Aeroallergen sensitivity in Hawai'i: association with asthma and increased prevalence of sensitivity to indoor allergens since 1966.

Asthma and allergic diseases have increased globally. Earlier studies suggest a history of excess asthma morbidity and mortality in Hawai'i, with high prevalence of sensitization to outdoor aeroallergens among atopic children. This study was undertaken to test the hypotheses that specific allergens are more associated with asthma, and that sensitivity to common aeroallergens has increased in Hawai'i since 1966. Adult participants were recruited between 2001-2013, according to approved protocols. Data from 211 adults who reported physician-diagnosed asthma and 404 non-asthmatic controls are included in this analysis. Skin test responses to 8 common aeroallergens were assessed, and association between specific aeroallergen response and asthma diagnosis evaluated, using Chi-squared analysis. P-values < .05 were considered statistically significant. Compared to non-asthmatic controls, asthmatic participants were older, more likely to be of Mixed and non-White race, and more likely to be obese. Allergen sensitivity (atopy) was found in 85% of asthmatic and 72% of the controls. Prevalence (%) of positive responses to specific aeroallergens in asthmatic, non-asthmatic, and all atopic subjects, were: D. farinae (74, 59, 83), D. pteronyssinus (68, 52, 75), roach (42, 31, 46), cat (45, 19, 37), dog (27, 15, 25), grasses (34, 26, 37), weeds (22, 18, 25), and molds (18, 11, 17). Adjusted for age, race, and BMI, highest prevalence ratios [PR (95% CI)] were: D. farinae [1.16 (1.1-1.2)], D. pteronyssinus [1.16 (1.1-1.3)], cat [1.34 (1.2-1.5)], and dog [1.19 (1.1-1.3)]. This data indicates a strong association with asthma, and an increased prevalence in sensitivity to indoor allergens.