Changes in Skin Allergy Testing Reactivity observed after a Hurricane. Is the Environment Responsible?

Abstract

AbsractBackground: Different patterns of skin reactivity were observed while performing intradermal dilutional allergy tests after the year 2011, the year that a severe storm (Hurricane Irene) affected the author's geographical area. Methods:In order to study these changes, consecutive patient's allergy charts were arranged in two groups: Group A (Pre-hurricane) contained test results obtained from 2005 to 2010. Group B (Posthurricane) contained test results obtained in 2012 and 2013.Results: Statistical analysis showed that there were clear differences in the test results between pre and post hurricane groups.More tests were positive and at significantly weaker dilutions in Group B. The wheal diameters (and spread) were also larger. Group B had an increased number of patients with lower respiratory symptoms and a significant increase in the number of children who tested positive for allergy. Conclusions:Allergic sensitivity, as reflected by increased skin reactivity and increased airway symptoms were significantly increased in Post-hurricane patients. The patient population in Group B appears to represent a more sensitized and potentially sicker population, suggesting that the potential role of severe climatic events should be considered as a contributing factor to allergic sensitization.

Increased Sensitization to Mold Allergens Measured by Intradermal Skin Testing following Hurricanes

“…Observation of this disparity is what motivated this study. Unlike our previous report on changes in skin reactivity following dust, epidermals, and pollen tests [ 9 ], mold tests rarely produced unusually large wheals.…”

“…Changes in skin reactivity had begun to be noted in late 2011 but appeared to be more evident each year following the hurricanes. To clarify the possible effect of this variable, we chose to eliminate all test results between the years 2011 to 2013 including only 2014 and 2015 for the posthurricane group, similar to the patient selection process used in our previous report on the effect of hurricanes on skin reactivity to dust and pollen [ 9 ]. Inclusion criteria were patients of any sex or age, with symptoms of allergic rhinitis with or without asthma, or lower respiratory symptoms (LRS) (i.e., symptoms pertaining to the lower airway but not formally diagnosed as asthma), provided that these patients were tested for the same panel of 18 molds.…”

Sublingual Immunotherapy: A Useful Tool for the Allergist in Private Practice

“…The increase appears to be greater in children and young adults (asthma affects 20%–25% of the total population but 20%–40% of childhood population) [ 62 ]. After severe storms affected the author's geographical area it was observed that the patient population consulting at the author's office for allergic conditions appeared to be younger, more sensitive, and more reactive [ 63 ]. It is likely that the same changes are happening in other areas of the US that have been flooded in the last decade.…”