Objective: To examine changing demand for specialist food allergy services for children aged 0-5 years over the 12 years from 1995 to 2006 as an index of changing prevalence.
Design, setting and participants: Retrospective analysis of the records of 1489 children aged 0-5 years referred to a community-based specialist allergy practice in the Australian Capital Territory (population, about 0.33 million).
Main outcome measures: Trends in demand for assessment for food allergy, dietary triggers and severity over 12 years, compared with Australian hospital morbidity data.
Results: 47% (697/1489) of 0-5 year-old children seen in private practice had food allergy (175 with food-associated anaphylaxis), most commonly to peanut, egg, cows milk and cashew. Over 12 years, the number of children in this age group evaluated each year increased more than fourfold, from 55 cases in 1995 to 240 in 2006. There was no change in the proportion diagnosed with allergic rhinitis in 1995 and 2006 (14.5% and 13.3%, respectively), urticaria (14.5% and 12.9%) or atopic eczema (54.5% and 57.0%). By contrast, the proportion with asthma dropped from 33.7% in 1995 to 12.5% in 2006 and the number with food allergy increased 12-fold, from 11 to 138 patients (and from 20.0% to 57.5% of children seen) The number with food anaphylaxis increased from five to 37 children (9.0% to 15.4%) over the same period. There were similar trends in age-adjusted Australian hospital admission rates for anaphylaxis in children aged 0-4 years, which increased from 39.3 to 193.8 per million population between the financial years 1993-94 and 2004-05, a substantially greater increase than for older age groups, or for the population as a whole (36.2 to 80.3 per million population).
Conclusions: There is an urgent need for coordinated systematic studies of the epidemiology of food allergy in Australia, to ascertain risk factors and guide public health policy. An increased prevalence of food allergy has implications for public health and medical workforce planning and availability of allergy services in Australia.