Data collected on 12-74 year-old participants (N=10,854) in the second National Health and Nutrition Examination Survey (NHANES) II, 1976-80, a sample of the U.S. civilian and non-institutional population, were used to determine the association of various respiratory diseases due to allergy. Prick-puncture allergen skin testing using 8 unstandardized 1:20 w/v, FDA licensed allergens (indoor: house dust, cat, dog; outdoor: Alternaria, mixed giant/short ragweed, oak, perennial ryegrass, Bermuda grass) were performed in addition to the information on respiratory diseases and smoking. The number of positive (+) allergy skin tests was quantitated using the mean erythema diameter (mm) as: nonreactor (0), + - (0.1 - less than 10.4), 1+ positive (greater than 10.5), 2+ (2 or more positive). Nonreactors were the referent group for the odds ratio for the + -, 1+ and 2+ groups. The odds ratio for allergic rhinitis was associated with allergy skin tests regardless of sex and smoking status for all age groups, and exceeded 8 for the 2+ groups. The odds ratio for asthma was highly associated with allergy skin tests reactivity for 12- to 24-year-olds and to a lesser degree for 25- to 74-year-olds in non-smokers. Chronic rhinitis and chronic bronchitis cough were not associated with allergy skin tests. The odds ratio for allergic rhinitis was higher with allergy skin tests to outdoor compared to indoor allergens. These data demonstrate the diagnostic value of allergy skin tests in predicting allergic rhinitis and asthma in the general population. Data from NHANES III (1988-1994) using standardized extracts will determine the reproducibility of allergy skin tests and risk of allergic respiratory disease.
