, Anaphylaxis, Environmental exposures, Food allergy, Immunology and allergyhttp://www.sciencedirect.com/science/article/pii/S1323893019300048 |
| spellingShingle | Rie Sakai-Bizmark Scott M.I. Friedlander Karin Oshima Eliza J. Webber Laurie A. Mena Emily H. Marr Yoshikazu Ohtsuka Urban/rural residence effect on emergency department visits arising from food-induced anaphylaxis Allergology International |
| title | Urban/rural residence effect on emergency department visits arising from food-induced anaphylaxis |
| title_full | Urban/rural residence effect on emergency department visits arising from food-induced anaphylaxis |
| title_fullStr | Urban/rural residence effect on emergency department visits arising from food-induced anaphylaxis |
| title_full_unstemmed | Urban/rural residence effect on emergency department visits arising from food-induced anaphylaxis |
| title_short | Urban/rural residence effect on emergency department visits arising from food-induced anaphylaxis |
| title_sort | urban rural residence effect on emergency department visits arising from food induced anaphylaxis |
| url | http://www.sciencedirect.com/science/article/pii/S1323893019300048 |
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