Ethnicity and skin test reactivity to aeroallergens among asthmatic children in Connecticut

Objectives: To examine the relationship between ethnicity and sensitization to allergens among children with asthma living in urban and suburban areas of Connecticut. Study design: Cross-sectional study. Study population: A total of 791 children with mild-to-severe asthma who received their medical care in the city of Hartford. Results: Puerto Rican ethnicity was associated with skin test reactivity (STR) to cockroach (odds ratio [OR], 3.3; 95% confidence interval [CI], 1.7 to 6.4), STR to dust mite (OR, 1.7; 95% CI, 1.2 to 2.4), STR to mixed grass pollen (OR, 1.7; 95% CI, 1.1 to 2.7), and STR to mugwort/sage (OR, 2.4; 95% CI, 1.4 to 4.1). African-American ethnicity was associated with STR to four outdoor allergens (ie, mixed tree pollen [OR, 2.3; 95% CI, 1.3 to 3.9], mixed grass pollen [OR, 2.7; 95% CI, 1.6 to 4.8], mugwort/sage [OR, 3.1; 95% CI, 1.6 to 6.0], and ragweed [OR, 2.1; 95% CI, 1.2 to 3.8]). Among all children, STR to outdoor allergens was strongly associated with the extent of allergen sensitization. As an example, children sensitized to mixed grass pollen had 34.7 times higher odds of having at least four positive skin tests to other allergens than nonsensitized children (95% CI for OR, 15.6 to 77.0). Conclusions: Our findings suggest that Puerto Rican ethnicity is associated with an increased risk of sensitization to indoor and outdoor allergens among children with asthma, and that allergy skin testing should be performed more often as part of the management of asthma in African-American children and in Puerto Rican children in the United States.