ABSTRACT
Introduction: While exposure to environmental peanut during infancy appears to promote sensitization by the epicutaneous route, early and frequent peanut ingestion during infancy may prevent peanut allergy through oral tolerance. Due to parental occupation, the offspring of peanut farmers are likely exposed to peanut protein in their environment, but they may also have early introduction into their diet due to ready access. The purpose of this study was to determine the prevalence of peanut allergy in offspring of peanut farmers. Methods: A survey was mailed by the National Peanut Board to peanut farmers in the United States collecting information on peanut consumption, peanut reactions, physician-confirmed peanut allergy (PA), epinephrine auto-injector prescription and history of other allergies in offspring. Egg allergy (EA) served as a comparator to peanut allergy. Results: Of 10,349 households surveyed, 1050 responses were received (2493 offspring, participation rate 10%). The self-reported prevalence of peanut allergy in the general population in the USA is 0.9%, 1.3%, and 0.7% for children 0 - 5 years, 6 - 10 years, and 11 - 17 years, respectively. In offspring of peanut farmers, PA vs EA was reported in 3.69% (10/271) vs 2.6% (7/271), 2.8% (14/493) vs 2.0% (10/493), and 1.48% (37/2493) vs 1.4% (35/2493) of offspring ≤10 years, offspring ≤15 years and all offspring, respectively. Physician-confirmed PA was reported in 3.3% (9/271), 2.6% (13/493), and 1.24% (31/2493) in the three groups, respectively. Physician-confirmed PA with epinephrine auto-injector prescription was reported in1.8% (5/271), 1.8% (9/493), and 0.68% (17/2493) in the three groups, respectively. Conclusions: We found that the self-reported prevalence of peanut allergy in offspring of peanut farmers was similar to that reported in the general population. This is a unique population that may provide insight into factors that influence development of peanut allergy.