Association between childhood allergic disease,psychological comorbidity,and injury requiring medical attention |
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| Affiliation: | 1. Department of Dermatology, Northwestern University, Chicago, Illinois;2. Departments of Dermatology, Preventive Medicine, and Medical Social Sciences, Northwestern University, Chicago, Illinois;1. Office of Professional Education, National Jewish Health, Denver, Colo;2. Department of Nursing, National Jewish Health, Denver, Colo;3. Department of Pediatrics, National Jewish Health, Denver, Colo;1. Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai Medical School, New York, NY, United States;2. Columbia University, College of Physicians and Surgeons, New York, NY, United States;1. Centre for Evidence-based Healthcare, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany;2. Department of Dermatology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands;3. Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, United Kingdom;4. Oregon Health & Science University, Portland, Ore;5. Department of Dermatology, Kyushu University, Fukuoka, Japan;6. University of California and Rady Children''s Hospital, San Diego, Calif;7. Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany;8. University of Alabama, Birmingham, Ala;1. Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 North Street Clair Street, Suite 1600, Chicago, IL 60611, USA;2. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA;3. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA;1. Unit of Pharmacoepidemiology and Pharmacoeconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands;2. Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;3. Medical Center Leeuwarden, Leeuwarden, The Netherlands;4. Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;5. Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts |
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| Abstract: | BackgroundChildren with allergic disease have multiple risk factors for accidental injuries.ObjectiveTo determine the prevalence of injuries requiring medical treatment in US children with allergic disease.MethodsThe 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.ResultsThe 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, R2 = 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.ConclusionThe results suggest that the association between allergic disease and injury is multifactorial, including being secondary to PBD. |
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