Association between childhood allergic disease, psychological comorbidity, and injury requiring medical attention

Ann Allergy Asthma Immunol. 2014 Jun;112(6):525-32. doi: 10.1016/j.anai.2014.03.006. Epub 2014 Apr 6.

Abstract

Background: Children with allergic disease have multiple risk factors for accidental injuries.

Objective: To determine the prevalence of injuries requiring medical treatment in US children with allergic disease.

Methods: The authors analyzed data from the 2007 to 2008 National Survey of Children's Health, including a nationally representative sample of 27,556 children 0 to 5 years old.

Results: The prevalence (95% confidence interval [CI]) of at least 1 allergic disease was 29.4% (28.0-30.8); 6.6% (5.8-7.4) were diagnosed with asthma, 15.0% (14.0-16.0) with eczema, 11.6% (10.6-12.6) with hay fever, and 6.1% (5.4-6.9) with food allergy. Children with allergic disorders had higher odds of at least 1 comorbid psychiatric and behavioral disorder (PBD; survey logistic regression; odds ratio 2.93, 95% CI 2.13-4.03), including attention-deficit/hyperactivity disorder (4.75, 2.89-7.80), depression (6.03, 1.29-28.27), anxiety (5.54, 2.70-11.37), conduct/oppositional defiant disorder (2.97, 1.88-4.70), and learning delay (2.49, 1.70-3.66), but not autism/Asperger disorder (1.89, 0.98-3.64). The prevalence of injury in the past year requiring medical attention was 10.5% (95% CI 9.5-11.4). The association between allergic disease and injury requiring medical attention was mediated in part by a PBD (Sobel test 0.0021, 95% CI 0.0014-0.0029, P < .0001; bootstrapping approach, indirect effects, odds ratio 1.005, 95% CI 1.003-1.007; Baron-Kenny β(yx,m) = 0.04, P < .0001, R(2) = 0.002). However, children with at least 1 allergic disorder (1.74, 1.23-2.46), including eczema (1.59, 1.01-2.50), asthma (1.91, 1.10-3.31), hay fever (2.05, 1.24-3.39), and food allergies (2.00, 1.10-3.67), had higher odds of sustaining injuries even after controlling for comorbid PBDs and medical disorders.

Conclusion: The results suggest that the association between allergic disease and injury is multifactorial, including being secondary to PBD.

MeSH terms

  • Accidents / statistics & numerical data
  • Anxiety / complications
  • Asthma / epidemiology
  • Asthma / etiology
  • Attention Deficit Disorder with Hyperactivity / complications
  • Child, Preschool
  • Conduct Disorder / complications
  • Conduct Disorder / epidemiology*
  • Depression / complications
  • Eczema / epidemiology
  • Eczema / etiology
  • Female
  • Food Hypersensitivity / epidemiology
  • Food Hypersensitivity / etiology
  • Humans
  • Hypersensitivity / epidemiology*
  • Hypersensitivity / etiology
  • Infant
  • Learning Disabilities / complications
  • Male
  • Prevalence
  • Rhinitis, Allergic, Seasonal / epidemiology
  • Rhinitis, Allergic, Seasonal / etiology
  • Risk Factors
  • Surveys and Questionnaires
  • Wounds and Injuries / complications
  • Wounds and Injuries / epidemiology*