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Skin test reactivity among Danish children measured 15 years apart
Simon Francis Thomsen1, Charlotte Suppli Ulrik, Celeste Porsbjerg
1Department of Internal Medicine, Bispebjerg Hospital, Copenhagen, Denmark. sft@city.dk
Insights
The prevalence of atopic sensitization in Danish children, measured by skin prick tests, decreased between 1986 and 2001. This contrasts with studies relying solely on questionnaires, highlighting the importance of objective allergy markers.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology
- Immunology
Background:
- Questionnaire surveys are the primary source for understanding childhood allergy trends.
- Objective markers of atopic sensitization are underutilized in population studies.
- Limited data exists on secular trends in objective allergy markers in children.
Purpose of the Study:
- To determine changes in skin prick test (SPT) positivity prevalence in Danish children from 1986 to 2001.
- To assess secular trends in objective measures of atopic sensitization.
- To compare findings with studies relying on subjective allergy reporting.
Main Methods:
- Serial cross-sectional population studies of Danish children aged 7–17 years.
- Two cohorts studied 15 years apart: 1986 (n=527) and 2001 (n=480).
- Skin prick testing with nine common aeroallergens performed in both cohorts.
Main Results:
- Overall SPT positivity decreased from 24.1% in 1986 to 18.9% in 2001 (p=0.05).
- Statistically significant declines in sensitization were observed for mugwort and Alternaria iridis.
- Fewer single-allergen sensitizations to D. pteronyssinus and mugwort were noted.
Conclusions:
- Atopic sensitization prevalence, assessed by SPT, either decreased or remained stable in Danish children over 15 years.
- The study did not replicate the reported increase in allergic disease prevalence from questionnaire-based studies.
- Objective markers of sensitization are crucial for accurate assessment of allergy trends.
Background:
Knowledge of secular trends in the prevalence of allergy among children stems in large part from questionnaire surveys, whereas repeated cross-sectional studies using objective markers of atopic sensitization are sparse.
Objectives:
To investigate whether the prevalence of skin prick test (SPT) positivity in Danish children has changed from 1986 to 2001.
Methods:
Serial cross-sectional studies of two different random population samples of children aged 7 to 17 years of age, living in urban Copenhagen, Denmark, were performed 15 years apart. The first cohort was investigated in 1986 (n = 527) and the second in 2001 (n = 480). Skin test reactivity to nine common aeroallergens was measured at both occasions.
Results:
The prevalence of positive SPT to at least one allergen decreased from 24.1% in 1986 to 18.9% in 2001, (p = 0.05). We found a declining prevalence of sensitization to most allergens tested, statistically significant; however, only for mugwort and Alternaria iridis. Among subjects, who were sensitized to only one allergen, we found significantly fewer individuals with reactions to D. pteronyssinus and mugwort.
Conclusions:
The prevalence of atopic sensitization as judged by SPT positivity has decreased or remained unchanged among Danish children during the 15-year period from 1986 to 2001. The increase in prevalence of allergic disease often reported in comparable studies using questionnaires as sole diagnostic criterion could not be reproduced in this study where objective markers of allergic sensitization were included in the design.
