Percutaneous

Immediate

Hypersensitivity to

Eight Allergens

United States, 1976-80

This report describes the distribution of

immediate cutaneous hypersensitivity

reactions to eight selected unstandardized

allergens for the civilian noninstitutionalized

U.S. population ages 6-74 years. The rates

of hypersensitivity, computed from data

collected in the second National Health and

Examination Survey (NHANES 11)1976-80,

are presented by selected demographic and

socioeconomic factors.

Data From the National Health Survey

Series 11, No. 235

DHHS Publication No. (PHS) 8f3-16&5

U.S. Department of Health and Hum@

Services

Public Health Service

National Center for Health Statistics

Hyattsville, Md.

.hty 1986
All material appearing in this report is in the public domain and may be

reproduced or copied without permission; citation as to source, however, is

appreciated.

National Canter for Health statistics, P. J. Gergen and P. C. Turkeltaub:

Percutaneous immadkste hyparaansitiv~ to eight allergens, United States,

1976-60. Vita/ and Health Stafrstba. Series 11, No. 235. DHHS Pub. No. (PHS)

66-1S65. Public Health Sawioe. Washington. U.S. Government Printing Dffica,

July 1986.

Gergan, Paler J.

Percutaneous immadale hy~raansitivity to eight allergens, Unfiad States,

1976-60.

(Series 11, Data from the national health suwey; no. 235) (DHHS

publication; no, (PHS) 66-1665)

“Computed from data collected in the second National Health and Nutrition

Examination Survey (NHANES 11)1976-60.”

Authors Peter J. Gergen and Paul C. Turkeltaub.

Bibliography: p.

Supt. of Dots. no.: He20.6209;l 1/235

1. Allergy-United Stataa-SWtiics 2. Health suweye-Unitad States.

1.Turkeltaub, Paul C. Il. National Cater for Health Statistics (U.S.), Ill. Ttie.

IV. series Vil and health atatiatics. series 11, Data from the national health

survey; no. 236. V. Series: DHHS publication; no. 66-16S5. [DNLM: 1.

Allergens-united Stataa+3tatiatii. 2. Hypersensitivity, lmmedat~

occurrence-Unitad States. 3. Skin Teats-united State~atistica.

W2 A N146vk no. 235]

RA407.3.A347 no. 235 362.1 ‘0s73021 s 85-600323

[RA645.A44] [614.5’9S3]

I For sale by the Superintendent of Documents, U.S. Qo}-ernment Printing Office, Washington, D,C. 20402

I
National Center for Health Statistics

Manning Feinleib, M.D., Dr.P. H., Director

Robert A. Israel, Deputy Director

Jacob J. Feldman,’ Ph.D., Associate Director for Arudysis and

Epidemiology

Garrie J. Losee, Associate Director for Data Processing and

Services

Alvan 0. Zarate, Ph.D., Assistant Director for International

Statistics

Peter L. Hurley, Acting Associate Director for Interview and

Examination Statistics

Stephen E. Nieberdlng, Associate Director for Management

Gail F. Fisher, Ph.D., Associate Director for Program Pkmning,

Evaluation, and Coordination

Monroe G. Sirken, Ph. D., Associate Director for Research artd

Methodology

Peter L. Hurley, ~ssociate Director for Vital and Hea[th Care

Statistics

Alice Haywood, Information Oficer

Interview and Examination Statistics Program

E. Earl Bryant, Associate Director

Mary Grace Kovar, Dr. P.H., Special Assistant for Data Policy and

Analysis

Division of Health Examination Statistics

Robert S. Murphy Director

Catherine E. Woteki, Ph.D., Deputy Director

Clifford L. Johnson, Chief, Nutrition Statistics Branch

Suzanne G. Haynes, Ph.D., Chief, Medicai Statistics Branch

Kurt R. Maurer, Chiej Survey Planning and Development Branch

Wilbur Hadden, Acting Chief, Programming Stati

Cooperation of the U.S. Bureau of the Cwrsus

Under the legislation establishing the National Health Survey, the Public

Health Service is authorized to use, insofar as possible, the services cr facilities

of other Federal, State, or private agencies.

In accordanea with specifications established by the National Center for

Health Statistics, the U.S. Bureau of the Census participated in the design and

selection of the sample and carried out the initial household interview stage of

the data colieotion and certain parts of the statistical processing.
Acknowledgments

Many persons outside the National Center for Health

Statistics contributed to the design and execution of the skin

testing portion of the second National Health and

Examination Survey, 1976-80. The authors wish to express

their gratitude to those involved in this effort, especially the

following persons: Harold Baer, Phillip Norman, David

Mathison, Charles Reed, Sheldon Siegel, Joanne Tignall,

Sheldon Spector, and Albert Sheffer.
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . I

Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...3

Source and limitations ofthe data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...4

NHANESII sample design and data collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...4

Skin testing procedures and allergenic extracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Method of analysis....,,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......7

Analytic strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...7

Statistical methods .,..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...7

Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...10

Overall prevalence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......1o

Variations in reactivity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...10

Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...11

Pollination location and season . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Sex and race comparisons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...,..I4

Socioeconomic status (SEA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Residency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Geographic region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...18

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , 24

List of detailed tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...28

Appendixes

I, Statistical notes .,,.... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . ...62

11. Data quality......,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...68

111.Definition of terms . . . . . . . . . . . . . . . . . . . , . . . . . .. . , . . .. . . , . . . . . . . . . . . . 72

Listoftextfigures

l, Allergy skin test form.,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,, ...,.5

2. Size distribution for house dust at the 20-minute reading for persons ages 6-74 years: United States,

1976-80 ..,,........,., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

3. Overall skin-test reactivity by age and sex for white persons: United States, 1976-80 . . . , , . . . . . . . . 12

4. Skin-test reactivity by age and sex for black persons: United States, 1976-80 , . , . . , . . . . . . , , . . . 13

5. Age-adjusted skin-test reactivity by sex for persons ages 6-74 years: United States, 1976-80 . , . . , , . , . 16

6. Age-adjusted skin-test reactivity by race and sex: United States, 1976-80 , , , . . . . . . , . , . . , , . , , 16

Listoftexttables

A. Selected studies on prevalence of allergies....,,..,.. . . . . . . . . . . . . . . . . . . . . . . . . . 1

B, Suggested grading systems for skin tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...7

C, Percent of positive skin-test reaction for persons ages 6-74 years by allergen groups; with standard errors:

United States, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

v
D. Percent distributions and mean size of positive reaction for persons ages 6-74 years by number of positive skin

tests; with standard errors: United States, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

E. Mean size of histamine reaction for persons ages 6-74 years by number of positive skin tests; with standard

errors: United States, 197680.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F. Mean size of histamine reaction for persons ages 6-74 years by mean size of rye grass reaction; with standard

errors: United States, 1976-80, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

G. Percent of positive skin-test reactions for persons ages 6-74 years by allergen and pollen area; with standard

errors andpvalues: United States, 197&80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .,, ,,. .

H. Percent of positive skin-test reactions for persons ages 6-74 yearsby allergen, geographic region, and pollen season;

with standard errors and p values: United States, 1976-80 . , . . . . . . , . . . . . , . , . . . . . . . , . .

J. Percent of positive skin-test reactions for persons ages 6--741years by allergen, geographic region, and pollen

season; with standard errors: United States, 1976-80 . . . . . . . . . . . . . , . , . . . . . . . . , , , . . .

K. Age-adjusted prevalence rates of skin-test reactivity for persons ages 6-74 years by selected allergens, sex,,

andrace; with standard errors: United States, 1~~76--80 . . . . . . . . . . . . . . . . . . . . . . . . . . . .,

L. p values of two-sided t-tests by selected allergens, sex, and race for persons ages 6-74 years: United

States, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

M. Skin-test reactivity for persons ages 6-74 years by poverty level and selected allergens; with standard errors and

pvalues: United States, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

N. Skin-test reactivity for persons ages &74 ye,ars by family income level; with standard errors: United

States, 197&80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

0. Skin-test reactivity for persons ages 6-74 years by education level; with standard errors: United

States, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

P, Skin-test reactivity for persons ages 6-74 years by selected allergens and urban or rural residence; with standard

errors andpvalues: United States, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .,

Q. Skin-test reactivity for white persons ages 6-74 years who are above the poverty level by place of residence;

with standard errors: United States, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,., ,

R. Skin-test reactivity for persons ages 6-74 years by allergen group and geographic region; with standard errors:

United States, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S. Skin-test studies of community samples or nonallergic populations . . . , . . . . . . . . . . . . . . . . . . .

T. Skin-test studies of allergic populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11

11

14

14

15

15

17

17

17

18

18

18

19

20

Symbols

--- Data not available

.,. Category not applicable

Quantity zero

0.0 Quantity more than zerc} but less than

0.05

z Quantity more than zercl but less than

500 where numbers are rounded to

thousands

* Figure does not meet stiandard of

reliability or precision

# Figure suppressed to comply with

confidentiality requirements
Percutaneous immediate

Hypersensitivity

to Eight Allergens

by Peter J. Gergen, M.D., M.P.H., Division of Health

Examination Statistics, National Center for Health Statistics,

and Paul C. Turkeltaub, M.D., Office of Biologics Research

and Review, Food and Drug Administration

Introduction

Allergic diseases are important causes of morbidity in

the United States. The 1980-81 National Ambulatory Medical

Care Survey reported that allergic rhinitis, asthma, and contact

demlatitis or eczema were among the 15 most common diagnoses made by physicians in their patients 11–20 years of

age. In addition, injections of allergenic extracts were the

most common drug prescribed to those 11–14 years of age

and the second most common drug prescribed to those 15-20

years of age.’

Estimates of the prevalence of allergic diseases have varied

wideiy. A selection of studies that have attempted to estimate

the prevalence of allergic disease is given in table A.2-’3

The majority of the estimates since 1960 fall in the 19–34-

percent range.

Tabio A. Salaotsd studies on prevalence of allergies

Differences in data collection techniques prevent ready

comparisons among the studies listed in table A. These differences include first, the lack of uniformity as to which dkeases

were included in the allergic syndrome. All of the studies

included at a minimum asthma and various forms of rhinitis.

Certain studies included varying numbers of other allergic

diseases (such as eczema, food allergies, and urticaria) in

their definitions .2+s8>‘-” Increasing the number of allergic

diseases, however, did not necessarily yield an increase in

the reported prevalence rate. Second, there was no uniformity

in the definitions for the diseases (such as asthma and hayfever)

that make up the allergic syndrome. And third, the ages of

the subjects and geographic locations varied greatly among

studies. Further studies using uniform criteria for the diagnosis

Reported

Author Age Study prevalence

of study group Location year Size of allergy

London’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Croc,kz. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

AW.M3.. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Freeman’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Arbeite? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Beck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Hag~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Maternowski’O . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

VanArsdel’’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sherry’* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Smith’3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Broder’4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Childhood

Childhood

14years or under

14years or under

14years or under

8th grade

12th grade

5-15 years

5-13 years

16-2U years

Median 20years

Under 25 years

15-25 years

Under 20 years

20years and over

6-60 years and over

N.C.

Term.

N.Y, Corm., Montreal

Corm.

N.Y.

Colo.

lrrd.

6 U.S.cities

R.L

Mich.

Wash.

D.C.

Iowa

Mich.

1937

1954

1%1

1961

1%1

19E4

1967

1$?83

1%9

1962

1859

1966

1964

1959-60

1,500

1,225

2,169

1,737

2,130

w

1,275

1,642

1,703

1,650

434

5,818

1,729

2,666

3,096

6,995

6.6

14.0

23.7

21.6

25.4

25.3

31.0

24.1

asthma 74.4

hay fever %0.4

34.8

19.1

16.7

26.0

5.8

11.0

asthma 74.1

hay fever 86.3

1Seereference2 at end of text.

‘See reference3 at end of text

3Seereference4 at end of text.

4Sce reference5at end of text.

5Scereference6 at end of text.

%e reference7atend of text.

7RMeis indicative of asthma only,

‘Rate is indicative of hay feveronly,

‘See reference8 at end of text.

1°Sc:ereference9 at end of text.

11%e reference10at end of text.

‘Z%e reference 11at end of text,

‘3.% reference12at end of text.

14S&areference 13at end of text.
of allergic disease are needed to clarify the actual prevalence

rate.

The determination of whether a clinical syndrome may

have an allergic etiology can be studied by the use of allergy

skin tests. Introducing an allergen into the skin of an allergic

individual will result in a cutaneous inflammatory reaction

within 10 to 20 minutes. This immediate hypersensitivity is

due to the release of inflammatory mediators from tissue mast

cells and basophils that have attached to their cell surfaces

IgE antibodies specifically directed against the allergen injected. “”5 In reactive persons, the intensity of the cutaneous

reaction is dependent on the dose of allergen injected.’6

The size of the skin reaction, the dose of allergen required

to produce a given skin reaction size, and the number of

positive skin tests are associated with other laboratory and

clinical indicators of immediate hypersensitivity. Positive skin

tests are positively correlated with total serum IgE17)’8 and

specific serum IgE levels. ‘9’20Skin-test sensitivity is also

highly correlated to basophil sensitivity’9 and tissue sensitivity

(both bronchial’ ’22and nasa123)to the allergen.

Clinically, the skin test reaction has been demonstrated

to have predictive diagnostic value. Persons with a history

of an allergic syndrome occurring during allergen exposure

and skin-test reactivity at low doses to that allergen are at

a very high risk of experiencing a recurrence of the allergic

syndrome when re-exposed to the allergen.’9>24The degree

and number of positive skin tests to a battery of allergens

has been shown to be positively associated with the reported

prevalence of allergic diseases (for example, hayfever, asthma,

or atopic dermatitis) in the population. 25’26Asymptomatic

persons, who are skin-test positive, are at higher risk of developing an allergic syndrome (especially under the age of

40 years)27 compared with persons who are skin-test

negative. 28

In summary, allergy skin testing is a useful method for

evaluating the prevalence of immediate hypersensitivity. A

clearer understanding of the prevalence of immediate hypersensitivity in the U.S. population will help advance our knowledge

of alllergicdiseases.

Most studies of skin-test reactivity have been done on

select populations who presented themselves at clinics or hospitals for evaluation of allergic symptoms. In a few studies

resea~chers have attempted to evaluate groups living in defined

geographic areas. The second National Health and Nutrition

Examination Survey (NHANES II) offered the first opportunity

to study skin-test reactivity in a systematic way on a national

sample of the civilian noninstitutionalized population. Skin

testing by the prick-puncture method was performed on all

persons 6-74 years of age in NHANES II. Each participant

was skin tested against eight allergens (house dust, alternaria,

cat, dog, mixed giant and short ragweed, oak, perennial rye

grass, and Bermuda grass), a positive control (histamine phosphate), and a negative control (50 percent glycerol saline).

Positive reactions were based on a mean erythema diameter

greatm than or equal to 10.5 millimeters (mm) at the 20-minute

reading.

This report will present the results of allergy skin testing

carried out in NHANES II for the individual allergens and

overall reactivity to at least one of the eight allergens by

age, race, sex, income, education, and urbanization.

A variety of individuals can use the estimates in this

report. Epidemiologists can compare the reactivity found in

their local studies with a national sample. Researchers interested in the etiology of immediate hypersensitivity can use

the results pointing out differing levels of reactivity between

certain subgroups to plan studies on these subgroups to determine the reasons for these differences. And health services

planners can use these results to identify the groups in which

allergic conditions are likely to be the greatest problem.
The following summary highlights the findings from

prick–puncture skin testing performed on persons 6-74 years

of age in NHANES II, 1976-80.

. The prevalence rate of skin-test reactivity to at least one

of eight selected allergens was 20.2 percent for persons

ages 6-74 years in the U.S. civilian noninstitutionalized

population.

. Among the individual allergens, ragweed and rye grass

had the highest individual rates of reactivity with approximately 10percent of the population reacting to each one.

. The age-adjusted prevalence rate of skin-test reactivity

to at least one of eight selected allergens in persons ages

6-74 years was higher in men (22.2 percent) than in

women (18.4 percent).

. The age-adjusted prevalence rate of skin-test reactivity

to at least one of eight selected allergens was higher

in black persons (23.2 percent) than in white persons

●

●

●

●

●

(19.5 percent), but this difference did not reach statistical

significance.

Peak reactivity to at least one of eight selected allergens

occurred in the group 18–24 years of age. The peak

reactivities were 33.3 percent for men and 25.2 percent

for women. Reactivity rates were lower in the younger

and older age groups.

Ragweed allergen had higher rates of reactivity in highpollen areas as compared with low-pollen areas (13.3

percent versus 7.2 percent).

Skin-test reactivity was greater with higher income and

education.

Skin-test reactivity was greater in urban dwellers (22 percent) than in rural dwellers ( 16.5 percent).

Skin-test reactivity was greatest in the Northeast (25.4

percent) and lowest in the South (14.2 percent).

3
Source and limitations of

the data

NHANES II sample design and data In NHANES 11 the total sample size was 27,801; of

collection these sample persons, 25,286 (91.0 percent) were interviewed

NHANES II, conducted between February 1976 and February 1980, was a probability sample (n= 27,801) selected

to represent the U.S. civilian noninstitutionalized population

(including Alaska and Hawaii) 6 months through 74 years

of age. Certain groups of special interest were oversampled

in the survey: Children 6 months through 5 years of age,

adults 60-74 years of age, and persons living in low income

areas. 29

During the examination period, mobile examination centers were set up in 64 locations in the United States. The

examination sites were selected from 1,924 primary sampling

units (PSU’S) into which the United States was divided. Each

PSU is a standard metropolitan statistical area (SMSA), a

county, or a group of two or three contiguous counties. The

areas and persons for the survey were chosen by complex

sampling techniques, in cooperation with the U.S. Bureau

of the Census.

NHANES II consisted of two components. The household

interview component involved the collection of socioeconomic

and demographic information on the family, as well as a

medical history questionnaire for each sample person. The

U.S. Bureau of the Census performed the initial household

interviews and aided in the scheduling of appointments for

the examination component. The examination component was

performed on the sample persons in mobile examination centers

specially designed for this study. Examination teams were

specifically trained to follow the study protocols. The requirement for standardizing the environment, equipment, materiaIs,

and methods minimized unwanted variation in the data collection resulting from changes in location, techniques, and materials over the course of the survey. The standardization also

allowed the performance of the individual examiners to be

evaluated.

The examination consisted of a series of tests and procedures that included

● A general medical examination and screening by a physician, including additional medical history information.

● Body measurements.

. A dietary interview.

● Selected diagnostic tests such as electrocardiograms and

x rays.

. Laboratory tests on whole blood, serum, and urine specimens.

and 20,322 (73. 1 percent) were examined. In the skin-test

sample (6-74 years of age) there were 22,732 sample persons;

20,L!I0 (89.8 percent) were interviewed and 16,204 (71.3

percent) were examined. Overall, 95.8 percent of the examined

skin-test sample received 5 to 8 skin tests; 0.2 percent received

1 to 4 skin tests; and 3.9 percent received O skin tests. These

percents remained fairly constant when examined using

selected demographic variables (appendix I).

Skin testing procedures and

allergenic extracts

To optimize the interpretation and replicability of the

skin-test results, a number of variables must be controlled,,30’31

The following paragraphs describe the procedures used in

NHANES 11to optimize the interpretability and replicability

of the skin-test results.

The most commonly employed methods of skin testing

are the intradermal and prick–puncture tests. 32The prick test

was chosen for a variety of reasons. It is simple to petiorm

and considered safer to use than the intradermal test in terms

of poten@d for anaphylactic reaction because the prick–

puncture method introduces only 0.01 to 0.0001 of the dose

of extract used in the intradermal method. 33’34It also has

been recommended as the screening method of choice.35

‘The allergy skin test component consisted of a prick test

with eight selected, commercially available, FDA-licensed

allergens and two controls-positive and negative. Figure 1

shows the allergy skin test form.

The extracts used included indoor allergens (house dust,

cat, dog) and outdoor allergens (altemaria, mixed giant and

short ragweed, oak, perennial rye grass, Bermuda grass).

The concentration of the extracts was 1:20 weight by volume

(W/V) in 50 percent glycerol saline. The labeled value simply

describes the weight of the starting material (such as pollen

or dust) and the volume of the extracting solution used to

malw the final extract (that is, 1 gram of pollen in 20 milliliters

(mL) of extraction fluid), and is not a measure of allergenic

potency. The positive control was histamine phosphate and

the negative control was 50 percent glycerol saline.

Two batteries of allergens, identical in type but differing

in bo,th method of manufacture and manufacturer, were used

during the course of the survey as a result of a mixup in

the purchase order at the beginning of the survey. The first
Fgure 1. Alfergy ekin test form

5
allergens purchased were from a different manufacturer than

originally intended. When replacement allergens were ordered

during the survey, they were purchased from the initially

designated manufacturer.

The first extracts were 1:20 W/V in 50 percent glycerin.

The second extracts were freeze-dried and reconstituted with

50 percent glycerin to 1:20 W/V prior to use. After the completion of 38 stands with the first extracts, the type of allergenic

extracts used was switched. During the remaining 26 stands,

the second allergenic extracts were used exclusively in 4

stands. In 22 stands both the first and second extracts were

used, The dual-use stands were carried out to compare the

reactivity between the two allergen batteries. In these dual-use

stands, study persons with odd case numbers received the

first extracts; those with even case numbers received the second

allergenic extracts. This selection process is equivalent to

random assortment of the sample persons.

Ideally, allergens used for testing should be standardized,3&38 to maximize comparability between studies.

However, in 1976-80 when NHANES II was carried out,

standardized allergens were not commercially available. Differences in allergenic potency can cause rates of reactivity

to vary. With the use of two different batteries of allergens

in NHANES II, the authors were able to evaluate the potential

variability in skin-test reactivity due to differences in allergenic

potency, This analysis was carried out by comparing rates

of reactivity to the individual allergens in the dual-use stands.

The results of this analysis are fully presented in appendix

11.In brief, the sample persons receiving freeze-dried extracts

had increased rates of reactivity for house dust, oak, and

Bermuda grass as compared with those sample persons receiving the glycerinated extracts. The absolute increase in reactivity

ranged from 3.5 percent to 4.7 percent. Only for the dog

extract did the sample persons receiving the glycerinated extracts have a higher rate of reactivity (absolute increase: 2.2

percent). No differences in reactivity were found for altemaria,

cat, ragweed, and rye grass. The small observed differences

in reactivity demonstrated that variations in allergenic potency

between the two allergen batteries had relatively small effects

on the prevalence estimates of the NHANES II survey. The

differential in reaction rates does not affect the subgroup comparisons made in this report as the two types of antigen extracts

were used in a uniform manner across all examined subgroups

except region. During the evaluation of regional rates of skintest reactivity, the method of allergen manufacture was taken

into account.

Fresh vials of antigen were provided at the beginning

of each stand, All vials, opened or unopened, were discarded

at the end of each stand. When not in use, the vials were

stored at a temperature between 24 degrees centigrade. During use, the vials were maintained in a cool state by placing

them in a cold pack.

The recommended histamine-base concentration for prick

skin testing is 1 milligram per milliliter (mg/mL) .32 In the

first 48 stands, 0.1 mg/mL histamine base (0.275 mg/mL

histamine phosphate) was used as the positive control, For

the last 16 stands, 1 mg/mL histamine base (2.75 mg/mL

histamine phosphate) was used. The increase in histamine

concentration led to an increased rate of histamine reactivity.

At the lower dose, the expected biologic variability of the

response is so great as to make any comparisons meaningless.

Thus the authors did not analyze the data collected on histamine

reactivity in the first 48 stands. Interexaminer variability was

examined only in the last 16 stands, which used 1.0 mg/mL

histamine base.

The procedure for carrying out the allergy-skin testing

was as follows .39 The inside of either forearm was cleaned

with alcohol and allowed to air-dry. Two rows of five dots

each were made with a black marking pen on the forearm.

The skin over the elbow and wrist was avoided. A drop

of each allergen solution was placed next to a different dot

until all 10 components had been used. The tip of a 25-gauge

needle was held at approximately a 45-degree angle to the

skinl and was inserted simultaneously through the drop and

top layers of the epidermis. The tip of the needle was then

gently lifted as it was removed, resulting in a slight tenting

of the skin.

As soon as the first puncture was made, a timer was

set. At 10 minutes, the initial readings were taken and the

timer reset for an additional 10 minutes. During the first

reading, the length and width of the erythema and wheal

for leach antigen was measured with a millimeter ruler, The

length was defined as the largest diameter parallel to the

length of the arm. The length, therefore, did not necessarily

represent the largest diameter of the wheal or flare. The width

was the diameter perpendicular to the length. If one reaction

overlapped another, “confluence” was checked for both antigens on the record sheet. If the wheal was greater than

6 mm in length or width, the antigen solution was wiped

off. At 20 minutes, an identical set of readings was recorded.

The times of the readings were noted only if they differed

from 10 or 20 minutes. To enhance the demarcation of the

border of the erythema, the area was wiped with alcohol

and a bright light was used.

Before testing began, the study persons were asked if

they had ever had a positive skin test or a history of allergy

to cat, dog, or ragweed. If the study person gave a positive

response to either question, the dog, cat, and ragweed allergens

were not applied initially. At the 10-minute reading the physician reviewed the results of the remaining five antigens, If

less than three showed a positive reaction, then dog, cat,

and ragweed were applied to the other arm. If three or more

antigens were positive, only ragweed was applied.

The allergy skin tests were both performed and read by

a he~althtechnician. A physician was consulted only when

there was doubt as to the safety of the test administration,

or if the patient experienced an untoward reaction to the

skin test.
Method of analysis

Analytic strategies

Although two readings were taken during the exam, only

the second reading was used for analytic purposes. The criteria

employed to select between the two readings were based on

detection of the maximum amount of reactivity. The 20-minute

reading found 18–25 percent more reactivity of the wheal

and erythema, depending on the antigen, than the 10-minute

reading. All of the increases were statistically significant.

Thus, the 20-minute reading was chosen for the analysis.

The size of the wheal and erythema was determined by

taking the average of the recorded length and width to compute

the mean diameter. When only a length or width was recorded,

this dimension was used as the mean diameter.

No uniformly agreed upon criteria exist to define a positive, percutaneous hypersensitivity reaction. In the NHANES

II survey, the cutaneous response was quantified by measuring

both the wheal and erythema at 10 and 20 minutes after

allergen administration. The size distributions for the wheal

and erythema reaction at 20 minutes for house dust are shown

in figure 2. The size of the erythema reaction was larger

than the wheal reaction. The size relationship between the

wheal and erythema as demonstrated here was typical of the

relationship found with the other allergens used in this study.

The size of both the wheal and erythema can be measured

with similar precision. “4’ However, the erythema response

was chosen because of two important considerations. First,

the precision of a bioassay is dependent upon the slope of

its dose-response curve-the steeper the curve, the greater

the precision. 42 The slope of the wheal dose-response curve

is flat,’6 significantly flatter than the slope of the erythema

dose-response curve. a Second, small reactions (less than

4 mm) are difficult to measure and highly variable.43’a

Erythema reactions are usually larger than wheal reactions4s

(as was found in this study), and thus would have less of

a tendency to fall within this unreliable range (see figure 2).

Systems for grading skin-test reactivity have been

suggested for both the intradermal and prick-puncture test

methods, as shown in table B.32146NO criteria are uniformly

accepted or used. The flatter dose-response curve for the

wheal is readily apparent by the grading criteria used in both

systems. The 1+ reaction in the intradermal grading system

has been used as a lower cutoff point for skin-test positivity.32

Using this grading system, patients with 1+ to 2+ skin

reactions at high dilutions of allergens have been shown to

have high levels of specific IgE and a high correlation of

symptoms following allergen exposure. 19

TableB. Suggestedgradingsyatemafor akintests

Intradermal’ PriclF

Grade Erythema (mm) Wheal(mm) Erythema (mm) Wheal(mm)

o........ <5 <5 Absent Absent

+1- . . . . . 5-1o 5-1o (3) (3)

l+ . . . . . . 11-20 5-1o <21 Absent

2+ . . . . . . 21-30 5-1o >21 Absent

3+ . . . . . . 31-40 10-15 Present Present (no

pseudopods)

4+ . . . . . . >40 >15 Present Present

(pseudopods)

1Sss reference32at snd of text.

2Seerefersnce46 at end of text.

3Not part of the grading system.

NOTE mm = millimeter.

A conservative approach, aimed at the selection of only

the more reactive individuals, was taken in deciding upon

a grading criteria for the erythema response in NHANES

II. Because the prick test is 0.001 to 0.0001 times less sensitive

than the intraderrnal test (due to the lesser amount of allergen

introduced), the adoption of the lower limit of the intradermal

criteria for a 1+ reaction (Z 10.5 mm) for a positive prick

test in this study is a conservative cutoff point for establishing

cutaneous reactivity to allergens. In support of this choice,

others have used a 10 mm erythema reaction following a

prick test as the threshold for detecting cutaneous allergic

reactions .47 Thus, intradermal criteria for the categorization

of the erythema response were used.

For the purposes of this analysis, skin reactions were

graded according to the mean diameter of their intraderrnal

erythema criteria, as specified in table B as follows: O mm

(negative); 0.5-10.4 mm (+ or -); 10.5-20.4 mm (1 +);

20.5–30.4 mm (2+); 30.540.4 mm (3 +); 40.5-99.5 mm

(4+).

Statistical methods

The findings in this report are national estimates of skintest reactivity in the U.S. civilian noninstitutionalized population 6-74 years of age as based on weighted observations.

The weights were calculated as though the examined persons

in each of the age, sex, and income classes were a random

subsarnple of all sample persons (examined and nonexarnined)

in the same class.

Initial analyses of the data revealed a marked change

in skin-test reactivity with age. Direct age standardization

7
50

40

30

20

10

— Erylhema

---- Wheal

10 20 30 40 50 60

Mean diameter in millimeters

F~ure 2. Sie distributionfor house dust at the 20-minute reading for pereons agaa 13-74 yeare: United States, 1976-60

was used to remove potential age confounding in the intergroup

comparisons made for this report. The reference population

used for standardization was the U.S. civilian noninstitutionalized population as of March 1, 1978, the midpoint

of the NHANES II survey.

The region of the country in which the skin testing occurred

was also found to be an important confounder for ragweed.

Therefore, ragweed intergroup comparisons were adjusted for

both age and region of the country.

Observed differences in skin-test reactivity by demographic and socioeconomic variables were tested for statistical

significance. Most of the analyses presented here are based

on t-tests comparing two population subgroups for means

or prevalence of certain conditions or characteristics. The

t-test consists of dividing the difference between the two means

or prevalence by the standard error of the difference. The

standard error of a difference of estimates can be calculated

as follows. Let s be the standard error of the difference;

8

S1 (and S2 are the standard errors of the estimates xl and

X2.Then

s = sqrt (sqr (S1) + sqr (s2) -2 (cov(xl ,xz))).

All the statistical testing in this report incorporate the calculated

covariance in the estimation of the standard error of the difference. However, covariances are not given in this report because

they would take a great deal of space. Readers, therefore,

wil’1have to perform their statistical testing without the use

of the covariance term. Thus, when two groups or measures

are positively or negatively correlated, the standard error of

the difference computed without the benefit of the covariance

terms will give an overestimate or underestimate, respectively,

of the actual standard error of the difference. The use of

this standard error will affect the calculated t statistic, either

decreasing, if the calculated standard error is increased, or

increasing it, if the calculated standard error is decreased.
This in turn could cause readers to come to differing conclusions concerning the statistical significance of a comparison

if the p value is near 0.05. The standard errors given in

this report will, however, allow readers to calculate confidence

intervals around the point estimates.

The standard errors of means and proportions in this

report, not requiring age-adjustment, are calculated by a replication technique that yields overall variability through observation of variability among random subsamples of the total

sample, and which is appropriate to the complex survey design

and estimation procedure. 48 The standard errors of means

and proportions, requiring age-adjustment, were crdculated

by a two-stage method: First, SURREGR49 to calculate the

variance-covariance matrix using Taylor series linearization

and second, passing the variance-covarktnce matrix into GENCAT50’5] a program for generalized least-squares categorical

data analysis. Unless otherwise specified, tests for statistical

significance are two-sided tests and use a probability level

of 0.05 as the limit of statistical significance.

Statistical notes on the sample design, including sample

size and national population estimates, reliability of data,

and sampling and measurements are included in appendix I. Sources of variation affecting the reliability of the

skin-test data are discussed in appendix II. Demographic and

socioeconomic terms are defined in appendix IN.

9
Overall prevalence

Detailed tables 1–30 present the percent positive, the

population estimates of the number of positives in thousands,

and the distribution of reactivity by age, race, and sex for

the individual allergens. Table 31 presents the median values

for the positive reactions by race and sex. These tables are

presented as reference for readers wishing to compare their

findings with the reactivity found in the various age-sex-race

subgroups in NHANES II. Caution must be used when intm-preting the skin-test results given for black persons in the detailed

tables as many of the estimates are unstable because of small

sample size. Despite this problem, the data are presented

because no other data on skin-test reactivity in a sample of

the U.S. black population exist. The analyses performed for

this report are based on overall reactivity with age-adjustment

and adjustment for region, when appropriate. The use of overall

reactivity for all age groups combined allows stable estimates

to be made for black persons during the subgr’oup analyses

carried out in this report.

Table C presents the overall prevalence rates for positive

skin-test reactivity to the allergens used in this study. The

allergens were divided into two groups: Indoor allergens—

house dust, cat, and dog; and outdoor allergens—altemaria,

ragweed, oak, rye grass, and Bermuda grass.

Rye grass and ragweed elicited the most positive reactions

with about 10 percent of the population reacting to each

Table C. Percent of positive skin-test reaction for persons ages 6-74 years by

allergen groupq with standard errors United States, 1976-60

Allergen group Percent positive’ Standard error

Allallergensz . . . . . . . . . . . . . . . . . . ,. 20.2 0.83

lndoorallergens3 . . . . . . . . . . . . . . . . . 7.6 0.62

House dust. . . . . . . . . . . . . . . . . . . . . . 6.2 0.86

Cat . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.3 0.26

Dog . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.3 0.25

0utdoorallergens4 . . . . . . . . . . . . . . 17.7 0.74

Ryegrass . . . . . . . . . . . . . . . . . . . . . . . 10.2 0.56

Ragweed . ., . . . . . . . . . . . . . . . . . . . . 10.1 0.57

Oak . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.7 0.36

Bermuda grass . . . . . . . . . . . . . . . . . . 4.4 0.42

Alternaria . . . . . . . . . . . . . . . . . . . . . . 3.6 0.26

1Mean diameter of the erythema reaction greater than or equal to 10.5 millimeters.

2At least one allergen positive.

3At least one indoor aeroallergen positive.

4At least one outdoor aeroallergen positive.

allergen. Reactivity to house dust, oak, Bermuda grass, alternaria, cat, and dog ranged from 2.3 percent to 6.2 percent.

Outdoor aeroallergens, in general, caused a higher rate of

reactivity than indoor aeroallergens (17.7 percent versus 7.6

percent, p< O.001).

Among persons who reacted to at least one allergen from

the indoor allergen group, 84.4 percent reacted to house dust.

The addition of either cat or dog to the house dust raked the

percent positive to 92.9 percent and 93.8 percent, respectively.

Among persons who reacted to at least one allergen from

the outdoor allergen group, 59.3 percent reacted to either

ra~gweedor rye grass separately. Reaction to ragweed and/or

rye grass occurred in 88.1 percent. The addition of alternaria

increased the reaction rate to 95.5 percent. Thus, it is possible

to detect a majority of the skin-test reactors in the population

by using only a small subset of the allergens (house dust,

rye grass, and ragweed).

Variations in reactivity

Skin-test reactivity can be used to dichotomize a population into allergic and nonallergic groups. In addition, skin

tests can also be utilized to study the variations in reactivity

vAthin the allergic group. The degree of reactivity can be

ranked by the size of the reaction to allergenic skin tests

and histamine. This section will examine the variations of

re~activityin the skin-test-positive group.

Overall, 20.2 percent of the population had at least one

polsitive skin test. An examination of the percent distribution

of the number of positive skin tests revealed a rapid dropoff

in the percent reactive as the number of positive skin tests

increased (9.0 percent reacted to only one allergen whereas

0.9 percent reacted to 6-8 allergens—table D). The percent

distribution of the number of positive skin tests did not change

when dermatographism was controlled by eliminating all sample persons who reacted to the saline control.

The mean size of the positive reaction ranged from

22.6 mm for persons reacting to just one skin test to 26.6

mm for persons reacting to 6-8 skin tests. A positive relationship was found between the number of positive skin tests

and the mean size of the allergic reaction (p<0,05).

The changing size of the histamine reaction with an increasing number of positive skin test reactions is shown in

table E. The recommended histamine concentration for skin

puncture testing is 1 mg/mL. 32 only the last 16 stands of

the survey, in which a 1 mg/mL histamine base was used,

10
TableD. Pementdistributionsand mean sizeof positivemactlonforpersons

ages 6-74 Yeatsbynumberof positiveskin tests;with standarderrors:

UnitedStatea, 1976-80

Mean size

Number of Percent Standard of positive Standard

posifive skin tests’ distribution error reaction (mm) error

o. . . . . . . . . . . . . . . . 79.8 0.83 0 0

1. . . . . . . . . . . . . . . . 9.0 0.37 22.6 0.39

2................ 4.7 0.24 24.0 0.32

3................ 2.6 0.21 24.2 0.43

4................ 1.8 0.15 25.7 0.45

5................ 1.2 0.16 27.3 0.68

6-8.............. 0.9 0.13 28.6 0.58

i Meandlsmeteroftheerythemareactiongreaterthanoraqualto 10.5mm.

NOTE mm = millimeter.

TableE Mean sizeof histaminerasotionfor pereonsages 6-74 yearsby

numberof positiveskintest!%with stendstderrors UnitedStates, 1976-60

Number of Mean size of Standard

positithz skin tests’ histamine (mmF3 error

o...... ... .... ... .... . ... ... ... ... 18.1 0.70

1................................. 19.5 0.69

2................................. 20.2 0.84

3................................. 18.6 0.89

4................................. 19.1 0.82

5................................. 2!?2 0.87

6-8............................... 22.3 2.46

1Meandiameteroftheerythemareactiongraaterthanorequalto 10.5mm.

2Limltedtostandsusing1mg/mLhistaminebaseasthe positivecontrol.

3MeandlameteroftheerythemareactiongrsaterthanOmm.

NOTES mm = millimeter.

m9 = milligram.

mL = milliliter.

TableE Mean sizeof histaminetsraotlonforpersonaages 8-74 yearsbymean

sizeof ye grassteactiowwith standardemors:UnitedStatea, 1976-80

Mean size

Mean size of of histamine Standard

rye grass reaction reaction (mm)’,2 error

0-10.4mm . . . . . . . . . . . . . . . . . . . . . . . . . . 18.4 0.70

10.5 -30.4 mm . . . . . . . . . . . . . . . . . . . . . . . . 18.4 0.88

30.5-88.9 mm . . . . . . . . . . . . . . . . . . . . . . . . 20.3 0.94

1Limitedtostandsualng1mg/mLhistaminebaseas the positivecontrol.

2Meandiameteroftheerjthema reactiongraatarthanOmm.

NOTES mm = millimeter.

m9 = milligram.

mL = milliliter.

are included in analyses of histamine reactions. The previous

48 stands used a 0.1 mg/mL histamine base. At this lower

dose, the expected biological variability of the response is

so great as to make any comparisons meaningless. See appendix II for further details. The size of the histamine reaction

ranged from 18.1 mm for persons with zero-positive skin

tests to 22.3 mm for persons with 6-8 positive skin tests.

Thus, a statistically significant positive relationship was found

between the number of positive skin tests and the mean size

of the histamine reaction.

Next, the relationship between the size of the histamine

and the size of the allergic reaction was examined (table F). Rye grass was chosen because it was one of the

most reactive allergens in our study. No significant association

was observed between the size of the histamine reaction and

the size of the allergic reaction.

In summary, a statistically significant relationship existed

between the number of positive skin tests and both the size

of the positive allergic skin test and the size of the cutaneous

histamine reaction. However, there was no relation between

the size of the histamine reaction and the size of the allergen

reaction.

Reactivity to at least one allergen differed markedly with

age. Peak reactivity occurred in the 18-24 years of age group

(men—33.3 percent, women—25.2 percent). The differences

in the prevalence rate of skin-test reactivity to at least one

allergen by age, race, and sex are shown in figures 3 and

4. Figure 3 displays the percent of white persons who reacted

to at least one allergen by age and sex. Reactivity peaked

in the 18-24 years of age group for both white males and

white females. The peak reactivities were 32.0 percent for

white males and 24.3 percent for white females. F@re 4

displays the percent of black persons who reacted to at least

one allergen by age and sex. Some point estimates, especially

over age 34 years, me unstable because of small sample

sizes, but the results are presented to show in general that

changes in reactivity with age appeared to be similar in black

and white persons. Reactivity peaked in the 18-24 years of

age group for black males and in the 12-17 years of age

group for black females. The peak reactivities were 39.5

percent for black males and 32.7 percent for black females.

On closer examination of tables 1-30, it is readily apparent

that skin-test reactivity for each individual allergen differed

in a similar manner with age. Peak reactivity was in the

12–24 years of age group for all of the allergens.

11
40

35

30

25

20

15

10

5

0

Male

---- Female

I 1 I 1 I I I I [

6-11 12–17 18–24 25-34 35-44 45-54 55-64 65-74

Years of age

NOTE: A positive reaction is a mean erythema diameter of greater than or equal to 10.5 millimeters resulting from at least one skin test.

Fiiure 3. Overall skin-test reactivity by age and sex for white persons United States, 1976-60

12
Male

---- Female

40 .

35

30 H

*

25

~

,-

,~

0

Q 20

E~

3

L

15

10 \

**

5

*

o I I 1 I I 1 I 1

6-11 12-17 16-24 2%34 35-44 45-54 5.5+4 65-74

Years of age

NOTE A positwe reatition is a mean erythema diameter of greater than or equal to 105 mdlimetersresukmg from at least one skm test

Fiiure’?4. Skin-test reaotivily by age and sex for black peraorw UnitedStateaj1976-S0

Pollination location and season

Not all the allergens tested in this survey are uniformly

distributed throughout the United States. Likewise, not all

allergens are present throughout the year in their respective

geographic domains. Thus, the geographic location or season

of the year in which the skin tests were performed could

possibly affect the prevalence of reactivity to certain allergens.

Therefore, the effects of geographic location and season on

skin-test reactivity were further explored for the appropriate

allergens.

The skin-test data from three pollen allergens (giant and

short ragweed, oak, and Bermuda grass) were analyzed to

determine the effects of intensity of pollen exposure on cutaneous reactivity. These allergens were chosen because they have

different geographic distribution52’53 and pollen intensities54

in the United States.

The percent positive was compared between the high-pollen areas and the low-pollen areas for each antigen shown

in table G. Only for ragweed did regionality appear to be

important (13.3 percent in high-pollen areas versus 7.2 percent

in low-pollen areas, p<O.001 ). The prevalence rates for skintest reactivity were essentially identical between high- and

low-pollen areas for oak and Bermuda grass.

Regarding seasonality, the skin-test data from two pollen

allergens that have well-recognized pollen seasons were

examined. The allergens and their pollination seasons are

giant and short ragweed—August through October and oak—

April through June. The analyses were carried out on data

collected only within the high-pollen areas for the respective

pollens to eliminate the potential for geographic confounding

(table H). No statistically significant seasonal variation was

noted. However, for both allergens the percent reacting was

increased in the out season, with ragweed reaching marginal

significance (11.6 percent in season versus 14.3 percent out

of season, p= O.06).

13
Table G. Percent of positive skin-test reactions for pereons ages 6-74 yeara

by allergen and pollen are% with standard errore and p values

United Statea, 1976-80

Allergen and Percent Standard P

pollen area positlve”2 error value3

Giant and

short ragweed

High-pollen area

Northeast and

Midwest . . . . . . . . . . . . . . . . . . . . . . 13.3 0.66

Low-pollen area

South and West . . . . . . . . . . . . . . . . 7.2 0.93 <0.001

Oak

High-pollen area

Northeast, Midwest,

and South . . . . . . . . . . . . . . . . . . . . . 4.6 0.46

Low-pollen area

West . . . . . . . . . . . . . . . . . . . . . . . . . 5.0 0.46 0.50

Bermuda grass

High-pollen area

South . . . . . . . . . . . . . . . . . . . . . . . . 3.1 0.71

Low-pollen area

Mideast . . . . . . . . . . . . . . . . . . . . . . 3.3 0.64 0.85

1Mean diameter of the erythema reaction greaterthan or equal to 10.5millimeters.

2Age.adjusted to U.S.population, March 1,1978.

sHigh pollan araavarsus low pollan area.

Tabfe H. %mentofpositive skln.test reactions forpemonaagea 6-74yeamby

ailergen, geographic region, and poiien aeaaom with standard errore and p

values United Statea, 1976-60

Allergen,

geographic region, Percent Standard IQ

and pollen season Positive’ ‘z error values

Giant and short ragwead,

Northaast and

Midwest only

In season:

Aug.15- 0ot.15 . . . . . . . . . . . . . . 11.6 0.93

Out of season:

0tt.16- Aug.14 . . . . . . . . . . . . . . 14.3 0.90 0.06

Oak, Northeast,

Midwest, and South

In seaeon

Apr.15- June7 . . . . . . . . . . . . . . . 4.5 1.12

Out of season:

June6-Apr.14 . . . . . . . . . . . . . . . 4.6 0.51 0.90

1Mesn dlsmeter of the e~hema reaction greaterthan or equal to 10.5mllllmaters.

2Aga.adjueted to U.S.population, March 1,1978,

3In seeson varsusout of aaaaon.

These findings suggest that the change in the skin-test

reaction may come after the pollen season, To investigate

this further, the out season was divided into two parts (table J). The first part covered a period of time immediately

following and of the same duration as the pollen season;

the second part encompassed the remaining time in the out

season. It appeam that reactivity in the out season was highest

in the period immediately following the pollen season. However, none of the differences reached statistical significance.

Tabfe J. Percant of positiva akin-test reactions for persons ages 6-74 years by

afiargen, geographic region, and poiien aeaaom with standard errors

United States, 1976-60

—

Allergen,

geographic region, Percent Standard

and pollen season positive”2 error

Giant and short ragweed,

Northeast and

Midwest oniy

In season:

Aug.15- oct.15 . . . . . . . . . . . . . . . . . . . . . . . . 11.6 0.93

Out of season:

0tt.16- Jan.15 . . . . . . . . . . . . . . . . . . . . . . . . 16.4 2.60

Jan.16- Aug.14 . . . . . . . . . . . . . . . . . . . . . . . . 13.3 0.91

Oak, Northeast, Midwest,

and South only

In season:

Apr.15- June7 . . . . . . . . . . . . . . . . . . . . . . . . . 4.5 1.12

Out of eeason:

Jlune6- Sept.15 . . . . . . . . . . . . . . . . . . . . . . . . 5.5 0.68

~ept.16-Apr.14....................... 4.1 0.76

1Mean diametsrof ths srythsma reaction greaterthan or equal to 10.5mlllimetsrs.

2Age.adjusbd to U.S.population, March 1,197&

Sex and race comparisons

Differences in skin-test reactivity by sex and race were

examined and the results reported in table K. The results

of tlhe statistical testing done among the various subgroups

are reported in table L. Given the changes in reactivity with

age, the sex- and race-specific analyses were controlled for

age. When examining ragweed, one must also control for

region of the country in addition to age. The prevalence rate

of skin-test reactivity to at least one allergen was higher in

males, as compared with females (22.2 percent versus 18,4

percent, p<O.001). (See figure 5.) When the difference in

reactivity by sex was stratified by race, white males had

a higher prevalence rate than white females (21.6 percent

versus 17.5 percent, p<0,001-figure 6), but the prevalence

rate in black males and females was approximately equivalent

(23.2 percent versus 23,3 percent—figure 6). Examining individual allergens for all races, data showed that males had

higher rates of reactivity than females for house dust, alternaria,, ragweed, oak, rye grass, and Bermuda grass. The absolute increases ranged from 0.7 percent to 3.3 percent. Among

white persons, males had higher rates of reactivity than femlales

for house dust, ragweed, oak, rye grass, and Bermuda grass.

The i~bdute increases ranged from 1 percent to 3.5 percent,

p< O.05. Among black persons, females had a higher rate

of reactivity than males for dog allergen (absolute increase=’ 1.8

percent; p= Oo04).

Differences in skin-test reactivity by race were examined.

The prevalence rate of reactivity to at least one allergen was

higher in black persons as compared with white persons for

both sexes combined, but the difference was not statistically

significant (23. 2 percent versus 19.5 percent). Looking at

the individual allergens by sex, data showed that black females

had a higher rate of reactivity as compared with white<females

(23.3 percent versus 17.5 percent, p= 0.03). Among males,

the rate of reactivity was higher in black persons as compared

14
TableK. Age-adjustedprevalenceratesof skin-testreactivityforpersonsages 6-74 yearaby seleded allergens,sex,and ractywith standarderrors

UnitedStates,1976-60

Both sexes Male Female

Race and Percent Standard Percent Standard Percent Standard

selected allergen positive”2 error positive’,2 error positive’,2 error

All races3

Allallergens4 . . . . . . . . . . . . . . . . . . . . . 20.2 0.83 222 1.06 18.4 0.87

House dust . . . . . . . . . . . . . . . . . . . . . . 6.2 0.62 8.8 0.81 5.6

Alternaria . . . . . . . . . . . . . . . . . . . . . . . .

0.64

3.6 0.26 4.1 0.36 3.2

Cat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.3

0.92

0.26 2.2 0.30 2.5 0.27

Dog . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.3 0.25 2.3 0.30

Ragweed5

2.3 0.25

. . . . . . . . . . . . . . . . . . . . . . . 10.1 0.57 11.6 0.70 8.7

Oak . . . . . . . . . . . . . . . . . . . . . . . . . . . .

0.56

4.7 0S6 5.4 0.44 4,1 0.36

Ryegrass, . . . . . . . . . . . . . . . . . . . . . . . 10.2 0.56 11.9 0.68 8.6

Bermuda grass . . . . . . . . . . . . . . . . . . . 4.4

0.62

0.42 4.8 0.47 4.1 0.45

White

Allallergens’ . . . . . . . . . . . . . . . . . . . . .

HOUSedust . . . . . . . . . . . . . . . . . . . . . .

Altemaria. . . . . . . . . . . . . . . . . . . . . . . .

Cat . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dog . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ragweed. . . . . . . . . . . . . . . . . . . . . . .

Oak, . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ryegrass . . . . . . . . . . . . . . . . . . . . . . . .

Berrnudagrass, . . . . . . . . . . . . . . . . . .

Black

Allallergens’ . . . . . . . . . . . . . . . . . . . . .

House dust . . . . . . . . . . . . . . . . . . . . . .

Altemaria . . . . . . . . . . . . . . . . . . . . . . . .

Cat,.. . . . . . . . . . . . . . . . . . . . . . . . . . .

Dog . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ragweed. . . . . . . . . . . . . . . . . . . . . . .

Oak . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ryegrass . . . . . . . . . . . . . . . . . . . . . . . .

Bermuda grass, . . . . . . . . . . . . . . . . . .

19.5

5.9

3.6

2.3

2.2

9.6

4.5

10.0

4.3

23.2

7.0

3.6

2.3

2.7

13.0

5.5

10.4

4.8

0.60

0.56

0.27

0.27

0.24

0.51

0.33

0.54

0.44

2.52

1.76

0.46

0.50

0.78

2.17

1.14

1.39

0.62

21.6

6.5

3.9

2.1

2.3

11.4

5.3

11.7

4.8

23.2

7.6

4.3

2.1

1.7

12.5

5.5

11.5

4.1

1.01

0.65

0.41

0.31

0.29

0.64

0.43

0.67

0.50

3.10

2.34

0.95

0.72

0.60

2.56

1.46

1.73

1.04

17.5

5.4

3.2

2.4

2.0

7.9

3.8

8.3

3.8

23.3

6.5

29

27

3.5

13.5

5.5

9.5

5.5

0.79

0.62

0.32

0.28

0.22

0.4s

0.35

0.57

0.44

2.84

1.50

0.64

0.56

0.94

2.23

1.25

1.62

1.06

1Ag&sdjusted to U.S.population, March 1,1978.

2Me.andiameter of the erythema reaction greaterthan or equal to 10.5millimeters.

slnclu~s data for racesnot shcwn Separately.

‘Rea:tion to at least one of the allergens.

5Aga and region adjustd.

TableL p valuesof twmsldedt.tests byselectedallergens,$e& and race forpereonsages6-74 yearx UnftedStater&1976-60

Male versus female White versus black persons

Allergen All races’ White Black Both sexes Male Female

Allallergens2 . . . . . . . . . . . . . . . . . . . < O.fx)l <0.031 0.99 0.14 0.58 0.03

House dust, . . . . . . . . . . . . . . . . . . . .

Alternaria . . . . . . . . . . . . . . . . . . . . . .

Cat . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dog... . . . . . . . . . . . . . . . . . . . . . . . .

Ragweed . . . . . . . . . . . . . . . . . . . . . .

Oak. . . . . . . . . . . . . . . . . . . . . . . . . . .

Ryegrass . . . . . . . . . . . . . . . . . . . . . .

Bermuda grass. . . . . . . . . . . . . . . . . .

0.04

0.05

0<15

0.85

< O.CQ1

0.093

O.CQ1

0.05

0.16

0.42

0.25

<0.001

0.001

<0.001

0.009

0.46

0.32

0.43

0.04

0.56

0.96

O.f?a

0.28

0.51

0.92

0.92

0.50

0.10

0.40

0.77

0.53

o.5a

0.70

0.68

0.46

0.63

0.86

O.ea

0.47

0.47

0,63

0.66

0.15

o.cFxl

0.21

0.49

0.15

1Includas data for races not shown separately.

2Re,actionto at least one oftheaUer9ens.

15
25

r

20

5

0

Female Male Both sexes

NOTE A positive reaction is a mean erythema diameter of greater than or equal to

10.5 millimeters reau!ting from at least one skin test,

Fwra 5. Age-adjusted skin-teat reactivity by sex for persons ages 6-74

yesm United States, 1976-60

with white persons, but it did not reach statistical significance

(23.2 percent versus 21.6 percent, p= O.52). Data for the

individual allergens showed that black persons had a tendency

to have higher rates of reactivity than white persons, but

none of the differences reached statistical significance except

for black females as compared with white females for ragweed

(13.5 percent versus 7.9 percent).

Socioeconomic ststus (SES)

The age-adjusted differences in skin-test reactivity between people living below poverty level and those living

at or above poverty level are shown in table M. Overall

reactivity was greater in persons living at or above the poverty

level (21.0 percent versus 15.8 percent, p< O.001). Data for

the individual allergens revealed that higher rates of reactivity

existed for people living at or above the poverty level for

altamaria, ragweed, oak, rye grass, and Bermuda grass. The

absolute increases ranged from 1.3 percent to 3.7 percent.

The relationship between poverty and skin-test reactivity

was further investigated by examining a more detailed income

distribution and the effects of education. The prevalence rate

for reactivity to at least one allergen increased from 15.3

percent with $0-5,999 income to 24.7 percent with $20,000

or more (table N). Controlling for age, there is a statistically

significant positive relationship between reactivity and income.

Female Male Both sexes Female Male Both sexes

White persons Black persons

NOTE: A positive reaction is a mean erythema diameter of greater than or equal to 105 millimeters resulting f mm at least one skin test

F~ure 6. Age-adjusted sldn-test reactivity by race and sex: United States, 197H0

16
Table M. Skin-test reactivity for persons ages 6-74 yeara by poverty level and selected allergenq with standard errore and p values United States, 1976-60

Below poverty level At or above poverty level

Percent Standard Percent Standard

A//ergen

P

positive’,2 error positive’,z error value

Allallergens3 . . . . . . . . . . . . . . . . . . . . . . . .

House dust . . . . . . . . . . . . . . . . . . . . . . . . .

Alternana. . . . . . . . . . . . . . . . . . . . . . . . . . .

Cat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dog . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ragweed. . . . . . . . . . . . . . . . . . . . . . . . . .

Oak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ryegrass . . . . . . . . . . . . . . . . . . . . . . . . . . .

Bermuda grass . . . . . . . . . . . . . . . . . . . . . .

15.8

5.3

1.9

1.8

2.5

7.2

3.6

7.1

2.8

1.51

0.95

0.35

0.44

0.5S

0.95

0.61

0.72

0.43

21.0

6.3

4.0

2.4

2.3

10.6

4.9

10.8

4.8

0.85

0.65

0.30

0.26

0.25

0.59

0.37

0.63

0.49

<0.001

0.12

<0.001

0.18

0.82

<0.001

0.04

< O.(XI1

0.032

1Ag&adjusted to U.S.population, March 1,197S.

2Mean dismeter of the erythema reaction greaterthan or equal to 10,5millimeters.

3Reaction to at least one of the allergens.

4Ageand region adjusted.

Table N, Skin-test raasth’ity for persons ages 6-74 yeare by family income

lev~ wiftr standard errors United States, 1976-S0

Family Percent Standard

income level positive”2 error

$0-$5,%39 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.3 1.36

$6,000 -$9,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.9 1.14

$10,030 -$19,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.6 0.97

$20,0000rmore . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.7 0.97

lAge-sd@sted to U.S.population, March 1, 197S.

‘Mean diamster of the erythema reaction greaterthan or equal to 10.5millimeters to at least

one allergen.

Table O. Skin-fest mactivityforpersons ages6-74yeare byeducationlava~

with standard errors United States, 1976-60

Percent Standard

Education level’ positive2,s error

0-8years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.0 1.33

9-12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.9 0.66

13yeara orrrwre . . . . . . . . . . . . . . . . . . . . . . . . . . 25.5 1.07

1Number of years attended by head of household for sample persons 19yearaof age and

under.Numberof years attended by sample personsXI yearaof age or over.

2Age-adjustedto the U.S.population, March 1,1976.

3Mean diameter of the erythema reaction greaterthan or equal to 10,5millimeters to at least

one allergen,

Next, the effects of education on overall skin-test reactivity

were examined (table O). Education level was defined in

one of two ways depending on the age of the sample person.

If the sample person was under 20 years of age, the education

level of the head of the household was used. If the sample

person was 20 years of age or over, the individual’s education

level was used. The prevalence rate for reactivity to at least

, one allergen increased with increasing education level (13.0

percent with O-8 years of education to 25.5 percent with

at least some college). Controlling for age, there is a statistically significant positive relationship between reactivity and

educational level. The effects of income and education remained constant in males and females.

Residency

Urban or rural differences in skin-test reactivity are

explored in table P. Higher rates of reactivity were noted

in urban areas for all allergens. Overall reactivity was greater

in the urban areas versus the rural areas (22.0 percent versus

16.5 percent, p<O.001 ). For the individual allergens, higher

rates of reactivity occurred in urban dwellers for altemaria,

cat, dog, ragweed, oak, and rye grass. The absolute increases

ranged from 0.7 percent to 3.2 percent.

The increase in reactivity in urban areas was investigated

further by subdividing residency into four parts: standard metropolitan statistical area (SMSAjcentral city, SMSA–not central city, not SMSA–not rural, and not SMSA–rural (table Q). To control for race and income effeets, this analysis

was limited to white persons above the poverty level. Reactivity remained higher in the SMSA (21.1 percent and 23.5

percent) than outside SMSA areas (17.6 percent and 15.6

percent). The difference between areas in the central city

and not in the central city within SMSA was not statistically

significant. However, results suggest that the higher rates

of reactivity in urban areas appear to lie outside of the central

city.

17
Table P. Skin-test reactivity for pereons ages 6-74 yeare by selected allergens and urban or rural residence; with standard emors and pvafue~ United States, 1976-80

Urban Rural —

Percent Standard Percent Standard P

Se/ected a//ergen pOsitive’,2 error positive’,2 error value

Allallergens3.. . . . . . . . . . . . . . . . . . . . . .

House dust . . . . . . . . . . . . . . . . . . . . . .

Alternaria .,..,.....,..,..,..,.. . . .

Cat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dog . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ragweed . . . . . . . . . . . . . . . . . . . . . . . . .

Oak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ryegraaa . . . . . . . . . . . . . . . . . . . . . . . . .

Bermuda grass, . . . . . . . . . . . . . . . . . . .

22,0

6.5

4.1

2.5

2.6

10.6

5.1

11.2

4.7

1.08

0.84

0.31

0.3.2

0.33

().7!3

0.46

0.74

0.5’1

16.5

5.4

2.5

1.8

1.6

8.5

3.9

8.0

3.9

1.12

0.73

0.35

0.29

0.26

0.72

0.42

0.65

0.49

<0.001

0.27

< O.OQ1

0.05

0.01

0.02

0.05

<0.001

0.16

1Age-adjusted to U.S.population, March 1,1978.

2Meandiameter of the erythema reaction greaterthan or equal to 10.5millimeters.

3Reaction to at least one of the ellergens.

4Ageand region adjusted.

Table Q. Skin-test reactivity for white pereons agea 6-74 years who are

abova the poverty Iaval by place of residencq with standard errors

United Statee, 1976-80

P/aca of Percent Standard

residence posithfe”2 error

SMSA

Central ity . . . . . . . . . . . . . . . . . . . . 21,1 1.74

Noncentral city..........,,..,.. 23.5 1.16

Not SMSA

Nonrural . . . . . . . . . . . . . . . . . . . . . . 17,6 1.46

Rural . . . . . . . . . . . . . . . . . . . . . . . . . 15.6 1.43

IAgeadjuated to US. population, March 1,1976.

2Mean diameter of the erythema reaction greaterthan or equal to 10.5millimeters.

NOTE SMSA = Standard metropolitan atatlatical area.

Geographic region

Reactivity to at least one allergen by geographic region

of the country is examined in table R. The Northeast was

consistently the highest area of reactivity (25,4 percent); the

South was the lowest (14.2 percent); and the Midwest (20.6

percent) and West (20.6 percent) were in an intermediate

position. The rates of overall reactivity by region were rerun

excluding ragweed. This approach was used to determine

if the difference seen could be explained by the geographic

distribution of ragweed—an important factor in ragweed’s

reactivity. The removal of ragweed had little effect on the

results other than that of lowering the rate of reactivity. The

geographic ranking of reactivity remained unchanged if only

the indoor allergens (house dust, cat, and dog) or only the

outdoor allergens (alterrtaria, ragweed, oak, rye grass, and

Bermuda grass) were examined. It was previously noted that

for four allergens (house dust, dog, oak, and Bermuda grass)

Table R. Skin-test reactivity for pereons agee 6-74 years by allergen group and

gmgraphic region; with stsndard errore: United Ststee, 1976-60

Allergen group Percent Standard

and geographic region positive”2 error

—

All allergens

Northeast. . . . . . . . . . . . . . . . . . . . . 25.4 1.47

Midwest . . . . . . . . . . . . . . . . . . . . . . 20.6 1.87

west . . . . . . . . . . . . . . . . . . . . . . . . . 20.6 1.10

South . . . . . . . . . . . . . . . . . . . . . . . . 14.2 2.40

Indoor allergens3

Northeast . . . . . . . . . . . . . . . . . . . . . 10.1 1.47

Midwest . . . . . . . . . . . . . . . . . . . . . . 8.1 1.21

Wee. . . . . . . . . . . . . . . . . . . . . . . . . 6.5 0.90

South . . . . . . . . . . . . . . . . . . . . . . . . 6.0 1.65

0utdoorallergens4

Northeast . . . . . . . . . . . . . . . . . . . . . 22.2 1.32

Midwest . . . . . . . . . . . . . . . . . . . . . . 17.4 1.47

West . . . . . . . . . . . . . . . . . . . . . . . . . 18.7 1.26

SOIJth . . . . . . . . . . . . . . . . . . . . . . . . 12.1 2.06

1Age-adjusted to the U.S.population, March 1,1978.

2Mf>andiameter of the arythema reaction greaterthan or equal to 10.5millimeters to at least

one allergen.

3Hc,usedust, cat, dog,

4Alternarla, ragweed,oak, ryegrasa,Bermuda graaa.

there was a difference in reactivity between the two types

of allergens (based on manufacture) used in this study. Also,

the use of the allergens was not uniform in all four regions

(see appendix II for more detail). To examine the possibility

that the interregional differences were due all or in part to

differential allergen use, the four allergens in which there

was a difference in reactivity were excluded and the regional

analyses were rerun. The regional differences remained the

same.

18
Discussion

The overall prevalence of skin reactivity to one or more

of the eight allergens in this study is 20.2 percent. This

is a conservative estimate of the prevalence of immediate

hypersensitivity for a number of reasons. A conservative cutoff

point was used to define a positive reaction. Also, approximately 11.3 percent of the eligible sample persons in NHANES

II did not receive alI eight allergen skin tests and histamine

for a variety of reasons, such as a past history of allergies,

a history of pmwious allergy shots, use of allergy medication,

and patient retkd. These nontested individuals reported a

higher rate of asthma, hayfever, and other allergies than the

skin-tested individuals (table V). Thus, it is likely that the

exclusion of these individuals from our survey &creased the

rates of reactivity found. The loss of the nontested individuals

did not introduce any significant amount of bias when making

subgroup analyses as it was spread fairly evenly over all

age, race, sex, urban or rural, and poverty level groups.

Prevalence rates for reactivity reported in the literature

can be divided into two groups according to whether the

Tdrlr)S. Skin-tsststdlssof ~fW-@ss cfrfmnde@c popdstbm3

population studied was or was not allergic. Studies completed

on a wide variety of populations consisting of either random

samples of communities or nonallergic persons are summarized

in table S.8’5- A wide range of prevalence rates of skin-test

reactivity has been reported (5 percent to 64 percent). Studies

conducted on allergic populations are summarized in table T.8’26’57’59$W’62’65 The range of prevalence estimates is

similar (27. 1 percent to 87 percent), but the estimated rates

of reactivity are higher. In both allergic and nonallergic populations, the rates of reactivity reported in international studies

are higher than those reported in domestic studies. This increase in reported reactivity maybe due to a variety of reasons,

such as differences in allergens used, varying criteria for

positivity, or true differences in reactivity. Our overall prevalence rate of 20.2 percent is approximately equal to the approximate mean value found in table S for domestic studies on

nonallergic populations.

The reactivity of the U.S. population to the allergenic

extracts tested was highest to pollens-16.5 percent, followed

Author Years Number of Typeof percent

of study Location Subjects of age extracts test positive

Domestic studies

Currant’ . . . . . . . . . . . . . . . . . . Ikston 100 nonallergic 16-80 +

Hag# . . . . . . . . . . . . . . . . . . . .

9 scratch 5.0

Providence 765 nonallergic 16-20

Lindblad3. . . . . . . . . . . . . . . . . .

15 scratch 17.4

Pittsburgh 100 nonallergic 16-81

Freidhofi . . . . . . . . . . . . . . . . .

5 intradermal 424.0

Saltlmom 115 random subjects la-55 7 prick 24.3

from industrial plant

Barbee6. . . . . . . . . . . . . . . . . . . Tucson 3102 community sample 3-75 + 5 prick 34.0

international studies

Bandele’ . . . . . . . . . . . . . . . . . . Nigeria lCOnonallergic

Tana

10-60 22 not stated 10.0

. . . . . . . . . . . . . . . . . . . . . . Singapore 50 nonallergic 10-73

Haahtelag . . . . . . . . . . . . . . . . .

21 prick 12.0

Finland 70Ssample of 15-17 16 prick 49.0

9th gradera

Herxheimer’” . . . . . . . . . . . . . . London 100 nonallergic 5-75

Haahtela’’ . . . . . . . . . . . . . . . . .

12

Finland

prick 50.0

295 nonallergic 18-19 16 prick 50.0

army conscripts

Cserhati’z . . . . . . . . . . . . . . . . . Hungary 300 nonallergic 2-16 20 prick 64.0

1seereference56atandof text.

‘see reference 8 at end of text.

3% reference 56 at end of text.

4Results from 1:10 concentration.

5Sea mfemrme 57 at end of text.

‘% rafemnoe 58 at end of text.

7Sss raference E4 at and of text.

%x3 mfemince EOat end of text.

‘sea mfemnca 61 at end of text.

‘OSs-s reference 62 at and of text.

‘‘ 8ss reference &3 at end of text.

‘2S-9s mfemnce 64 at end of text,

19
by house dust-6.2 percent, animal allergens—3. 8 percent, and mold—3. 6 percent. Other studies have reported differing percents of reactors and/or different orders of

relative reactivity to some of the allergens testecl in

NHANES 11.56’58’6’‘G346However, comparison of skin-test

results between different studies must take into account the

number and type of allergenic extracts used for testing, the

method of test administration, the criteria for test positivity,

the demographic and atopic characteristics of the populations

tested, and the locales in which the testing was carried out.

The potency and composition of the allergenic extracts

used to detect immediate hypersensitivity are critical determinants of the presence and degree of cutaneous reactivity to

those extracts in allergic persons. 67–73In the estimate of prevalence in NHANES 11the effect resulting from the putative

differences in allergenic potency and composition was determined by testing two batteries of allergens, manufactured

by two different methods and obtained from different manufacturers (see appendix II). In the dual-use stands, where the

two batteries of allergen extracts were applied by the same

examiners to subsamples in the same locale, the absolute

differences in estimated reactivity did not exceed 5 percent

(table XII). The small observed differences in reactivity demonstrated that variations in potency between the two allergen

batteries had relatively small effects on the prevalence estimates of the NHANES II study. Until standardized extracts

are employed for large scale screening by standardized

methods, the NHANES II prevalence estimates reflect the

largest experience in estimating immediate cutaneous hypersensitivity in U.S. population; and these estimates have been

shown to be relatively robust, in spite of differences

in manufacture of the allergenic extracts used. The marlced

discrepancies between the prevalence estimates in NHANES

II and many of the studies reported in table S thus may

be attributable more to differences in skin-test technique and

criteria for skin-test positivity rather than to differences in

potency of the allergens used.

A positive relationship was found between the number

of positive skin tests and the size of the histamine reaction.

However, no significant association was found between allergic-reaction size and histamine-reaction size. This suggests

that multiple positive allergy skin tests are required to influence

histamine-reaction size. In prior studies,58>74researchers observed no association between histamine and allergen reactivity, suggesting that before acceptance of a causal association

between histamine and allergen skin reactivity, local skin

interactions due to proximity and intensity of positive allergen

and histamine skin reactions75’76 will need to be explored

further.

The total number of positive skin tests appears to be

associated with the degree of immune responsiveness, because

a positive relationship was found between the number of positive skin tests and the intensity of the allergic response. Allergic

persons with multiple positive allergen skin tests and/or larger

skin reactions tend to have higher total and specific IgE

levels. .23This suggests that the association of allergen reaction

size and multiple allergen reactivity may indicate immunological hyperresponsivity, as indicated by IgE, in this subset of

the population. In contrast, no significant association exists

between histamine skin-reaction size and total IgE in skin-test

positive allergic patients .23

The use of positive and negative control skin-test solutions

demonstrated that cutaneous reactivity was specifically related

to the allergen, because the response to the diluent was uniformly less than 2 percent except for one examiner who reported 2.2 percent reactivity (table VI). Similarly, the prevalence rate of 91 percent of cutaneous reactivity to 1.0 mg/mL

histamine base demonstrated cutaneous responsiveness to one

inflammatogr mediator of the immediate hypersensitivity reaction (histamine) in most patients, indicating end-organ

Table T. Skin-test studies of allergic populations

Author Years Number of Type of Percent

of study Location Subjects of age extracts test positive

Domestic studies

Freidhoff’ . . . . . . . . . . . . . . . . . Baltimore 262 reporting allergies 18-55 7 prick 55.0

Hagyz . . . . . . . . . . . . . . . . . . . . Providence 478 reporting allergies 18-20 15 scratch 363.9

%26.7

International studies

Bandele5 . . . . . . . . . . . . . . . . . Nigeria 221 asthmatics 10-60 22 not stated 57.0

TanG . . . . . . . . . . . . . . . . . . . . . Singapore 138 asthmatics 10-73 21 prick 69.0

Hendrick . . . . . . . . . . . . . . . . . London 656 asthmatics < 10-30+ 22 prick a4.o

Haahtelaa . . . . . . . . . . . . . . . . . Finland 292 reporfing allergies 15-17 16 prick ‘87.0

%3.o

“69.0

Herxheimer’z . . . . . . . . . . . . . . London 300 with respiratory allergies 5-75 12 prick 95.0

1See reference 57 at end of text.

‘See reference Sat end of text.

3Asthma, hayfever, and/or nonseasonal allergic rhinitis.

40ther allergies.

5See reference 59 at end of text.

6See reference S0 st end of text.

7See reference 65 st end of text.

8See reference 26 at end of text.

‘Aathmatica.

10Allergic rhinitls.

11Atopic dermatitis.

12Sse rsfersnce 62 at end of text.

20
responsiveness to this mediator. The optimal concentration

of histamine base to be used as a positive control for prick

testing is still in question42 and differs between the United

States32and Europe. 77In this regmd, NHANES II data relevant

to the size of the cutaneous reaction to 1.0 mg/mL histamine

base, as reported in table XI, can serve as reference values

for histamine skin testing.

Because development of immediate hypersensitivity follows allergen exposure, the prevalence of immediate hypersensitivity to selected pollen allergens was evaluated with respect

to the geographic distribution of the appropriate plants .53 In

all instances, the regions of “dense” and “sparse” pollen exposure are relative, because the plants were not entirely absent

in any region. ‘4 Only ragweed had increased reactivity in

areas reported to have high plant density.

Despite the reported differences in the geographic distribution and density of oak trees and Bermuda grass, no differences

in the prevalence of skin reactivity to oak and Bermu& grass

pollens wem found in these regions. This lack of geographic

variation in cutaneous reactivity parallels the airborne pollen

data for grasses and oak. Similar peak levels of airborne

grass and oak pollen have been found in regions with high

and low densities of these plants.w However, a caution in

interpreting pollen counts needs to be stres~d. Grass pollen

counts reflect all grasses—not just Bermuda grass, and oak

pollen counts include data on all species of oak. Thus, regional

differences among the species of these plants will be obscured

by the pollen counts. In addition, Bermuda grass cross-reacts

to some degree with other grasses. Thus, Bermuda grass may

contain sufficient allergenic components that cross-react with

other grasses78to obscure regional differences in the prevalence

of Bermuda grass specific allergens. There is lithe previous

study of regional differences in skin-test reactivity to a specific

plant among areas with high- and low-pollen densities. Investigators in Sweden have found small differences in skin reactivity to selected tree allergens concordant with the density of

the respective tree pollen sources.79

The effect of seasonality on prevalence of skin reactivity

was examined because boosts in allergen-specific IgE and

skin reactivity have been noted in allergic patients following

natural exposure to the allergen. “81 Oak and ragweed, which

have relatively well-defined seasons,54 were selected for

evaluating the effect of season of the year on the prevalence

estimates. In neither instance was a statistical] y significant

increase in the prevalence of reactivity noted during the season

of exposure (table H). However, for both allergens, a small

but statistically insignificant increase was noted in the period

of time immediate] y following the pollen season (table J).

This suggests a slight booster effect in skin-test reactivity

that lags behind the pollen season, consistent with the immunological observations .80

Despite methodologic problems in comparing prevalence

estimates of skin reactivity to specific allergens with other

epidemiologic studies, the effects of age, race, and sex on

prevalence of cutaneous immediate hypersensitivity should

be more comparable because they reflect internal comparisons

from the same study.

Age had an important influence on immediate hypersensitivity reactions. In general, the 12–24-year-old age group

demonstrated peak reactivity to all allergens used in this study.

Both the younger and ol&r age groups were less reactive

to the allergens tested. Diminished end-organ responsiveness

to inflammatory mediators is one contributory mechanism in

the decreased prevalence and &gr* of allergen skin-test reactivity in older individuals because there is age-associated loss

of vascular bed, 50 percent reduction of mast cells, 35 percent

reduction of venular cross-sections, and a reduction in histamine release observed in the skin of old aduhs.82 The overall

effect of age on allergen reactivity (greater than 10 percent

absolute difference in prevalence at the extremes of age) is

not explained solely by the inability of the skin to respond

to histamine, because there is little or no decrease in the

prevalence of reactivity to histamine with age until after age

55 (table XII), whereas the prevalence of allergen reactivity

peaks in the second and third &cades of life.

Another explanation for the effect of age on reactivity

may be a link between immediate hypersensitivity and survival.

In recent studies researched reported a positive association

between IgE levels and cardiovascular disease in men after

adjusting for smoking, fasting glucose, blood pressure, and

cholesterol. 83 In contrast, Vena et al. reported an inverse

association between the reported history of allergic diseases

and cancer.w However, no scientists have studied the question

of survival as related to the presence of imtnedate

hypersensitivity.

Several other studies have reported decreased prevalence

of skin reactivity with age. 65,85,86 pe~ skin.~st reactivity

previously has been reported to be highest in the 15-30-yearold age group, *7 20-34-yew-old age gmuP, w the first half

of the third decade,ss and in people under the age of 40

years.65

Age changes seen in skin-test reactivity parallel the

changes seen in IgE levels. The highest total IgE levels are

noted in males 6-24 years of age and in females 6-14 years

of age with a gradual fall off thereafter. 88Similarly, the highest

allergen specific IgE levels are found betwem 12 and 20

years of age. w The increase in IgE antibody levels during

these years may reflect the higher proliferative capacity and

number of clonable T and B cells seen in people 24-35 yews

of age, declining in later years.89

Consistent sex differences in prevalence of skin reactivity

were also noted in NHANES II. Males &monstrated a higher

prevalence of reactivity than females (22.2 percent versus

18.4 percent, p<O.05). However, females had higher rates

of reactivity to 1 mg/mL histamine than males (92 percent

versus 89.9 percent, p<O.05). Thus, the lower reactivity in

females does not appear to be due to decreased end-organ

reactivity to histamine. Researchers have also reported, in

other studies, the tendency for males to have larger skin

reactions at lowe# or equa16] concentrations of allergen or

to have significantly more positive skin tests or a higher

rate of reactivity to the allergens tested than females have.61‘w

The male predominance in allergen skin-test reactivity

is in keeping with tlie higher levels of total IgE88’w and

earlier manifestations of allergic syndromes in males, with

females not equaling the prevalence of males until the third

21
or fourth decade of life.91–94When tables 1–30 are examined

for sex differences by age, females do not equal males in

skin-test reactivity until approximately 45 years of age. Interestingly, cat and dog were the only allergens in which males

and females of all races did not have a statistically significant

difference in reactivity. This discrepancy in reactivity may

be related to the higher frequency and intensity of domestic

pet exposures for females to cat allergens,95 which partially

cross-react with dog allergens. 96, Because house dust may

contain many allergens other than cat and dog allergens, such

as dust mite and cockroach ,97 which were not included in

the battery of skin-test allergens, the higher prevalence of

reactivity to house dust among males is not inconsistent with

the higher reactivity to cat and dog allergens among females.

No statistically significant differences were found in allergen skin-test reactivity by race, although black persons

demonstrated a consistently higher rate of allergic skin reactivity than white persons. These findings are consistent with

the observed higher total IgE levels in the U.S, black population versus the U.S. white population. 98This higher reactivity

to allergens in black persons was discordant with the lower

degree of skin reactivity to histamine observed in black persons. If the lower rates of histamine reactivity in the black

population represent an underreading of the skin-test reactions

secondary to skin color, then the increased rates of allergen

skin reactivity noted in the black population may be very

conservative estimates of much higher prevalence rates of

immediate hypersensitivity. Another explanation for the discordance between allergen and skin reactivity may be endorgan unresponsiveness to histamine (one of many inflammatory mediators released in the allergic reaction) in black persons.

Few researchers have compared racial differences in skintest reactivity in the United States. Lindblad and others56

found no difference between the races. Freidhoff and others57

found black persons more reactive than white persons, but

the difference reached significance (y= .046) only in women

reporting allergies.

Socioeconomic factors were correlated with skin-test reactivity. Overall reactivity is greater in persons living at or

above the poverty index than in those below the poverty

index (21.0 percent versus 15.8 percent, p< O.05). Further

analysis found overall reactivity increased as education level

or family income increased.

Barbee et al.58 found increasing skin-test reactivity with

increasing income levels. Linna99found statistically significant

increases in reactivity in white-collar children as compared

with blue-collar children for grass pollens (in urban dwellers)

and tree pollens (in urban and rural dwellers), but also a

statistically significant increase in reactivity in blue-collar children for house dust. Reactivity to house dust mite also was

found to be associated positively with family size, regardless

of income. No controlling for family size was attempted in

the Linna analyses. Thus, it is unclear whether the increase

in reactivity in blue-collar children is due to larger family

sizes,

Urban dwellers were more reactive than rural dwellers

(22.0 percent versus 16.5 percent, p< O.001). The relationship

between location of residency and reactivity was further

analyzed by subdividing location into 4 parts: SMSA-central

city, SMSA—not central city, not SMSA—not rural, and

not SMSA—rural. After controlling for race and income,

it appears that the urban hyperreactivity may be located outside

of the central city. This suggests that factors in the urban

environment, especially outside the central city, may potentate

immunologic (IgE) reactivity to aeroallergens.

Linna9g found reactivity to tree pollens increased in urban

blue-collar dwellers versus rural dwellers @<O.0001) and

house dust mite reactivity more common in rural blue-collar

versus urban dwellers (p< O.05). Again, family size was not

controlled for in the house-dust comparison. No differences

in skin reactivity were found between white-collar workers

in urban versus rural settings. Rhyne as quoted by Smith

et al.lm reported significantly less skin reactivity to ragweed

(8.3 percent) and grass (6.7 percent) in rural children than

in urban children (15.3 percent and 9.9 percent, respectively).

Similarly, comparative studies of rural and urban populations

suggest “the same or lower incidence” for rural populations. ‘m

The cause for this increased prevalence of reactivity in urban

populations is not apparent, but may be related to pollutants

in the urban environment, urban clustering of families with

positive allergic histories, or cultural differences between,urban

and rural groups that may have an effect on the development

of immediate hypersensitivity.

Increasing socioeconomic status (SES) levels as diemonstmted by increasing income or education appear to be associated with increasing tendencies to develop cutaneous immediate hypersensitivity. Controlling for urbanization will not

erase the effect of income or education on skin-test reactivity.

Nor will control of income or education erase the effect of

urbanization. This leads one to postulate that the development

of cutaneous hypersensitivity may be dependent upon life

styilesinvolved in higher SES urbanized environments. It has

been noted in animals and humans that exposure to an antigen

eady in life will promote the development of tolerance to

this antigen. 101’102It is possible that by growing up in an

upper SES urbanized environment, exposure to the aeroallergens used for testing is reduced and tolerance is not

developed as it would be in a lower SES environment. On

the other hand, there may be some environmental factor that

is a~ssociatedwith the upper SES lifestyle that makes people

more susceptible to the development of hypersensitivity.

Further research is needed to answer these questions.

Overall reactivity was examined according to geographic

regilon. The Northeast had the most reactors, with the South

containing the lowest number and the West and Midwest

being in the middle. These differences could not be explained

by the differential reactivity by region to ragweed. Controlling

for urbanization, education, and income also could not explain

the observed differences. One speculation as to the explanation

for the observed differences in reactivity, at least for the

outdoor aeroallergens, may be the prevailing winds in the

continental United States during the year. 103The 10-year

(195 1-60) mean surface wind direction in the United States

for the spring (April), summer (July), and fall (October) was

such that the prevailing winds in the Northeast were either

from the South or the West; whereas in the South the prevailing

22
winds were from the Gulf of Mexico or the Atlantic Ocean. pollen because of the prevailing winds coming over large

Thus, an individual in the Northeast would be exposed to bodies of water where little pollen exists. This differential

heavier and more persistent aeroallergen loads secondary to pollen exposure could be a partial explanation for the differing

polIens carried into the the Northeast from the West and levels of reactivity in different geographic regions. A full

South by the prevailing winds. In the South, on the other exploration of these regional differences will require further

hand, an individual would be exposed to a lighter load of study.

23
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27
List of detailed tables

1. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for persons ages 6-74 years, to house dust allergen, by

race and age: United States, 1980-81 . . . . . . . .

2. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for males ages 6-74 years, to house dust allergen, by

race and age: United States, 1976-80 . . . . . . . .

3. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for females ages 6-74 years, to house dust allergen, by

race and age: United States, 1976-80 . . . . . . .

4. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for persons ages 6-74 years, to akemaria allergen, by

race and age: United States, 1976-80 . . . . . . . . . .

5. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for males ages 6-74 years, to akemaria allergen, by race

and age: United States, 1976-80 . . . . . . . . . . . . . .

6. Sample size, percent positive, standard emors of percent

positive, and percent distributions of the erythema reaction

for females ages 6-74 years, to altemaria allergen, by

race and age: United States, 1976-80 . . . . . . . .

7. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for persons ages 6-74 years, to cat allergen, by race and

age: United States, 197&80.. . . . . . . . . . . . . . . .

8. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for males ages 6-74 years, to cat allergen, by race and

age: United States, 197&80. . . . . . . . . . . . . . . . .

9. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for females ages 6-74 years, to cat allergen, by race and

age: United States, 1976-80 . . . . . . . . . . . . . . . . .

10. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for persons ages r5--74years, to dog allergen, by race and

age: United States, 197&80.. . . . . . . . . . . . . . . .

11. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for males ages 6-74 years, to dog allergen, by race and

age: United States, 197&80. . . . . . . . . . . . . . . . .

12. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for females ages 6-74 years, to dog allergen, by race

and age: United States, 1976-80 . . . . . . . . .

13. SampIe size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for persons ages 6-74 years, to oak allergen, by race and

30 age: United States, 197G80 . . . . . . . . . . . . . . . . . 42

14. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for males ages 6-74 years, to oak allergen, by race and

31 age: United States, 1976-80, . . . . . . . . . . . . . . . . 43

15. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for females ages 6-74 years, to oak allergen, by race and

32 age:UnitedS tates,1976-80. . . . . . . . . . . . . . . . . 44

16. Sample size, percent positive, standard errors of percent

positive, and percent dkributions of the erythema reaction .

for persons ages 6-74 years, to rye grass allergen, by

33 race and age: United States, 1976-80 . . . . . . . . . . 45

17. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for males ages 6-74 years, to rye grass allergen, by race

34 alnd age: United States, 1976--80 . . . . . . .. . . . . . . 46

18. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for females ages 6-74 years, to rye grass allergen, by

35 ralce and age: United States, 1976-80 . . . . . . . . . . 47

19. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

fa,r persons ages 6-74 years to Bermuda grass allergen,

36 by race and age: United States, 1976-80 . . . . . . . . 48

20. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for males ages 6-74 years, to Bermuda grass allergen,

37 by race and age: United States, 1976-80 . . . . . . . .. 49

21. Sa\mple size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for females ages 674 years, to Bermuda grass allergen,

38 by race and age: United States, 1976-80 . . . . . . . . 50

22. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for persons ages 6-74 years, to ragweed allergen, by race

39 and age: United States, 1976-80 . . . . . . . . . . . . . . 51

23. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for males ages 6-74 years, to ragweed allergen, by race

40 and age: United States, 1976-80 . . . . . . . . . . . . . . 52

24. Sample size, percent positive, standard emors of percent

positive, and percent distribution of the erythema reaction

for females ages 6-74 years, to ragweed allergen, by race

41 ancl age: United States, 1976-80 . . . . . . . . . . . . . . 53

28
25. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for persons ages 6-74 years, to ragweed allergen (high

pollen regions-Northeast and Midwest), by race and age:

LJnited States 1976-80 . . . . . . . . . . . . . . . . . . . .

26. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for males ages 6-74 years, to ragweed allergen (high pollen

regions—Northwest and Midwest), by race and age: United

States, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . .

27. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for females ages 6-74 years, to ragweed allergen (high

lmllen regions-Northwest and Midwest), by race and age:

United States, 1976-S0 . . . . . . . . . . . . . . . .

28. Sample size, percent positive, standard errors of percent

positive, and percent distributions of the erythema reaction

for persons ages 6-74 years, to ragweed allergen (low

pollen regions-South and West), by race and age: United

States, 197&80 . . . . . . . . . . . . . . . . . . . . 57

29. Sample size, percent positive, standard errors of percent

54 positive, and percent distributions of the erythema reaction

for males ages 6-74 years, to ragweed allergen (low pollen

regions-South and West), by race and age: United States,

1976-S0 . . . . . . . . . . . . . . . . . . . . . . . . 58

30. Sample size, percent positive, standard errors of percent

55 positive, and percent dis~butions of the erythema reaction

for females ages 6-74 years, to ragweed allergen (low

pollen regions-South and West), by race and age: United

States, 197&80 . . . . . . . . . . . . . . . . . . . . 59

31. Median size of positive skin-test reaction to individual al56 Iergens for persons ages 6-74 years, by race and sex:

United States, 1976-80 . . . . . . . . . . . . . . . . 60

29
Table 1. Sample size, percent positive, standard er?oreof percent positive, and percent distnlmtions of the erythema reaction for pereons ages 6-74 years, to house dust

allergen, by race and sga United States, 1976-80

Race and aae

Positive skin-test

reactiorzl Percent distribution of erytherna reaction2

0.1- 1o.5- 20.5- 30.5- 40.5 and

Sample Standard 10.4 mm 20.4 mm 30.4 mm 40.4 mm more

size Percent error Omm ( +/-) (l+) (2+) (3+) {4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15,519

1,623

1,897

1,961

2,155

1,522

1,388

2,464

2,509

13,267

1,317

1,545

1,663

1,831

1,321

1,209

2,183

2,198

1,942

268

308

251

272

166

155

253

269

6,2

5,2

6.5

10.0

8.5

6.8

3.3

3.3

2.2

5.9

4.7

6.2

9.5

8.0

6.6

3.4.

3.3

2.0

7,2

5.8

8.0

13.5

8.9

‘6.8

‘1.9

‘3.7

●2.7

0.66

0.82

0.66

1.43

0.92

1.08

0.58

0.58

0.41

0.58

0.70

0.89

1.30

0.86

1.10

0.64

0.62

0.41

1.83

1.60

2.34

4.63

2.57

“2.53

“1.15

*1.44

“ 1.07

89.9

90.4

89.2

86,2

87,6

89.4

91.8

93.9

94.5

90.3

91.3

90.0

66.7

88.4

89.2

91.5

93.8

94.6

89.0

66.1

66.6

63.0

87.3

91.7

94.9

94.4

94.8

3.9

4.4

4.3

3.8

3.9

3.8

4.9

2.8

3.3

3.8

4.0

3.8

3.8

3.6

4.2

5.0

2,9

3.4

3.7

6.1

5.4

3.5

3.8

1.5

3.2

1.8

24

3.3

3.7

3.7

5.2

4.7

2.7

1.5

1.9

1.4

3.1

3.1

3.3

4.8

4.7

2.7

1.5

1.9

1.2

4.7

4.3

5.9

8.9

6.1

2.0

0.8

2.4

2.5

2.3

1.3

2.5

3.7

2.9

3.1

1.4

1.0

0.7

2.1

1.4

2.6

3.5

2.6

2.8

1.5

0.9

0.7

2.4

1.1

1.4

4.6

2.8

4.8

1.1

1.3

0.2

0.6

0.2

0.4

1.0

0.8

1.0

0.4

0.5

0.1

0.6

0.2

0.3

1.2

0.8

1.0

0.4

0.5

0.1

0.2

0.3

0.7

0.1

0.1

0.1

0.1

-

1Mean diameter of the erythema reaction greater than or equal to 10.5 mm.

2Figurea may not add to 100 percent becauae of rounding.

31ncludes data for races not shown separately.

NOTE mm = millimeter.

30
Table 2. sample size, percent pos”tie, standard errora of percent positive, and percent diatributfons of the erythema reaction for males ages +74 year~

to house dust allergen, by race and age: United States, 1976-60

Positive skin-test

reaction’ Percent distribution of erythema reactionz

0.1- 1o.5- 20.5- 30.5-

Sample

40.5 and

Standard 10.4 mm 20.4 mm 30.4 mm 40.4 mm

Race and age

more

size Percent error Omm ( +1-) (1+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,534

823

999

943

1,038

718

663

7,~87

1,163

6,469

675

818

811

879

628

594

1,049

1,017

898

125

152

112

132

70

60

126

121

6.6

6.7

6.8

11.0

9.7

7.7

3.3

2.6

2.1

6.5

6.3

6.4

10.2

9.2

7.4

3.6

2.7

2.0

“7.9

‘5.9

“8.5

‘17.5

*8.5

●7.8

*1.1

*3.O

*3.5

0.79

1.15

0.92

1.63

1.26

1.46

0.92

0.60

0.54

0.65

1.05

0.99

1.70

1.19

1.53

1.03

0.87

0.56

‘2.41

*26JI

*3.14

‘6.69

“3.23

‘4.18

40.96

● 1.79

“2.44

89.0

6a.5

66.6

85.4

86.4

67.2

92.4

94.2

94.1

89.4

89.3

69.8

85.7

87.2

66.9

92.0

94.0

94.3

66.4

86.6

83.7

82.1

87.7

90.5

95.1

95.9

94.4

4.2

4.9

4.6

3.6

3.9

5.1

4.3

3.1

3.8

4.1

4.5

3.9

4.1

3.6

5.7

4.5

3.3

3.7

3.7

5.5

7.8

0.4

3.7

1.7

3.8

1.1

2.1

3.2

4.3

3.8

5.0

4.7

2.1

1.3

1.4

1.3

2.9

3.5

3.3

4.3

4.6

2.2

1.3

1.4

1.1

5.2

5.4

6.4

10.0

6.8

2.1

1.1

1.4

3.0

2.7

2.0

2.7

4.3

4.0

4.1

1.3

0.5

0.7

2.6

2.3

2.9

4.0

3.6

3.7

1.5

0.4

0.7

2.5

0.5

1.1

7.5

1.7

5.7

1.6

0.5

0.8

0.4

0.3

1.6

0.9

1.4

0.7

0.7

0.1

0.9

0.5

0.2

1.8

0.9

1.4

0.8

0.7

0.1

0.2

1.0

0.1

0.1

0.1

0.1

0.1

0.1

0.1

0.1

0.1

0.1

lMean ,dlameterof the erythema reaction greaterthan or equal to 10.5mm.

2Figuresmay not add to 100percent because of rounding.

31ncludesdata for races not ahown separately.

NOTE:mm = millimeter.

31
Table 3. Srm@e size, percent positive, standard errora of percent pwitiie, and percent rfhtributions of the erythema reaction for females sges 6-74

yeare, to house dust allergen, by race and ageu United State$ 197WJ0

Positive skin-tesf

reaction’ Percent distribution of erythema reaction2

o.7- 1o.5- 20.5- 30.5- 40.5 and

Sample Standard ?0.4 mm 20.4 mm 30.4 mm 40.4 mm more

Race and age size Percent error Omm (+ l-) (1+) (2+. ) (3+) (4-!-)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-64 years . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,985

800

898

1,018

1,117

604

725

1,277

1,346

6,798

642

727

652

952

695

615

1,134

1,161

1,044

143

156

139

140

96

96

127

148

5.6

3.8

6.2

9.1

7.4

6.0

3.4

4.0

2.2

5.3

3.2

6.0

8.7

6.9

5.8

3.3

3.9

20

6.7

●5.7

7.5

“1O.3

9.2

“6.0

‘2.6

“4.4

“2.2

0.63

0.86

1.14

1.38

0.97

1.03

0.66

0.60

0.53

0.61

0.63

1.23

1.37

0.91

1.11

0.71

0.86

0.51

1.56

‘2.20

2.19

‘4.46

2.66

‘2.08

“2.04

‘1.66

‘0.91

90.7

92.3

89.8

66.9

88.8

91.5

91.2

83.6

94.6

91.1

93.4

90.3

87.7

89.5

71.4

91.1

93.6

94.9

69.5

87.6

89.6

63.7

87.0

92.7

94.6

93.1

95.2

3.7

3.9

4.0

4.0

3.8

2.6

5.4

2.5

3.0

3.6

3.5

3.7

3.6

3.5

2.8

5.5

2.5

3.1

3.8

6.7

2.9

6.0

3.8

1.4

2.6

2.6

2.6

3.4

3.0

3.6

5.4

4.7

3.2

1.7

2.3

1.4

3.2

2.7

3.4

5.2

4.7

3.1

1.7

2.3

1.3

4.2

3.3

5.3

8.0

5.5

1.9

0.6

3.3

2.2

1.8

0.7

2.2

3.2

1.9

2.2

1.5

1.4

0.7

1.7

0.5

2.2

3.0

1.5

2.0

1.5

1.3

0.7

2.3

1.8

1.7

2.3

3.7

4.0

2.0

1.1

0.4

0.1

0.4

0.4

0.7

0.6

0.1

0.3

0.1

0.4

0.4

0.5

0<7

0.7

0.1

0.3

0.”1

0,2

0.7

0.5

‘Mean diameter of the erythema reaction greatar than or equal to 10.5 mm.

2Figures may not add to lW percent because of rounding.

31ncludes data for races not shown separately.

NOTE mm = millimeter.

32
Table 4. Sample size, percent positive, standard errore of percent positive, and percent distributions of the erythema reaction for persons ages 6-74 years, to altemana

allergen, by race and age United States, 1976-80

Positive skin-test

reactionl Percent distribution of erythema reactionz

0.7- 1o.5- 205- 30.5- 40.5 and

Samr31e Standard 10.4 mm 20.4 mm 30.4 mm 40.4 mm more

Race and age size Percent error Omm (+/-) (l+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

All ages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-W years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

85-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15,543

1,624

1,696

1,987

Z161

1,525

1,389

2,485

2,514

13,287

1,319

1,545

1,889

1,834

1,324

1,210

2,164

2,202

1,945

267

309

251

275

188

155

%3

269

3.6

5.1

6.4

5.3

3.4

3.7

1.6

1.2

0.6

3.5

4.7

6.0

5.3

3.4

3.9

1.8

1.2

0.6

4.0

‘7.0

7.7

‘3.8

3.5

*2.3

“1.8

“1.4

0.26

0.58

0.79

0.68

0.55

0.65

0.50

0.35

0.17

0.27

0.58

0.90

0.65

0.84

0.67

0.55

0.36

0.16

0.48

‘2.49

1.44

‘ 1.41

0.62

●1.29

‘1.24

“0.69

95.1

92.9

923

93.7

95.4

95.2

97.0

97.6

96.3

95.2

93.4

92.8

93.6

95.4

94.9

96.8

97.5

96.3

94.9

90.3

90.4

94.5

95.8

97.7

96.2

96.6

99.7

1.3

2.0

1.3

1.0

1.2

1.2

1.2

1.2

1.1

1.3

1.9

1.2

0.9

1.2

1.3

1.4

1.4

1.1

1.1

2.7

1.9

1.8

0.7

0.3

1.5

2.8

3.0

1.9

1.3

1.0

1.0

0.2

0.3

1.4

2.6

2.4

1.9

1.1

1.0

1.1

0.2

0.2

2.1

4.5

5.6

0.9

2.0

0.4

0.8

1.5

1.9

2.6

2.4

1.3

1.2

0.6

0.8

0.3

1.4

1.7

2.7

2.3

1.3

1.3

0.5

0.9

0.3

1.5

25

1.7

2.1

1.5

0.3

1.8

0.2

0.5

0.2

0.6

0.9

0.6

1.1

0.1

0.1

0.5

0.3

0.6

0.9

0.7

1.1

0.2

0.1

0.4

0.4

0.7

1.6

0.4

0.2

0.1

0.2

0.2

0.2

0.4

0.1

0.2

0.1

0.3

0.2

0.3

0.4

0.1

1Mean diameter of the erythema reaction greaterthan or equal to 10,5mm.

‘Figures may not add to 103percent because Ofrounting.

3includes data for races not ahown separately.

NOT~ mm = millimeter.
Table 5. Sampla size, percent poaitiva, standard errors of parcent poaitlve, and percent diatrfbutions of the erythema mactlon for males agaa 6-74 yeara, to alternaria

allergen, by rata and age United Statea, 1976-60

Pos/t/ve skin-test

react/on’ Percent distribution of erythema reaction2

o.1- 1o.5- 20.5- 30,5- 40,5 and

Sample Standard 10.4 mm 20.4 mm 30.4 mm 40.4 mm more

Race and age size Percent error O mm ( +/-) (l+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 yaars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,546

623

999

945

1,042

721

863

1,187

1,166

6,478

676

817

813

881

629

594

1,049

1,019

900

124

153

112

134

70

60

126

121

4.1

6.7

7.1

5.7

3.6

4.6

“1.5

‘1.3

‘0.3

3.9

5.9

6.”1

6.1

3,4

4.6

●1.7

‘1,3

“0.4.

5.0

* 10.9

9.9

‘2.6

“4.5

*2.7

‘2.0

0.39

1.03

1.08

0.95

0.59

0.95

“0.81

‘0.48

“0.19

0.41

0.64

1.13

1.C6

0.62

1.03

“0.91

*0.52

“0.21

1.05

●5.42

2.15

● 1.23

*2.13

‘2.54

* 1.26

94.6

91.5

91.6

92.9

95.3

93.8

97.5

97.7

98.4

94.8

92.4

92.6

92.7

95.4

93.5

97.2

97.6

98.4

94.0

87.2

88.4

94.8

95.4

97.3

10Q.O

98.0

100.0

1.3

1.8

1.3

1.4

1.1

1.5

1.0

1.0

1.2

1.3

1.7

1.3

1.2

1.2

1.6

1.1

1.2

1.2

0.9

1.9

1.6

2.4

1.6

3.2

3.9

2.2

1.3

1.4

1.3

0.3

0.1

1.6

2.8

2.7

2.4

1.1

1.3

1.5

0.2

0.1

3.0

6.3

8.0

0.7

2.5

1.1

1.4

3.0

2.4

2.4

1.0

1.0

0.9

0.1

1.4

2.5

2.5

2.5

1.0

1.1

1.0

0.1

1.5

4.6

1.2

2.1

2.0

0.6

0!4

0.7

0.9

0.8

1.7

0.1

0.1

0.7

0.5

0.7

0.9

0.9

1.6

0.2

0.5

0.7

2.7

0.9

0.2

0.2

0,2

0.2

0.4

0.6

0.1

0.3

0.2

0.3

0.2

0.5

0.7

0.1

1Mean diameter of the srythsma reaction greaterthan or squal to 10.5mm.

‘Figures may not add to 100percent because of rounding.

31ncludeadata for races not shown separately.

NOTE mm = millimeter.

34
Table6. Samplesize,percentpositive,standarderroraof percentpositive,and psrcentdiatrtbutlonsof the erythemareactionforfernaleaagaa 6-74 years,to altemaria

allergen,by race and agrxUnitedStatea, 1978-86

. ..—

Positive skin-test

reaction’ Peroant distribution of erythema reactionz

o.1- 70.5- 20.5- 30.5- 40.5and

Sample Standard 10.4mm 20.4 mm 3(I4 mm 40.4 mm more

Race and age size Percent error Omm (+/-) (l+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

85-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

85-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

O-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1844yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 yaars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 yaars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

85-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,997

801

899

1,022

1,119

S04

728

1,278

1,348

6,E!J19

843

728

858

953

695

616

1,135

1,183

1,045

143

158

139

141

S6

85

127

148

3.2

3.4

5.7

5.0

3.2

2.8

2.1

1.0

‘0.8

3.1

3.5

5.9

4.5

3.3

3.0

2.0

‘1.1

‘0.8

3.1

●3.3

‘5.4

●4.5

“2.6

●1.9

*3.4

“0.8

0.29

0.75

1.02

0.85

0.95

0.78

0.61

0.44

“0.30

0.32

0.88

1.12

0.75

1.05

0.89

0.65

‘0.49

‘0.31

0.80

“1.83

“1.64

‘2.26

‘1 .69

“1.09

“2.32

‘0.48

95.6

94.4

93.1

94.4

95.4

88.4

98.5

97.5

98.3

95.6

64.4

63.0

94.9

95.4

98.1

98.4

97.3

68.2

95.6

93.3

92.4

94.2

98.1

98.1

98.6

S9.2

99.4

1.2

22

1.2

0.6

1.4

0.8

1.4

1.4

0.9

1.2

21

1.0

0.6

1.2

1.0

1.6

1.6

1.0

1.3

3.4

2.2

1.3

1.3

0.6

1.2

2.5

2.1

1.5

1.2

0.7

0.6

0.2

0.4

1.1

2.5

2.0

1.3

1.2

0.7

0.7

0.2

0.3

1.4

28

3.2

1.0

1.5

0.7

0.4

1.5

0.9

2.9

2.3

1.6

1.4

1.2

0.7

0.5

1.5

1.0

3.0

2.1

1.7

1.5

0.9

0.8

0.5

1.4

0.6

2.2

2.2

1.1

0.6

3.4

0.4

0.4

0.1

0.5

0.9

0.4

0.5

0.1

0.1

0.4

0.1

0.6

0.9

0.4

0.6

0.2

0.2

0.3

1.3

0.6

.

0.1

0.2

0.2

0.1

0.2

0.2

0.1

0.3

0,2

0.1

0.2

0.2

lMenn diameter of the erythema reaction greater than or equal to 10.5 mm.

‘Figuresmay not add to 100percant because of rounding.

31nclweS data for races not shown separately.

NOTE mm = millimeter.

35
Table 7. Sample size, percent positive, standard errors of percent positive, and percent distributions of the erythema reaction for persons ages 6-74 yeare, to cat

allergen, by race and age United States, 1976-80

Positive skirr-tesf

reaction’ Percent distribution of erythema reactionz

0.1- 70.5- 20.5-

Sample

30.5- 40.5 and

Standard 10.4 mm 20.4 mm 30.4 mm 40.4 mm more

Race and age size percent error Omm ( +/-) (l+) (2+) (3+) (4+)

Ail races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years....,.....,........,.. . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Ailages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15,474

1,617

1,888

1,948

2,150

1,515

1,382

2,461

2,531

13,229

1,313

1,537

1,653

1,825

1,315

1,205

2,180

2,201

1,939

267

306

248

273

166

155

253

289

2.3

1.6

2.2

4.0

3.4

2.7

1.7

‘0.7

0.6

2.2

1.6

2.2

4.1

3.2

2.6

1.4

“0.8

0.6

2.4

“1.9

‘1.9

●3.6

“3.4

‘1.0

“5.0

“0.2

0.26

0.37

0.49

0.50

0.55

0.46

0.35

“0.26

0.17

0.27

0.41

0.52

0.52

0.55

0.49

0.35

‘0.30

0.18

0.53

‘0.90

“0.95

“1 .31

“1 .30

*1 .05

“2.34

“0.19

96.0

97.2

98.4

94.3

94.1

96.3

96.1

98.0

97.7

96.1

97.2

98.4

94.3

94.5

98.3

98.3

97.8

97.6

98.4

96.9

96.7

94.3

95.2

98.4

94.1

99.0

98.7

1.7

1.2

1.4

1.7

2.4

1.1

2.2

1.3

1.7

1.7

1.2

1.4

1.7

23

1.2

2.3

1.4

1.8

1.2

1.3

1.4

2.1

1.3

0.6

0.9

0.8

0.3

1.2

1.1

0.9

2.0

1.7

1.0

1.1

0.6

0.4

1.1

1.2

0.8

2.1

1.6

0.9

0.7

0?7

0.4

1.3

1.2

1.3

1.3

1.6

4.6

1.0

0.4

1.2

1.7

1.4

1.4

0.6

0.1

0.1

0.9

0.4

1.3

1.6

1.4

1.3

0.6

0.1

0.1

0.9

0.7

0.6

1.9

1.1

1.0

0.4

0.2

0.2

0.1

0.3

0.4

0.3

0.2

0.1

0.3

0.3

0.4

0.2

0.3

0.7

0.1

0.1

1Meandiameter of the erythema reaction greaterthan or equal to

‘Figures may not add to 100percent because of mundlng.

31ncludeadata for races not shown separately.

10.5

NOTE mm = millimeter.

36
Tebfe8. Semplesize,percentpositive,standarderrorsof percentpoeMve,end percentdiatrilxrfiorrsof the wytheme reactbn * males ages 6-74 years,to cat altMwn,

by raw and ag@UnitedStates, 1976-88

P&tin? skin-test

reaction’ Percent distribution of erythema reaction2

o.1- 1o.5- 20.5- 3r25-

Sample

40.5and

Standard 10.4mm 2Q.4mm 304 mm 40.4 mm more

Race and age size Percent error Omm (+/-) (1+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S&f4years. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Allages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

O-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 yeers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 ysars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

85-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alla{]es . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years...............................,..

25-34 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 Wars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,518

821

895

837

1,036

716

881

1,188

1,166

6,455

674

815

807

876

624

592

1,048

1,019

8%

124

152

110

133

70

60

126

121

22

1.6

1.5

4.4

3.5

2.0

‘1.8

“0.4

“0.2

22

1.9

‘1.4

4.5

3.4

1.7

“1.7

“0.4

‘0.2

20

●0.5

“0.5

●4.3

●4.1

●21

●24

0.30

0.38

0.44

0.85

0.71

0.58

“0.70

“027

“0.15

0.32

0.48

“0.43

O.cm

0.84

0.48

“0.77

‘0.31

‘0.17

0.68

“0.57

“0.48

●231

“1.54

“231

●1.3a

S6.O

97.1

97.5

83.9

93.8

%.5

w3

97.9

97.9

%.1

96.8

97.3

93.8

84.3

98.5

88.3

97.8

97.7

S9

97.6

98.5

93.3

94.9

97.9

95.7

w.4

Im.o

1.8

1.3

1.1

1.7

2.7

1.5

1.9

1.7

1.9

1.8

1.3

1.3

1.7

24

1.8

1.9

1.8

20

1.1

1.8

25

1.0

1.9

1.6

1.2

1.2

0.8

23

20

0.4

1.2

0.4

0.1

1.2

1.4

0.6

25

1.9

0.4

1.1

0.4

0.1

1.1

0.5

0.5

1.5

3.2

24

0.8

0.4

0.7

1.7

1.4

1.0

0.6

0.8

0.4

0.8

1.7

1.4

0.6

0.7

0.7

2.1

0.9

21

0.1

0.1

0.3

0.6

0.1

0.1

0.3

0.1

0.7

0.1

0.7

0.1

0.1

0.1

0.1

1Meandiameteroftheetytharrrareactiongreeterthanore@al to 10.5mm.

2Figurssmaynotaddto lCOpercart because of rounding.

31ncludeedataforracesnofshcwnsaperstely.

NOTE mm = millimeter.

37
Table 9. Sample size, percent positive, standard errors of paraent positive, and percent distrflbutiona of the erythema reaction for femalas ages 6-74 years, to cat

allergen, by race and age United States, 1976-80

Positive skin-test

reaction’ Percent distribution of erythema reaction2

0.1- 1o.5- 20.5- 30.5- 40.5and

Sample Standard 10.4mm 20.4mm 30.4mm 40.4mm more

Race and age siza Percent error Omm (+/-) (7+) (2+) (3+) (4+)

All racea3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . .. c. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,956

769

693

1,011

1,114

799

721

1,275

1,347

6,774

839

722

848

949

691

613

1,132

1,162

1,043

143

156

138

140

98

95

127

148

2.5

●1.6

2.9

3.7

3.4

3.3

.,.7,

‘1.1

(),$)

2.3

“1.3

3.0

3.6

3.1

3.3

●1.1

●1.1

0.9

2.7

●3.1

“3.3

3.1

“29

“7.2

‘0.4

0,27

“0.51

0.83

0.53

0.86

0.73

“0.55

“0.37

0.28

0.28

“0.58

0.91

0.61

0.59

0.77

“0.40

“0.42

0.29

0.80

●1.65

‘1.80

0.92

●1.55

‘4.18

“0.38

98.0

97.3

95.4

94.6

94.4

S6.1

95.9

98.0

97.6

68.1

97.5

95.5

94.7

94.7

98.1

98.2

97.8

97.5

98.0

98.1

93.9

95.1

95.5

98.6

92.8

99.6

99.6

1.6

1.1

1.7

1.6

2.2

0.6

2.4

0.9

1.4

1.6

1.2

1.5

1.7

2.2

0.5

2.7

1.0

1.6

1.3

0.7

2.9

1.9

1.6

1.2

0.4

1.2

1.1

1.1

7.7

1.3

1.6

1.0

0.6

0.7

1.1

1.0

0.9

1.7

1.3

1.3

0.3

0.9

0.7

1.5

1.8

2.1

1.2

0.4

6.4

1.1

0.5

1.7

1.7

1.3

1.7

0.6

0.3

0.2

1.1

0.3

1.9

1.5

1.3

1.9

0.6

0.3

0.2

1.0

1.4 ‘

1.1

1.9

1.3

0.8

0.4

0.2

0.1

0.3

0.8

0.1

0.2

0.2

0.4

0.5

0.1

0.2

1.2

0.1

0.2

1Meandiameter of the erythema raactlon greaterthan or squal to

2Flgurasmay not add to 10Cpercant because of mundirrg.

31ncludesdata for races not shown separately.

10.5

NOTE mm = millimeter.

38
Table10. Sample size,peroentpositive,atendarderrorsof percentpositive,and psroentdistributionsof the erythemareactionforpersonsages 6-74 yasre,to dog

allergen,by race sndagesUnitedStates, 1976-60

Positive skin-test

reaction’ Percent distribution of erythema reaction2

o.1- 1o.5- 205- 30.5- 40.5and

Sample Standard 10.4mm ~.4 mm 30.4mm 40.4mm more

Race and age size Percent error Omm (+/-) (l+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 yaars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15,465

1,618

1,8435

1,951

~ms

1,513

1,381

2,458

2,511

13,225

1,314

1,533

1.656

1;625

1;315

1,205

2,177

2,200

1,934

267

309

24s

271

164

154

253

268

2.3

1.4

2.3

4.0

3.3

2.9

1.4

0.9

‘0.6

2.2

1.4

2.1

4.1

2.9

2.5

1.3

0.9

“0.6

2.7

“0.8

*3.6

*3.6

●4.3

“3.5

‘2.6

‘0.6

0.25

0.36

0.44

0.55

0.58

0.57

0.34

0.24

“0.22

0.24

0.38

0.46

0.54

0.51

0.54

0.36

0.25

‘0.23

0.77

80.83

81.29

*1.45

“1.71

●1.53

“1 .28

“0.53

96.0

97.3

98.1

94.3

94.7

94.9

98.6

98.1

97.7

88.1

97.5

68.3

84.4

95.0

94.9

96.6

98.0

97.6

98.2

97.6

95.6

64.6

94.6

96.2

95.7

89.4

88.1

1.7

1.3

1.6

1.7

2.0

2.2

2.0

1.1

1.6

1.8

1.2

1.6

1.5

21

2.5

2.1

1.2

1.7

1.1

1.6

0.9

1.7

1.2

0.4

1.7

0.9

1.3

1.0

1.4

2.3

1.6

1.1

0.9

0.6

0.3

1.2

0.9

1.2

2.5

1.3

1.1

0.8

0.6

0.3

1.6

0.8

2.8

1.6

2.5

0.8

26

0.4

0.9

0.4

0.5

1.6

1.5

1.3

0.4

0.2

0.3

0.8

0.4

0.4

1.5

1.5

1.1

0.4

0.2

0.3

0.9

0.8

2.0

1.5

1.7

0.2

0.2

0.4

0.1

0.2

0.5

0.1

0.2

0.5

0.1

0.2

0.3

0.1

0.1

0.2

1.0

—

1Mean diameter of the erythema reaction greaterthan or equal to 10.5mm.

‘Figures may not add to lW percent beaause of rounding.

31ncludesdata for races not shown separately.

NOTE mm = millimeter.

39
Table 11. Sample size, percent poaltive, standard enws of percent positive, and percent distributlona of the afytffama reaction for males ages 8-74 yearq to dog

allergen, by race and ag~ United States, 1976-80

%sitiw skin-test

reaction’ Percent distribution of erythema reactionz —

o.1- 1o.5- m.5- 305- 410.5and

Sample Standard 10.4 mm M4 mm 30.4 mm 40.4 mm more

Race and age size Percent error O mm ( +/-) (l+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-2-4years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 yaars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Allagea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 yeers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7)510

821

892

939

1,038

713

659

1,184

1,186

6,450

674

811

809

877

623

591

1,046

1,019

893

124

153

110

132

88

59

128

121

.2.3

21

1.6

4.4

3.4

3.0

“0.9

“0.7

‘0.4

2.3

2.1

2.0

4.7

3.3

●2.4

“0.9

“0.7

“0.4

“1.7

“1.0

‘0.9

“2.7

●2.2

“3.9

“1.1

“0.5

0.31

0.88

0.43

0.80

0.70

0.60

“0.42

“0.31

“0.20

0.30

0.67

0.51

0.26

0.73

“0.82

‘0.48

“0.34

“0.22

“0.78

‘1.09

“0.77

●1.43

‘1.17

●2.88

●0.97

“0.45

95.7

98.2 .

98.7

93.8

94.0

64.7

%.2

98.2

93.1

95.6

98.5

88.7

93.7

93.8

94.9

88.1

98.0

97.8

97.2

%.9

98.5

95.1

97.4

98.1

98.0

99.5

100.0

2.0

1.6

1.5

1.8

2.6

2.2

29

1.1

1.6

2.1

1.4

1.4

1.6

3.0

26

3.0

1.2

1.8

1.1

21

0.6

2.2

0.4

2.6

1.1

1.5

0.8

2.3

1.4

0.6

0.8

0.6

0.3

1.2

1.3

0.8

2.6

1,3

0.7

0.8

0.6

0.3

0.7

1.0

0.5

0.5

1.7

1.1

0.5

1.0

0.7

0.6

2.0

1.8

1.8

0.1

0.1

0.1

1.0

0.8

0.6

1.9

1.8

1.5

0.2

0.1

0.1

0.6

0.5

22

1.8

0.2

0.4

0.2

0.2

0.6

0.2

0.5

0.2

0.2

0.2

0.3

0.5

21

1Msandiameterof theerythemareaction greater than or equal to 10.5 mm.

2Figurea may not add to 1133percent besauae of rounding.

31ncludes data for races not shown separately.

NOTE mm = mitlimster.

40
Table 12. Sample size, percant positive, standard errors of percent positive, and percent distributions of the erythema reaction for females ages 6-74 years, to dog

allergen, by race and ag% United States, 1976-66

Positive skin-test

reaction’ Percent distribution of erythema reactionz

o.1- 1o.5- 205- 30.5- 40.5and

Sample Standard 10.4mm 20.4 mm 30.4 mm 40.4 mm more

Race and age size Percent error Omm (+/-) (l+) (2+) (3+) (4+)

All race??

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-11 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

All ages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,955

797

893

1,012

1,112

60)

722

1,274

1,345

6,775

640

722

647

946

692

614

1,131

1,181

1,041

143

156

136

139

96

95

127

147

2.3

0.6

2.8

3.6

3.2

2.8

1.8

1.0

0.8

2.0

0.7

2.3

3.6

2.5

2.6

1.6

‘1.0

‘0.8

3.6

“0.7

‘6.2

●4.3

‘5.9

“3.1

●3.9

‘0.7

0.24

0.30

0.74

0.57

0.76

0.65

0.44

0.33

0.36

0.22

0.33

0.72

0.53

0.62

0.70

0.42

‘0.36

‘0.36

0.94

“0.72

●2.51

*1.75

“2.46

*1.56

●2.32

‘0.61

96.3

96.4

95.5

94.9

95.3

95.0

97.0

96.0

97.5

S6.5

96.4

95.9

95.0

96.2

94.9

97.1

97.9

97.5

95.3

96.2

92.6

94.3

92.4

96.2

95.3

99.3

96.5

1.5

0.9

1.7

1.6

1.4

2.2

1.2

1.0

1.7

1.5

0.9

1.9

1.4

1.2

2.5

1.2

1.1

1.7

1.1

1.1

1.2

1.4

1.7

0.7

0.8

1.5

1.4

0.6

2.0

2.3

1.8

1.6

1.1

0.6

0.4

1.2

0.6

1.5

2.4

1.3

1.5

0.6

0.6

0.3

2.4

0.7

5.2

24

3.2

1.4

3.9

0.3

0.7

0.1

0.4

1.2

1.3

0.9

0.6

0.3

0.4

0.7

0.1

0.3

1.1

1.2

0.8

0.7

0.3

0.5

1.2

1.1

1.9

2.7

1.7

0.4

0.1

0.4

0.1

0.1

0.3

0.1

0.1

0.2

0.5

0.1

0.1

0.4

0.2

1Mean diameter of the erythema reaction greaterthan or equal to

2Figurcs may not add to 103p-arcentbecause of rounding.

31ncludesdata forracesnot shown separately.

NOTE mm = millimeter.

10,5Imm.
Table 13. Sample size, percent poaltlve, standard errore of percent positive, and percent dlatributiona of the erythema reaction for pereons ages 6-74 yeare, to oak

allergen, by race and age United States, 1976-60

PositWe skin-test

reaction’ Percent distribution of erythema reactionz

0.1- 1o.5- 20,5- 30.5-

Sample

40.5 and

Standard 10.4 mm 20.4 mm 30.4 mm 40.4 mm

Race and age

more

size Percent errcv O mm (+ /-) (1+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3544years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15,507

1,626

1,890

1,981

2,152

1,524

1,383

2,462

2,5)9

13,265

1,321

1,541

1,664

1,827

1,324

1,207

2,182

2,199

1,932

267

306

250

273

165

152

252

267

4.7

3.9

6.0

7.7

4.7

5.7

3.8

2.5

1.3

4.5

3.5

5.7

7.4

4.5

5.5

3.8

2.5

1.1

5.8

5.5

7.8

10.4

●4.9

●6.1

‘2.4

‘2.2

“1.8

0.36

0.60

0.93

0.91

0.48

0.76

0.73

0.45

0.27

0.33

0.61

0.65

o.6a

0.54

0.77

0.77

0.53

0.24

1.23

1.56

2.27

2.81

“1.69

●2.35

“1.28

●1.19

‘0.90

92.7

93.9

91.4

89.5

92.4

91.4

94.4

95.1

95.8

92.9

94.5

91.4

89.8

92.7

91.7

94.3

95.1

95.9

92.1

92.2

90.3

68.5

91.1

91.3

97.2

96.1

95.9

2.6

2.2

2.6

2.8

2.9

2.8

1.8

2.4

2.9

2.6

2.1

2.9

2.8

2.8

2.8

1.9

2.3

2.9

2.1

2.2

1.9

1.0

4.0

2.5

0.4

1.7

2.3

2.0

2.6

2.8

3.3

1.7

1.8

1.4

1.1

0.6

1.9

2.6

2.8

3.1

1.7

1.4

1,2

1.1

0.5

2.6

2.1

3.1

5.4

1.6

2,2

2.4

1.9

1.0

1.7

0.8

2.1

2.5

1.7

2.5

1.6

0.8

0.6

1.7

0.4

2.0

2.5

1.7

2.5

1.9

0.9

0.5

1.8

2.6

2.4

2.2

1.5

3.1

0.4

0.9

0.8

0.3

1.0

1.5

1.1

1.0

0.5

0.5

0.2

0.8

0.3

0.9

1.5

1.0

1.2

0.5

0.6

0.2

0.9

0.5

2.0

1.8

1.3

0.2

0.1

0.1

0.4

0.3

0.4

0.2

0.2

0.1

0.3

0.2

0.3

0.2

0.5

0.3

0.3

1.1

0.6

0.8

1Meandiameter of the erythema reaction greaterthan or equal to

‘Figures may not add to lCOpercent because of rounding.

31ncludeadata for races not shown separately.

NOTE mm = millimeter.

10.5mm.

42
Table 14. sample size, pement positive, stsndsrd errors of percentpositive, snd percentdlstrfbutfonsof the erythemsrwctlon for msfesages 6-74 yssrs,to osk

silergen,by race andsgo UnitedStstes, 1976-60

Wiitlva skin-test

reaction’ Fwcant distribution of erythema reactionz

o.1- 1o.5-

Sample

20.5- 30.5- 40.5 and

Standard 10.4 mm 204 mm 304 mm 40,4 mm more

Race and age size Paroant error O mm (+/-) (l+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years,., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years...........,..........,.. . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Ailages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Biack

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n yews . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

85-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,531

825

983

943

1,037

721

E&

1,188

1,165

6,469

678

813

812

878

629

593

1,048

1,018

895

124

152

111

132

70

59

128

121

5.4

4.0

6.7

9.4

5.8

6.7

4.4

1.6

1.3

5.3

3.7

6.3

9.8

5.6

6.4

4.5

1.7

“1.0

5.9

●4.3

10.1

“8.2

“5.9

‘8.7

“1.1

‘0.4

●2.1

0.43

0.83

1.11

1.30

0.75

0.98

1.20

0.45

0.39

0.43

0.85

0.93

1.43

0.83

1.19

1.31

0.s

“0.26

1.45

*1.98

3.20

“2.83

“2.22

“3.64

“0.97

“0.39

‘1.83

92.0

93.3

91.4

87.1

91.5

S0.4

94.2

95.9

95.8

92.1

93.2

91.9

86.7

91.7

90.7

93.9

95.8

98.0

92.6

94.3

87.3

60.4

91.3

90.3

98.9

S6.8

2.6

2.8

1.9

3.6

2.6

3.0

1.4

2.6

2.9

27

3.1

1.9

3.6

2.7

3.0

1.5

25

3.0

1.5

1.4

26

1.4

28

1.0

1.2

2.3

3.1

3.0

3.6

2.2

2.8

1.3

0.8

0.7

22

3.0

2.8

3.9

2.1

23

1.1

0.8

0.4

26

2.1

4.6

1.9

2.3

4.8

1.1

0.4

1.4

1.9

0.5

2.3

3.4

2.0

2.3

2.3

0.5

0.4

1.9

0.3

2.2

3.3

1.9

2.4

2.6

0.6

0.4

2.1

2.1

2.8

4.3

2.3

2.1

0.7

1.0

0.4

1.3

2.1

1.3

1.3

0.7

0.3

0.2

1.1

0.4

1.2

2.1

1.3

1.5

0.8

0.3

0.2

0.7

2.0

2.0

0.5

0.2

0.1

0.3

0.4

0.3

0.1

0.1

0.4

0.4

0.1

0.5

0.6

0.9

1.7

lMean diameter of the erythema reaction greater than or equal to 10.5 mm.

2Figures may not add to 100 percent because of rounding.

31ncludes data for races not shown separately.

NOTEmm = millimeter.

43
Table 15. Sample size, percent positive, standard errors of percent positive, and percent distributions of the arythema reaction for femafee ages 6-74 yeare, to oak

allergen, by race and age United Statea, 1976-80

Positive skin-test

reaction’ Percent distribution of erythema reactionz

o.1- 1o.5- 20.5- 30.5- 40.5 and

Sample Standard 10.4 mm 20.4 mm 30.4 mm 40.4 mm more

Race and age size Percent error Omm (+ l-) (1+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 yeara . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Whita

Alleges . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,976

801

897

1,018

1,115

803

722

1,276

1,344

6,796

643

726

852

949

695

614

1,134

1,181

1,037

143

154

139

141

95

93

126

146

4.1

3.8

5.2

6.1

3.6

4.9

3.2

3.3

1.4

3.8

3.2

5.2

5.2

3.5

4.6

3.1

3.3

1.2

5.7

‘6.7

*5.5

12.2

●4.1

‘4.0

“3.4

“3.9

*1.7

0.3.5

0.95’

1.19

0.84

0.56

0.95

0.87

0.75

0.32

0.35

0.91

1.32

0.81

0.59

0.89

0.78

0.89

0.33

1.38

‘2.30

‘1 .98

3.98

“2.21

‘2.43

‘2.35

‘2.20

‘1.07

93.4

94.6

91.4

91.9

93.3

92.4

94.6

94.4

95.8

93.7

95.6

90.9

92.8

93.7

92.7

94.6

94.5

95.9

91.7

90.2

93.3

87.0

91.0

92.2

95.8

92.9

95.2

2.6

1.6

3.4

2.0

3.2

2.7

2.2

2.3

2.8

2.5

1.0

3.8

2.0

2.8

2.7

2.3

2.2

2.9

2.6

3.0

1.2

0.8

4.9

3.8

0.8

3.2

3.1

1.7

2.2

2.6

3.0

1.2

0.9

1.5

1.5

0.5

1.6

2.3

2.8

2.3

1.3

0.6

1.3

1.4

0.5

2.7

2.1

1.4

8.1

1.0

3.4

3.2

0.7

1.5

1.0

1.9

1.7

1.4

2.7

1.0

1.1

0.6

1.4

0.6

1.9

1.8

1.4

2.6

1.2

1.2

0.5

1.6

3.0

2.1

0.5

0.9

4.0

0.7

1.0

0.6

0.3

0.8

1.0

0.8

0.8

0.3

0.7

0.2

0.6

0.2

0.6

0.9

0.7

0.9

0.2

0.8

0.2

1.0

1.0

2.0

1.6

1.9

0.2

0.2

0.5

0.1

0.5

0.3

0.2

0.2

0.2

0.1

0.6

0.4

0.5

0.6

2.0

0.4

1Meandiameter of the erylhema reaction greaterthan or squal to 10.5mm.

2Figurasmay not add to 100percent because of rounding.

31ncludesdata for races not shown separately.

NOTE mm = millimeter.

44
Ta41aI& Sampb siza,paroantpoalti~ standardamxa of parcantpoaftivqand parcantdistdtrutionsof tha atyhama maotionforparaons ages 6-74 yeara,to ryegrass

allatgfen,t3yma and agm UnitadStatas, 197S-60

PrxWbeskin-test

raactlonf FWcant distribution oferythema mactionz

o.t- 1o.5- a.5- 305- 40.5and

Sample Standard 10.4mm 204 mm 3.4 mm 40.4mm

Raoa and age

more

siza Percent error Omm (+/-) (l+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyaara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

lS-24yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

KF44yaarxi. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 yaara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 Ware . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-11 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 yaare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 yaara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 yaara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

W%64yeam... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

&3-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

AIIwIs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

a-llyeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16-24 yearn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

S64yeare. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15,497

1,627

1,667

1,962

2,155

1,520

1,363

2,457

&ala

13,253

1,323

1,536

1,664

1,629

1,319

1,206

2,179

2,195

1,934

266

306

251

274

166

153

250

266

10.2

9.5

14.1

16.1

127

9.4

6.1

4.6

3.7

9.9

8.6

129

15.9

12.8

9.5

6.1

4.8

3.7

11.4

14.0

220

16.4

10.2

●7.3

●29

●2.4

●26

0.56

0.66

1.27

1.37

0.78

1.13

0.87

0.63

0.36

0.53

0.94

1.31

1.31

0.60

1.11

0.91

O.ea

0.37

1.45

204

2.78

3.62

1.66

●2.39

“1.41

“0.s7

‘0.95

87.9

86.7

64.4

81.9

65.3

66.8

91.6

93.8

94.2

66.1

69.6

65.4

81.8

65.1

66.4

91.8

&3.4

94.3

87.5

85.3

77.3

63.3

67.9

92.7

92.8

97.6

%.1

1.9

1.7

1.5

2.0

20

1.9

23

1.7

21

20

1.9

1.7

23

2.0

21

21

1.7

20

1.1

0.7

0.7

0.3

1.9

4.3

1.3

2.3

2.9

3.2

3.0

24

23

1.3

1.2

1.2

2.2

2.8

25

3.1

24

23

1.4

1.2

1.1

2.6

27

7.4

2.2

1.3

2.4

0.5

0.9

0.8

3.3

3.9

4.4

5.0

4.2

2.8

2.1

1.4

1.1

3.1

3.3

3.7

4.5

4.2

2.5

2.1

1.4

1.2

4.6

6.9

8.0

6.8

3.5

3.3

0.4

1.2

0.9

3.0

2.4

4.1

4.9

3.9

2.8

1.9

1.3

1.0

3.0

21

4.0

5.0

3.9

3.1

1.8

1.4

1.1

3.1

4.4

5.4

4.1

3.5

0.9

21

0.8

1.6

0.3

25

3.2

2.2

1.4

0.7

0.7

0.3

1.7

0.3

2.8

3.2

2.3

1.6

0.8

0.7

0.4

1.1

1.2

3.3

1.9

0.7

0.2

lMearrdlmnstsroftheerythsmsmsctiorrgrsatsrthanorsqualto IDSmm.

2FQumsMSynot●dd to 100 p8HIt bCSUSS Of rounding.

%ICIWOS dataformcaaM2tShOWnS$PSmt8~.

NOTBmm = mlllimster,

45
Table 17. Sample size, percent positive, standard er?orsof percent positive, snd percent distributions of the erythema reaction for males ages 6-74 yeare, to rye grass

allergen, by race and age United States, 1976-60

Positive skin-test

reaction’ Percent distribution of erythema reaction2

—

o.1- 1o.5- 20.5- 30.5- 40.5 and

Sample Standard 10.4 mm 20.4 mm 30.4 mm 40.4 mm more

Race and age size Percent error Omm (+ l-) (l+) (2+) (3+) (4+)

All races3

Alleges, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . .

16-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years, . . . . . . . . . . . . . . . . . . . . . . . . ..7......

55-64 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16-24 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,527

626

993

943

1,040

718

660

1,183

1,164

6,463

679

613

611

679

626

592

1,046

1,017

897

124

152

112

134

70

59

125

121

12.0

11.5

15.5

20.1

14,1

11.0

7.7

4.5

4.3

11.6

11.0

14.3

19.9

14.1

11.3

7.9

4.7

4.3

12.6

12.2

23.2

18.2

13.5

‘9.6

“1.6

*2.9

●2.6

0.68

1.14

1.40

2.07

1.15

1.39

1.60

0.66

0.63

0.67

1.23

1.35

1.98

1.18

1.43

1.68

0.93

0.61

1.70

3.03

4.13

4.91

2.93

‘3.69

“ 1.26

*1.56

● 1.95

85.8

67.2

83.0

77.2

63.1

67.5

89.5

93.2

93.2

85.9

87.6

84.1

77.1

63.0

87.0

89.4

92.6

93.2

68.5

67.3

76.1

81.1

64.9

90.2

95.0

97.1

96.6

2.2

1.3

1.4

2.7

27

1.5

2.6

2.4

2.5

2.3

1.4

1.6

2.9

2.8

1.7

2.7

2.5

2.5

0.9

0.5

0.7

0.6

1.6

3.2

0.6

2.6

3.7

3.0

3.5

2.6

2.4

2.0

1.4

0.6

2.5

3.8

2.2

3.9

2.5

2.3

2.1

1.4

0.6

3.1

26

8.1

0.9

1.6

4.5

1.0

2.0

4.1

4.7

5.4

6.8

4.4

3.3

2.7

1.6

1.8

3.8

4.6

4.7

5.7

4.4

3.0

2.5

1.7

1.9

5.0

5.0

8.9

9.1

4.4

3.3

0.8

0.9

1.4

3.6

2.7

4.1

6.1

4.9

3.5

2.6

1.0

1.3

3.7

2.4

4.2

6.3

4.8

3.9

2.9

1.1

1.3

3.4

4.6

4.4

5.4

5.4

1.3

1.2

1.8

0.4

3.0

3.6

2.2

1.8

0.4

0.5

0.4

1.9

0.2

3.3

4.0

2.3

2.1

0.4

0.5

0.5

1.1

1.8

2.8

1.9

0.7

1Meandiameter of the erythema reaction greaterthan or equal to 10.5mm,

2Flgurssmay not add to 10Qparcant bacause of rounding,

31ncludesdata for racea not shown separately.

NOTE mm = millimeter.

46
Table 18. Sample size, percent positive, standard errore of pement positive, and percent distributions of the erythema reaction for fematea ages 6-74 yeare, to ry@graas

allergen, by raoe and ag~ United States, 1976-86

Positive skin-test

reaction’ Percent distribution of erythema reactionz

o.1- 1o.5- 2i15- 30,5- .W5 and

Sample Standard 10.4mm 20.4 mm 30.4 mm 40.4mm more

Race and age size Percent error Omm (+/-) (l+) (2+) (3+) (4+)

All races3

Allagas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-11 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Allagm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,970

801

894

1,019

1,115

802

723

1,274

1,342

6,7!30

644

725

853

950

693

614

1,133

1,178

1,037

142

154

139

140

98

94

125

147

8.5

7.5

12.6

123

11.3

7.8

4.6

4.7

3.1

8.2

6.1

11.5

12.1

11.6

7.9

4.4

5.0

3.3

10.4

15.6

20.7

14.9

‘7.6

“5.2

●3.8

“1.9

“2.6

0.61

1.13

1.61

1.24

0.87

1.29

1.04

0.93

0.51

0.56

1.11

1.76

1.29

0.93

1.23

1.02

1.01

0.53

1.71

3.78

3.16

4.41

“2.89

“2.49

●2.34

“0.80

“1.44

89.6

90.2

86.7

S6.3

67.4

89.9

93.5

94.3

95.0

30.1

91.6

88.7

88.2

87.2

89.7

94.1

94.0

95.1

88.3

83.4

78.5

85.1

90.2

94.6

91.0

98.1

95.8

1.7

22

1.6

1.4

1.3

22

1.9

1.0

1.8

1.7

2.3

1.6

1.7

1.2

2.5

1.6

1.0

1.6

1.3

0.8

0.8

2.2

5.2

1.6

20

20

3.4

2.5

2.3

2.1

0.7

1.0

1.5

1.9

1.8

2.8

2.4

2.2

2.3

0.6

1.1

1.6

2.3

29

6.7

3.2

0.9

0.7

1.4

2.6

3.0

3.3

3.4

3.9

2.4

1.5

1.2

0.5

2.4

2.1

27

3.3

4.1

2.0

1.8

1.2

0.5

4.1

8.7

7.2

4.9

2.9

3.4

1.5

0.6

2.5

2.2

4.1

3.7

2.9

2.2

1.3

1.6

0.8

2.4

1.9

3.8

3.8

3.1

2.3

0.8

1.7

0.9

2.9

4.2

6.3

3.1

2.0

0.6

3.8

0.6

1.4

0.3

1.9

2.6

2.1

1.1

1,0

0.9

0.2

1.5

0.3

2.2

2.5

2.2

1.1

1.2

0.9

0.3

1.1

0.6

3.7

1.9

0.6

0.4

1Meandiameterof the erythema reaction greater than or equal to 10.5mm.

2Figuresmay not add to 100percent because of rounding.

31ncludeadata for racesnot shown separately.

NOTE mm = millimeter,

47
Table19. Samplesize,peroentpositive,standarderrorsof percentpositive,and percentdl~trfbufionsof the erythemareactionfor personaagee6-74 yearn,to Bermuda

graaaallargen,by race and afyx UnitedStates, 1976-80

Positive skin-test

reaction’ Fement distribution of erythema reactionz —

o.1- 1o.5- 205- 30.5- 40.5and

Sample Standard 10.4 mm 20.4 mm 30.4 mm 40.4 mm

Race and age

more

size Percent error O mm (+ /-) (l+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15,523

1,628

1,894

1,984

2,155

1,523

1,385

2,464

2,510

13,277

1,323

1,543

1,387

1,831

1,323

1,207

2,184

2,199

1,937

267

308

250

272

165

154

253

268

4.4

3.0

6.7

7.0

5.2

4.7

3.1

2.0

1.2

4.2

2.6

6.6

6.6

5.3

4.3

2.7

2.1

1.2

5.1

*4.4

6.4

“1O.7

4.3

“5.4

● 2.8

‘0.6

‘0.2

0.42

0.47

1.10

0.99

0.52

0.92

0.83

0.40

0.28

0.43

0.45

1.20

0.92

0.57

0.92

0.88

0.45

0.30

0.8s

“1.37

1.67

●3.65

0.98

‘ 1.92

“1.44

‘0.38

“0.21

93.9

95.7

91.7

91.1

92.7

93.7

94.9

98.6

97.3

94.0

96.0

91.5

91.6

92.7

93.9

95.1

98.3

97.2

93.8

95.2

92.7

87.2

93.5

94.0

98.2

99.4

88.8

1.7

1.3

1.6

1.8

2.0

1.6

2.0

1.4

1.5

1.8

1.4

1.8

1.8

1.9

1.7

2.1

1.6

1.5

1.1

0.4

0.9

2.2

2.2

0.6

1.0

0.9

1.5

1.6

25

20

1.7

1.4

0.8

0.7

0.5

1.4

1.4

2.3

1,8

1.9

1.2

0.5

0.7

0.5

1.8

1.9

3.1

2.7

0.7

1.7

2.4

0.2

0.2

1.8

1.2

2.5

3.1

2.1

1.9

1.3

0.8

0.4

1.7

0.9

2.3

3.0

2.1

1.8

1.0

0.9

0.3

2.1

2.1

3.0

5.0

1.3

2.2

0.4

0.2

1.0

0.3

1.4

1.8

1.2

0.9

0.8

0.5

0.3

1.0

0.3

1.7

1.6

1.1

1.0

0.9

0.5

0.3

1.0

0.5

0.3

2.9

2.3

0.2

0.2

0.3

0.2

0.2

0.5

0.2

0.2

0.3

0.2

0.2

0.3

0.2

0.2

1.6

lMean diameter of the erythema reaction greater than or equal to

2Figureamay not add to lGOpercent because of rounding.

31ncludesdata for races not shown separately.

NOTE mm = millimeter.

10,5mm.

48
Table 20. Sample size, percent positive, standard errors of percent positive, and persent distributions of the erythems reaction for males ages 6-74 yesrs, to Bermuda

grass allergen, by race and age United States, 1976-60

Positive skin-test

reaction’ Percent distribution of erythems resctionz

0.7- 1o.5- 2115- 30.5- 40.5 and

Sample Standard 10.4 mm 204 mm 30.4 mm 40.4 mm more

Race and age size Percent error Omm (+/-) (7+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyei]rs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 yaars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 yaars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,536

826

996

944

1,039

721

660

1,187

1,165

6,475

679

815

813

8=W

629

592

1,049

1,018

896

124

153

111

132

70

59

126

121

4.9

3.4

7.0

7.9

6.4

4.6

*3.5

“1.3

‘1.2

4.8

3.2

6.9

7.8

6.6

4.3

*3.3

*1.4

1.3

4.3

●3.2

*6.4

*8.5

●4.2

“6.4

0.46

0.65

1.18

1.48

0.75

0.91

‘1.20

‘0.39

‘o.%

0.51

0.66

1.22

1.53

0.81

0.97

*1.25

“0.44

0.39

1.06

“1.93

●2.36

●4.32

‘1.94

●3.23

93.2

95.1

91.2

89.8

91.5

93.3

94.3

97.0

96.8

93.2

95.2

91.2

90.1

91.4

93.5

94.4

98.7

96.7

93.9

96.8

92.7

87.2

924

923

97.9

100.0

96.6

2.0

1.5

1.7

2.3

2.2

2.1

2.2

1.7

2.0

20

1.6

20

21

2.0

2.2

2.2

1.9

2.0

1.8

0.9

4.3

3.3

1.3

21

1.4

1.4

1.7

2.0

1.7

2.4

0.8

0.6

0.7

0.6

1.4

1.9

1.8

1.5

2.6

0.7

0.4

0.8

0.7

1.2

0.6

2.3

2.1

1.0

2.0

2.2

1.5

3.0

4.0

2.8

2.7

1.5

0.4

0.4

2.2

1.2

2.6

4.2

2.7

2.5

1.3

0.5

0.5

20

26

3.5

2.8

2.2

1.7

0.9

0.1

1.5

1.9

0.9

0.7

1.4

0.1

0.2

1.0

0.2

1.7

1.8

1.0

0.8

1.6

0.1

0.2

0.6

0.6

3.6

1.0

0.2

0.5

0.3

0.3

0.5

0.1

0.2

0.7

0.3

0.3

0.3

0.1

0.3

2.7

1Mean diameter of the erythema reaction greaterthan or equal to 10.5mm.

‘Figures may not add to 100percent because of rounding.

31nclud(?sdata for races not shown separately,

NOTE mm = millimeter.

49
Tabla21, Sampla aiza,percentposltiva,standardarroraof percentposltiva, and parcant diatributlons of tha erythamareactionforfemalasagaa 6-74 yaara, to Bermuda

graaa allergen, by race and age Urrltad Statea, 1976-80

Positive skin-test

reactionl Percent dlstrlbutlon of erythema reactlonz —

0.1- 1o.5- 20.5- 30.5- 40.5 and

Sample Standard 10.4 mm 204 mm 30.4 mm 40.4 mm more

Race and age size percent error Omm (i- /-) (1+) [2+) (3+) (4+)

All racas3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8-n yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

85-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyaara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,985

802

898

1,020

1,116

802

725

1,277

1,345

6,802

644

728

854

951

694

615

1,135

1,181

1,041

143

155

139

140

95

95

127

147

4.1

2.6

6.4

6.3

4.1

4.7

2.8

2.6

1.2

3.7

2.0

6.4

5.5

4.0

4.3

2.1

2.8

“1.2

5.8

‘5.7

“6.4

* 12.4

“4.3

‘4.6

‘5.3

*1.1

‘0.4

0.44

0.69

1.28

0.94

0.58

1.14

0.88

0.65

0.35

0.43

0.66

1.40

0.87

0.56

1.09

0.58

0.72

“0.40

1.08

*1.83

‘2.38

“4.01

“2.10

●2.46

*2.68

“0.69

“0.37

94.5

98.4

92.1

92.4

93.9

94.1

95.4

96.2

97.7

94.7

98.9

91.9

93.0

94.1

94.4

95.8

95.9

97.6

93.7

93.6

92.7

87.2

94.3

95.4

94.7

98.9

99.0

1.4

1.0

1.5

1.3

1.9

1.2

1.8

1.2

1.1

1.5

1.1

1.6

1.5

1.9

1.3

2.0

1.3

1.2

0.6

0.7

0.9

0.5

1.4

0.6

1.5

1.4

3.0

2.3

1.1

1.9

1,0

0.6

0.4

1.4

1.0

2.8

2.1

1.2

1.6

0.7

0.7

0.4

2.3

3.1

3.9

3.2

0.5

1.5

4.4

0.3

0.4

1.4

0.8

2.0

2.3

1.5

1.2

1.1

1.2

0.3

1.3

0.6

2.0

1.7

1.4

1.1

0.8

1.3

0.2

2.2

1.6

2.5

6.7

0.5

2.5

0.8

0.4

1.0

0.5

1.4

1,6

1.5

1.1

0.2

0.8

0.4

1.0

0.4

1.6

1.5

1.2

1.3

0.3

0.8

0.5

1.1

1.0

2.4

3.3

0.4

0.1

0.1

0.1

0.4

0.4

0.2

0.1

0.1

0.4

0.5

0.1

0.6

1Mesndiametaroftheerythsmareactiongreaterthsnorequalto 10.5mm,

2Figurea may not add to 1W percent because of rounding.

31ncludes data for races not shown separately.

NOTE mm = mllllmster.

50

. .
Table 22. Sample size, percent positive, standard errors of percent positive, and percent distributions of the erythema reaction for persons ages 6-74 yeare, to ragweed

allergen, by race and agtx United States, 1976-80

Positive skin-test

reaction’ Percent distribution of erythema reactionz

o.f- 1o.5- 20.5- 30.5- 40.5and

Sample Standard 10.4mm 20.4 mm 30.4 mm 40.4 mm more

Race and age size Percent error Omm ( +/-) (l+) (2+) (3+) (4+)

All races3

All ages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Allagea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15,450

1,620

1,8433

1,951

2,140

1,513

1,380

2,454

2,509

13,214

1,316

1,531

1,658

1,816

1,313

1,207

2,176

2,199

1,930

267

309

248

273

168

150

2.50

287

10.1

8.7

12.0

14.5

12.6

10.7

7.3

5.7

4.5

9.7

7.5

11.9

13.9

12.1

10.4

7.2

5.7

4.4

13.5

15.0

14.8

21.1

17.1

11.3

4.8

“6.3

5.4

0.57

0.70

1.03

1.13

0.79

1.04

0.97

0.66

0.48

0.51

0.62

0.98

0.98

0.88

1.04

1.04

O.m

0.51

2.34

2.47

3.25

4.40

3.39

295

1.41

“3.02

1.17

86.9

88.6

85.0

82.4

84.2

88.1

89.8

91.3

92.2

87.2

89.3

85.3

82.8

84.6

86.6

90.0

91.3

92.2

84.2

64.4

62.1

77.5

79.6

84.8

921

921

92.6

3.0

2.8

3.0

3.1

3.2

3.2

2.8

2.9

3.3

3.1

3.1

2.9

3.3

3.3

3.0

2.8

29

3.4

24

0.6

3.1

1.4

3.1

4.0

3.1

1.7

2.1

3.6

4.7

4.0

5.2

3.7

3.7

2.9

2.0

1.6

3.4

3.9

3.7

5.0

3.5

3.3

2.9

2.1

1.4

5.2

8.2

5.9

8.1

5.1

4.6

1.0

1.3

2.7

3.7

25

4.9

4.7

5.6

3.2

27

23

1.7

3.6

2.2

5.0

4.7

5.5

2.8

2.6

2.4

1.8

4.7

4.6

5.4

5.3

6.8

5.5

3.2

1.4

1.5

2.1

1.2

2.2

3.4

2.7

2.6

1.6

1.0

1.0

2.1

1.2

2.3

3.2

2.5

3.0

1.5

1.0

1.0

2.5

1.6

2.5

5.0

4.8

0.6

1.2

1.2

0.6

0.3

0.8

1.1

0.6

1.2

0.1

0.4

0.2

0.6

0.2

0.9

0.9

0.7

1.2

0.1

0.2

0.3

1.1

0.6

0.9

2.8

0.4

1.2

2.4

lMearr diameter of the erylhema reaction greater than or equal to 10.5 mm.

2Flguras may not add to 1W percent because of rounding.

31ncludes data for races not shown separately.

NOTE mm = millimeter.

51
Table 23. Sample size, percent po$itive, standard errore of percent positive, and persent cfktnbutiona of the erythema reaction for males ages 6-74 yeara, to ragweed

allergen, by race and age United States, 1976-60

Positive skin-test

reactionl Percent distribution of erythema reactionz

o,7- 70.5- 20.5- 30.5- 40.5 and

Sample Standard 10.4 mm 20.4 mm 30.4 mm 40.4 mm

Race and age

more

size Percent error Omm (+ /-) (1+) (2+) (3+) (4+)

Al I races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,508

822

991

939

1,032

716

659

1,183

1,166

6,447

675

810

808

873

624

592

1,046

1,019

895

124

153

111

133

70

56

125

121

11.6

9.6

“12.8

17.6

14.8

11.8

9.2

5.8

5.1

11.6

8.7

13.0

17.6

14.9

11.7

9.1

6.0

5,2

12.7

14.1

14.4

21.7

17.2

‘9.5

‘3.5

●4.6

‘3.7

0.70

1,09

1.34

1.62

1.14

1.50

1.66

0.99

0.74

0.65

1.14

1.24

1.46

1.31

1.53

1.65

1.10

0.76

2.91

3.60

4.57

6.01

4.17

“4.04

“1 .88

“2.41

‘2.80

85,3

87.9

84.3

79.3

81.7

85.1

87.8

90.8

91,4

85.3

68.6

84.2

79.3

81.4

85.5

87.5

90.6

91.0

85.2

85.5

82.2

75.8

80.8

86.1

95.2

95.4

95.6

3.1

2.5

2.9

3.1

3.4

3.1

3.1

3.4

3.5

3,2

2.7

2.7

3.1

3.7

2.8

3.3

3.4

3.8

2.1

0.4

3.4

2.6

2.0

4.4

1.4

0.8

4.0

5.1

4.7

7.3

3.2

3.1

3.4

1.7

1.7

3.6

4.0

4.4

6.7

3.3

2.3

3.4

1.8

1.6

6.3

9.7

7.5

13.0

3.8

4.8

2.1

1.1

1.3

4.4

2.8

4.1

5.6

7.7

3.4

3.3

2.9

2.0

4.5

2.8

4.4

6.0

7.7

3.4

3.3

3.0

2.2

3.9

3.2

3.6

4.3

8.7

3.0

1.3

3.0

1.1

2.8

1.5

2.8

3.5

3,3

3.7

2.4

1.2

1.1

2.8

1.6

3.0

3.7

3.4

4.3

2.5

1.3

1.2

1.6

1.2

2.3

2.4

3.7

1.2

0.7

0.2

1.2

1.3

0.5

1.6

0.3

0.7

0.3

1.2

1.2

0.5

7.7

0.3

0.9

1.0

2.1

1.0

1.7

0.5

1Mean diameter of the efyth ema reaction greater than or equal to

‘Figures may not add to 100 percent because of rounding.

31ncludes data for races not shown separately.

NOTE mm = millimeter.

10.5 mm.

52
Table 24. Sample size, percent positive, standard errora of percent positive, and pwcent distributions of the erythema reaction for females ages 6-74 yeare, to ragweed

allergen, by race and age United States, 1976-80

Positive skin-test

reacfiorr’ Percent distribution of erythema reaction2

0.1- 1o.5- 20.5- 30.5- 40.5 and

Sample Standard 10.4 mm 20.4 mm 30.4 mm 40.4 mm more

Race and age size Percent error Omm ( +/-) (7+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n year s. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,942

796

692

1,012

1,108

797

721

1,271

1,343

6,767

641

721

848

943

689

615

1,130

1,160

1,035

143

156

137

140

96

92

125

146

8.6

7.8

11.1

11.5

10.4

9.6

5.6

5.6

4.1

7.9

6.4

10.7

10.3

9.4

9.1

5.3

5.5

3.7

14.1

15.9

15.2

20.6

17.0

12.7

‘6.0

“7.8

6.6

0.54

1.09

1.31

1.24

0.92

1.15

0.95

0.94

0.62

0.47

0.94

1.31

1.24

1.01

1.20

0.99

0.97

0.67

2.14

4.36

3.53

5.27

3.97

3.46

‘2.06

‘3.67

1.97

88.4

89.2

85.7

85.4

66.6

67.1

91.8

91.6

92.8

89.1

90.1

86.3

86.2

87.8

87.6

92.3

92.0

93.2

83.3

83.3

62.1

78.9

79.1

83.7

89.4

89.1

90.4

3.0

3.0

3.2

3.1

3.0

3.2

2.6

2.6

3.2

3.0

3.5

3.0

3.5

2.8

3.3

2.4

2.5

3.1

2.6

0.7

2.7

0.5

3.9

3.6

4.7

3.1

3.0

3.3

4.2

3.2

3.3

4.1

4.4

2.4

2.3

1.5

3.1

3.9

3.1

3.3

3.7

4.3

2.5

2.4

1.3

4.2

6.8

4.3

4.1

6.0

4.5

1.4

3.7

3.1

2.2

5.7

3.9

3.6

2.9

2.2

1.8

1.4

2.8

1.5

5.6

3.6

3.2

2.2

2.0

1.9

1.4

5.4

5.9

7.4

6.1

5.4

7.6

4.9

1.7

1.6

1.0

1.7

3.3

2.0

1.6

0.8

0.9

0.9

1.4

0.8

1.5

2.8

1.6

1.6

0.6

0.8

0.8

3.2

2.1

2.8

7.0

5.6

1.1

2.3

1.1

0.6

0.3

0.5

1.0

0.7

0.8

0.2

0.7

0.2

0.5

0.1

0.5

0.7

0.8

0.8

0.2

0.4

0.3

1.2

1.2

0.7

3.4

0.7

4.0

I Meand!ameter of the erythema reaction greaterthan or equal to 10.5mm.

‘Figures may not add to lIYJpercent because of rounding.

31ncludesdata for races not shown separately.

NOTE mm = millimeter.

53
Table 25. Sample size, percent positiie, standard errors of percent Positive, and Percent diatnbutions of the erythema reaction for persons sgea 6-74

years, to ragweed allergen (h~h pollen regions-Northeast and IWdweat), by rase and age: United States, 1976-8o

Positive skin-test

reaction’ Percent distribution of erythema reactionz

o.1- 1o.5- 20.5- 30.5- 40.5 and

Sample Standard 10.4 mm 20,4 mm 30.4 mm 40.4 mm

Race and age

more

size Percent error Omm ( +/-) (l+) (2+) (3+) (4+)

Al I races3

Alleges ...,..,..,..,..,..,..,.. . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years.............,..,..,.. . . . . . . . . . . . .

18-24 years ., . ., . ., . ., . .,..,..,. . . . . . . . .

25-34 years ., . ., . ., . ., . .,..,..,. . . . . . . . . .

35-44 years.,..,..,..,..,..,..,.. . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . ., . ., . ., . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years..........,........,.. . . . . . . .

12-17 years...,..,..,..,..,..,.. . . . . . . . . . . . . .

18-24 years...,..,..,..,..,..,.. . . . . . . . . . .

25-34 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years.......,..,..,..,..,.. . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years................,..,.. . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,613

783

912

1,015

1,061

752

689

1,216

1,185

6,703

648

772

907

929

665

617

1,089

1,076

849

129

130

100

120

79

67

122

102

13,2

13,3

16.0

19.4

15.5

13.7

10.1

6.7

5.7

13,0

17,6

15,6

19.2

15.1

13.4

10.3

7.2

5.8

15.6

21,6

19.6

21.3

19.3

15.8

“6.1

“2.0

5.0

0.67

1.”10

1.55

1.60

0.[15

1,46

1.76

0.97

0.70

0.66

1.01

1.54

1,52

0.91

1.54

1.91

1.0,3

0.74

2.26

4.12

4,16

5,29

3.25

3.8$)

‘2.6zI

“1.41

1.54

83.6

83,3

80.7

77.7

81.4

84.2

66.6

89.4

91.1

83.9

84.4

81.5

77.9

81.6

84.4

86.3

86.8

90.9

82.7

77.6

77.5

76.7

78.2

83.3

90.6

95.0

93.4

3.1

3.3

3.3

2.9

3.1

2.1

3.3

3.9

3.2

3.2

3.8

2.9

2.9

3.2

2.2

3.4

4.0

3.4

2.1

0.8

2.8

2.0

2.5

1.0

3.3

3.1

1.6

4.5

7.4

5.1

6.4

4.3

4.7

3.0

2.0

1.7

4.2

6.2

4.6

6.2

4.3

4.4

3.2

2.1

1.6

6.6

12.8

9.2

9.3

3.9

6.5

1.1

0.8

2.9

5.1

3,8

7.4

6.7

7.2

3.6

4.1

2.9

2.3

4.9

3.2

7.1

6.9

6.7

3.1

4.1

3.1

2.3

6.9

7.7

9.3

4.6

12.0

6.7

5.0

1.1

2.1

3.0

1.8

3.1

4.9

3.2

4.0

2.7

1.6

1.6

3.2

1.9

3.4

4.8

3.3

4,5

2.8

1.7

1.8

1.7

1.2

1.3

5.2

3.3

0.7

0.4

0.5

1.4

0.7

1.5

0.2

0.3

0.1

0.7

0.4

0.5

1.3

0.8

1.4

0.2

0.3

0.2

0.6

2.2

2.5

1Mean diameter of the erythema reaction greater than or equal to 10,5 mm,

2Figures may not add to 100 percent because of rounding.

31ncludes data for races not shown separately.

NOTE mm = millimeter.

54
Table 26. Sample size, percent poeitiie, standard errors of percent pm-tie, end percent distributions of the erytherna reaction for males ages 6-74

yea~ to ragweed eHergen (high @en regions-krtheaat and hliiest~ by race end agfx United Stateq 1976-60

Positive skin-test

reaction’ Percent distribution of erythema reactionz

o.1- 1o.5- 20.5- 30.5- 40.5and

Sample Standard 10.4mm 20.4 mm 30.4 mm 40.4mm more

Race and age size Percent error Omm (+/-) (l+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 year s. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 yaars, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

85-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3,691

397

471

4$9

501

365

336

5a5

537

3,280

336

404

452

441

328

313

520

484

380

54

61

44

53

32

22

65

49

15.3

15.3

17.4

22.0

18.9

74.8

122

7.0

7.0

15.3

13.5

17.2

21.8

18.7

15.5

13.1

7.5

7.5

16.2

*24.9

20.3

“25.3

25.4

“8.7

●

*2.2

“1.1

0.80

1.52

1.33

2.39

0.99

2.16

2.87

1.51

1.15

0.83

1.71

1.51

2.22

1.01

2.31

2.98

1.66

1.28

2.85

●6.64

4.28

*1O.12

3.74

“5.81

.

“2.26

“1.08

81.5

81.4

79.7

75.8

77.5

83.0

84.5

8a.5

88.7

81.4

82.6

80.0

76.1

77.8

623

83.4

87.6

87.8

81.9

75.1

77.3

71.9

69.2

89.2

*

97.6

98.9

3.2

3.3

2.9

2.2

3.5

2.1

3.3

4.5

4.3

3.3

3.9

2.8

2.1

3.4

2.2

3.6

4.9

4.7

1.9

24

2.9

5.4

2.2

●

5.1

7.9

6.7

8.4

4.2

4.3

3.2

1.8

2.0

4.7

6.2

6.0

7.6

4.6

4.1

3.3

20

22

8.3

16.5

12.8

17.7

1.1

4.7

.

5.7

4.8

6.0

7.6

9.7

28

4.9

3.5

2.6

5.7

4.5

6.1

7.9

9.1

3.2

5.3

3.6

2.8

6.0

7.5

5.9

5.0

19.6

.

2.2

1.1

3.8

2.0

3.8

4.9

4.5

5.2

4.2

1.7

2.0

4.1

2.3

4.1

5.2

4.5

5.8

4.5

1.9

22

1.2

0.9

1.6

1.1

4.7

*

0.8

0.5

0.9

1.2

0.5

2.5

0.3

0.8

0.6

1.1

1.2

0.5

2.4

0.4

0.7

1.5

4.0

●

1Mean diameter of ths srythsma reaction greater than or equal to 10.5mm,

+igurss ~lay not add to i m percent bscause OfrOundin9.

31ncludesdata for races not shown separately.

NOTE mm = millimeter.

55
Table 27. Sample size, percent pos”tie, standard errore of percent positiie, and peroent distributions of the erythema reaction for females ages 6-74

yeare, to ragweed allergen (hiih pollen region~ortheast and Mkhvest), by race and agfx United States, 1976-S0

Positive skin-test

reaction’ Percent distribution of erythema reactionz

o.7- 1o.5- 20.5- 30.5- 40.5 and

Sample Standard 10.4 mm 20.4 mm 30.4 mm 40.4 mm more

Race and age size Percent error Omm ( +/-) (7+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Ailages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3,922

366

441

516

560

387

353

631

846

3,423

310

368

455

488

337

304

569

592

489

75

69

56

67

47

45

57

53

11.3

11.4

14.6

16,8

12.2

12,7

7.9

6.4

4.7

10.7

10.0

14.0

16.5

11.6

11.4

7.6

6.9

4.5

15.5

‘19.0

●19.3

18.0

●15.7

21.3

●8.5

‘1.7

‘8.0

0.74

1.90

2.11

2.04

1.37

1.77

1.60

1.33

0.83

0.6!>

1.79

1.97

2.07

1.61

1.8[1

1.87

1.47

0.87

2.3[1

*6.7$1

●6.81

2.71

‘6.15

5.ICI

*3.91

“1.43

“2.84

85,6

85.2

81.7

79.6

85.0

85.3

8a.7

90.2

92.9

86.2

86.2

83.0

79.9

85.3

86.3

89.3

69.9

93.2

62.3

79.6

77.6

80.8

83.6

78.7

85.9

92.0

89.2

3.1

3.4

3.7

3.6

28

2.0

3.3

3.4

3.4

3.1

3.7

3.1

3.6

3.1

2.3

3.1

3.2

2.4

2.3

1.5

3.1

1.3

0.8

5.5

6.3

2.8

3.9

6.8

3.5

4.5

4.3

5.1

2.8

2.1

1.4

3.8

6.3

3.1

4.8

4.1

4.8

3.2

2.2

1.1

5.2

9.7

6.2

2.3

5.6

7.9

1.7

5.0

4.5

2.9

8.7

5.9

4.9

4.3

3.4

2.4

2.0

4.0

2.0

8.2

5.9

4.4

3.0

2.8

2.6

1.9

7.7

7.8

12.1

4.2

7.6

12.0

8.5

2.9

2.3

1.5

2.3

4.9

2.1

2.8

1.3

1.4

1.4

2.3

1.5

2.6

4.4

2.0

3.2

1.1

1.6

1.5

2.0

1.5

1.0

8.6

2.5

0.6

0.2

1.6

0.9

0.5

0.4

0.5

0.6

0.3

1.4

1.1

0.3

0.5

0.6

0.6

2.8

1.4

1Mean diameter of the erythema reaction greater than or aqual to 10.5 mm.

‘Figures may not add to 100 percent because of rounding.

31ncludes data for racea not shown separately.

NOTE mm = millimeter.

56
Table 28. Sample size, percent posithre, standard errors of percent poeitiwj and percent dMibutm“ ns of the erytheme reeotion for pereons ages 8-74

yeara, to ragweed sffergen (low pollen ragione-south and West), by raoe and sw United Stetesj 1978-80

Positive skin-test

reaction’ percent distribution of erythema reaction2

o.1- 1o.5- 20.5- 30.5- 40.5and

Sample Standard 10.4mm .Z14mm 30.4 mm 40.4mm more

Race and age size Percent error Omm (+/-) (1+) (2+) [3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Ailages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Allages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,837

637

971

936

1,079

761

691

1,23a

1,324

6,511

688

759

749

867

848

5SQ

1,087

1,123

1,081

13a

179

148

153

87

83

126

185

7.2

4.6

6.5

9.8

10.0

7.9

4.9

4.8

3.4

6.5

3.6

8.5

8.3

9.3

7.5

4.2

4.4

3.0

*11.7

9.3

“11.2

21.0

*15.5

‘7.5

“3.9

*1O.3

5.6

0.91

0.74

1.37

1.83

1.27

1.49

0.98

0.82

0.61

0.78

0.65

1.32

1.15

1.36

1.48

0.93

0.76

0.65

●3.66

2.22

●4.63

6.54

‘5.51

●4.31

‘1.72

‘4.37

1.84

89.8

93.2

66.6

88.6

68.7

87.9

92.8

93.1

93.2

90.5

93.9

66.7

87.9

87.5

68.7

93.5

93.8

83.6

65.7

90.3

65.5

78.0

81.0

86.0

93.1

69.3

921

3.0

2.3

2.8

3.3

3.3

4.2

23

2.0

3.4

3.0

2.5

2.8

3.8

3.3

3.8

23

1.9

3.4

2.6

0.4

3.3

1.1

3.5

6.5

3.0

0.3

2.3

2.8

2.3

3.0

4.1

3.2

29

2.8

2.0

1.5

26

1.8

3.0

3.7

28

2.2

2.7

2.2

1.3

4.2

4.3

3.6

7.3

5.9

3.1

0.9

1.7

2.6

2.5

1.4

2.9

28

4.2

2.8

1.5

1.8

1.1

2.4

1.2

3.1

2.4

4.3

2.5

1.2

1.7

1.2

3.1

1.9

2.7

5.7

3.0

4.4

1.9

1.7

1.1

1.3

0.8

1.5

2.0

2.1

1.4

0.5

0.5

0.4

1.0

0.6

1.2

1.5

1.7

1.6

0.3

0.4

0.1

3.1

2.0

3.4

4.8

5.9

1.0

2.4

1.9

0.6

0.2

1.2

0.9

0.5

0.9

0.5

0.3

0.5

1.2

0.6

0.5

1.1

0.1

0.4

1.4

1.1

1.5

3.1

0.8

4.6

lMean diamster of the erythema reaction greaterthan or equal to 10.5mm.

‘Figures maynotadd to 1(XIpercent because of rounding.

31ncludesdata for races not shown separately.

NOTE mm = millimeter.

57
Table 29. SSMple size, peroent positive, standard emors of percent positive, and percent distnbutiona of the erythema reaction for males ages 6-74

yeare, to ragweed allergen (low pollen regions-south and West), by race and age: United States, 1978-60

Positive skin-test

react/onl Percent distribution of erythema reaction2 —

0.1- 1o.5- 20.5- 30.5- 40.5and

Sample Standard 10.4mm 20.4mm 30.4 mm 40.4mm more

Race and age size Percent error Omm (+ /-) (l+) (2+) (3+) (4+)

All races3

Allages . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 yeara . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3,617

425

520

440

531

351

323

598

629

3,167

337

406

356

432

296

279

526

535

515

70

92

67

80

38

36

60

72

8.3

4.7

9.0

13.2

11.2

9.1

6.2

4.7

3.4

7.9

4.3

9.2

12.8

11.3

7.9

5.2

4.6

3.0

‘ 10.4

*5.9

*1O.8

● 19.4

“12.5

*1 0.2

“4.0

“7.3

*5.3

1.13

1.14

2.15

2.25

1.94

2.16

1.88

1.14

0.83

1.01

1.12

1.93

1.80

2.29

2.25

1.53

1.30

0.80

‘4.49

*2.81

“7.02

“8.14

‘8.22

“5.66

●2.41

*3.78

‘4.93

88.6

93.5

66.1

82.7

85.4

87.0

90.9

93.0

93.9

89.0

94.0

88.2

63.0

84.7

88.7

91.7

93.5

94.1

87.4

93.3

85.1

78.2

87.5

83.6

93.9

92.7

93.5

3.1

1.8

2.9

4.1

3.4

3.9

2.9

2.3

2.7

3.1

1.6

2.7

4.2

4.0

3.4

3.0

1.8

2.9

2.3

0.8

4.1

2.4

6.2

2.2

1.3

3.0

2.7

3.0

6.1

2.4

2.0

3.7

1.6

1.4

2.6

2.0

2.9

5.8

2.1

0.6

3.5

1.6

1.0

5.0

4.5

4.4

10.1

5.4

4.9

1.8

2.3

2.2

3.2

1.1

2.6

3.6

6.0

3.9

1.8

2.4

1.5

3.2

1.3

2.9

3.8

6.4

3.6

1.3

2.3

1.6

2.6

2.2

3.8

2.5

5.3

2.1

4.0

1.2

1.6

1.0

2.0

2.0

2.4

2.3

0.8

0.7

0.3

1.6

1.0

2.0

2.0

2.4

2.6

0.4

0.7

0.1

1.8

1.4

2.7

3.1

3.1

1.9

0.6

1.4

1.3

0.5

0.6

0.1

0.2

0.6

1.4

1.2

0.4

0.9

0.2

1.0

1.6

2.4

1.6

1.1

1Meandiameter of the erythema reaction greaterthan or equal to 10.5mm.

‘Figures may not add to 103percent because of rounding.

31ncludesdata for racesnotahown separately.

NOTE mm = millimeter.

58
Tebla 30. sample size, percent positiie, standard errors of percent positive, and percent distributions of the erythema reaction for females agea 8-74

years, to ragweed allergen (low pollen region-uth and West), by raoe and age United States, 1976-80

Positive skin-test

reaction’ Percent distribution of erythema reactior?

0.1- 1o.5- 20.5- 30.5- 40.5and

Sample Standard 10.4mm 20.4 mm 30.4 mm 40.4mm more

Race and age size Percent error Omm (+/-) (l+) (2+) (3+) (4+)

All races3

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-llyew’s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

White

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Black

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45-54 )ears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4,020

412

451

498

548

410

368

840

695

3,344

331

353

393

455

352

311

581

588

566

68

87

81

73

49

47

68

93

6.2

4.5

8.1

6.6

8.6

6.9

3.6

5.0

3.4

5.2

“29

7.7

4.2

7.3

7.1

●3.2

4.1

“2.9

13.0

13.0

11.6

●22.2

18.3

“5.1

‘3.7

‘12.6

“5.8

0.79

1.09

1.60

1.44

1.18

1.48

1.CMJ

1.35

0.93

0.88

“0.89

1.75

1.17

1.13

1.55

R1.01

1.30

“1.01

3.26

4.26

3.43

*7.92

5.63

‘4.04

●2.32

●5.03

‘2.80

909

92.8

89.2

90.5

8a.o

8&7

94.6

93.3

92.7

91.9

93.7

89.3

92.4

90.2

88.7

95.1

94.0

93.2

84.7

67.0

66.0

77.8

74.9

88.2

92.4

86.8

91.1

2.9

2.8

2.8

2.7

3.2

4.3

1.9

1.8

3.9

2.9

3.4

2.9

3.4

2.5

4.2

1.7

1.9

3.9

29

2.4

6.8

6.8

3.9

0.6

3.1

2.7

1.9

2.9

2.3

4,0

3.7

2.0

2.5

1.6

2.6

1.E1

3.0

1.8

3.4

3.8

1.9

2.6

1.5

3.4

4.0

2.6

5.2

6.4

1.4

1.2

2.9

1.9

1.7

3.1

2.1

2.4

1,7

1.2

1.3

0.8

1.6

1.1

3.2

1.2

2.1

1.5

1.2

1.2

0.8

3.5

3.9

3.2

7.2

3.4

3.6

1.7

1.0

1,0

0.6

1.1

1.9

1.9

0.4

0.4

0.4

0.5

0.5

0.2

0.5

1.2

1.1

0.5

0.2

0.1

4.2

2,7

4.4

6.1

8.5

2.0

4.2

1.8

0.6

0.3

1.0

0.6

0,5

1.1

0.9

0.5

0.5

1.0

0.6

1.3

0.2

0.5

1.8

2.3

1,4

3.7

7.2

1Meanciameter of the erythema reaction greaterthan or equal to 10.5mm.

‘Figures may not add to 1W percent because of roundfng.

31ncludEs data for races not shown separately.

NOTE rlm = millimeter.

59
Table 31. Mednn size of positive ekin-test reaction to indtiual alfwgens for perems ages 8-74 yeara, by race and sge United Steteq 1978-80

Individual All races’ White Black

a//ergen Both sexes Male Female Both sexes Male Female Both sexes Male Female

Median in millimeters

House dust ., . ., . ., . ., . .,, .,.,,.., ... ..,.. 20,0 20.5 19.0 20.0 21.0 19.0 18.5 18.0 18.5

Alternaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.0 21.5 22.5 22.5 22.0 22.5 20.0 20.0

Cat. ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

21.0

20.0 20.0 21.0 20.5 20.0 21.0 18.0 17.0 19.5

Dog . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.0 20.5 19.0 20.0 20.0 20.0 17.0 23.0 17.0

Ragweed —allregions. .,..,..,..,.. . . . 24.0 25.0 23.0 24.5 25.0 22.5 230 20.5 25.0

Ragweed — high pollen regionsz, . . . . . . . . 25.0 25.0 24.0 25.0 25.5 24.0 22.5 20.0 24.0

Ragweed — low pollen regionsa . . . 23.0 23.5 22.5 22.5 24.0 2Q.5 26.0 21.5 27.5

Oak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.0 23.0 23.0 23.0 23.5 23.0 22.5 22.5 20.5

Ryegrass. .,..,..,..,..,..,..,.. . . . . . . . . . . 29.0 29.0 29.0 29.5 29.5 30.0 27.5 27.5 27.0

Bermuda grass,..,.....,..,..,.. . . . . . . . . 24.0 25.0 23.5 25.0 25.5 23.5 23.5 25.0 23.5

~Includes data for races not shown separately.

‘Northeast, Midwest.

3South, West.

60
Appendixes

Contents

I. &atisticai notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

lntroductian . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

!Wrveydesign. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..62

Estimati,on procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

Nonresponse bias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

Standard deviaticms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...66

Wmdarderroas....... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..66

Data limitations andreliability. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

.4nalytic methodology .,.... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

11. Da{a quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6S

inter.e~aminer va~iahility. , ................... ................... ............... 68

Skin ccdor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

Histamine reactivity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

Methodofal?ergenm anufacture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

HI. Definition ofterms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

Listofappendixtables

I. Number ofexamined persons intheallergy skin-test sample mdestimated ppulation, by race, sex, andage: Second

Nationa[ Health wrd Nutrition Examination Survey, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11. Percent distribution of nonresponse adjustment factors: Second National Health and Nutrition Examination Survey:

United States, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

111. Samplesiz eandpercen tresponsefor allergy skin-test subsample, byselected characteristics: Second National Health

and Nutrition Examination Survey, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

IV. Reportedprevalerrce ofselectedallergies forpersons ages &74yems, byintewiewed-nonexaminedversus interviewedexamined sample persons: Second National Health and Nutrition Examination Survey, 1976-80 . . . . . . . . .

v. Reported prevalence of selected allergies for persons ages 6-74 years, by examined nonskin-tested versus examined

skin-tested sample persons: Second National Health and Nutrition Examination Survey, 1976-80 . . . . . . . .

W. Size ofreaction tothenegati\~e control (diluent) atthe20-minute reading adnumber oftests given forpersons ages

6-74 years, by examiner number: United States, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

VII. Major examiners forpersons ages &74yews, bystand andhistamine base use: United States, 1976-80 . . . . . . .

VIII. Prevalence of skin-test reactivity to 1.0 mg/mL histamine base at the 20-minute reading and number of tests

given for persons ages 6-74 years, by major examiners: United States, 1976-80 . . . . . . . . . . . . . . . . . .

IX. Chmgeinreacti\' itytol.Omg/mL histamine baseatthe 20-minutereading bychronological order forselectedexaminers

farpersons ages &74years: United States, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

x. P(:rcent positi\7e andsize ofe~thema andwheal reaction atthe20-minute reading for l. Omg/mLhistarnine base for

pcrscmsage s6-74yea rs,byrac eandsex:Uni tedStates, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

XI. Size of wheal and erythema reaction in millimeters at the 20-minute reading for 1.0 mg/mL histamine base for

persons ages 6-74 yems, bysex: United States, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

XII. Prevalence ofskin-test reactivity to l. Omg/mLhistamine base atthe20-minute reading for~rsons ages &74yems,

bvselected characteristics: LTnitedStates, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

XIII. P;.evalence of skin-test reactivity for persons ages 6-74 years, by selected allergens and allergen manufacture in stands

using bath batteries ofextracts: United States, 1976-80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

63

64

65

65

66

68

68

69

69

70

70

71

71

61
Appendix I

Statistical notes

Introduction

This report is based on data collected in the seconcl National Health and Nutrition Examination Survey

(NHANES II) from February 1976 through February 1980,

NHANES II, conducted by the National Center for Health

Statistics (NCHS), was a survey of the U.S. civilian noninstitutionalized population (including Alaska and Hawaii) 6

months through 74 years of age. Both interview and examination procedures were used to collect a broad spectrwm of

demographic, socioeconomic, and morbidity data and related

medical and nutritional information. During household interviews, demographic, socioeconomic, and some medical history data were obtained for sample persons. Dietary interview,

medical examination, and related clinical tests and procedures

were performed in specially designed mobile examination centers (MEC’S) that were transported to each sample location

to provide standardized conditions and equipment.

Survey design

NHANES II utilized a stratified, multistage probability

sample design. In hierarchical order, the stages of selection

were as follows: Primary sampling units (PSU’s-a PSU is

a county or a small group of contiguous counties), segments

(a segment is a cluster of eight households), households,

and finally, sample persons.

Four hundred sixty-one primary sampling units were

formed in the first design stage from the PSU’S of the National

Health Interview Survey (NHIS), another major survey program of NCHS. These units were counties, groups of small

contiguous counties, or, in some New England States, areas

defined by minor civil divisions. PSU’S were stratified into

a total of 64 strata on the basis of region, population size,

median income, and other social and demographic characteristics that varied with region. One PSU was selected from

each strata using a modified Goodman-Kish controlled-selection technique. 104These 64 PSU’S represented the geographic

locations visited by the MEC’Sduring the survey period.

The second stage of the design consisted of the selection

of clusters of households (segments) within enumeration districts (ED’s). An ED is a geographical area that contains

approximately 300 housing units. The U.S. Bureau of the

Census had the major responsibility for selecting households

and sample persons within each of the PSU’S. Three sampling

frames of housing units were used to select the sample within

each of the PSU’s. The list frame consisted of all housing

units based on the 1970 Census of the Population. An area

frame was used in areas with “rapid” growth (housing units

built prior to 1970) and in areas with “slow” growth (all

housing units regardless of year built). A new construction

frame was used to supplement the list frame for all places

built since 1970 and in about half of the places in the area

sa~mplethat were experiencing rapid growth,

ED’s within each PSU were stratified into poverty and

nonpoverty strata. The poverty strata contained ED’s with

13 percent or more of persons below the poverty level, and

the nonpoverty strata contained ED’s with less than 13 percent

of persons below the poverty level, as determined by the

1970 Census. To oversimple persons with low incomes, segments were drawn from the poverty strata with an average

of 2.3 times the probability that segments were drawn from

the nonpoverty strata, Sampling fractions were determined

within PSU’s by a mathematical model to ensure an adequate

and manageable sample size and to minimize the variance

of the estimated proportion of persons below the poverty

level. To ensure sampling reliability, clusters of 16 listed

adklresses were drawn from the sampling frames and then

systematically subsampled at a rate of 1 out of 2 to produce

a ilnal set of eight household address listings.

At the third stage of sampling, the interviewer made

a list of all eligible sample persons within the selected households. Using instructions and a worksheet in the interview

folder with the following sampling rates, the interviewer

selected sample persons to be examined so that the younger

and older age groups were oversampled, ensuring that approximately one person per sample household was selected

Age Rate

6montha-5 years . . . . . . . . . . . 314

6-59 years . . . . . . . . . . . . . . . 1/4

60-74 years . . . . . . . . . . . . . 314

After a person was selected, the interviewer conducted

a medical history interview and then phoned the field office

to make an appointment for the examination. The sample

scheduled to receive skin testing included all sample persons

6-74 years of age. Table I shows the number of examined

persons and population estimates at the midpoint of the survey

in the skin-test sample by race according to sex and age.

NOTE: A list of references follows the text,

62
Table L Number of examined persona in the allergy skin-test aarnple and estimated population, by race, sex and age Second National Health and

Nutri60n Examination Survey, 1978-S0

All rac.es~ White Black

Estimated Estimated Estimated

population pqwlation population

Sample in Sample in Sample in

Sex and age size thousands sk”e thoussndsz size thousands2

Both sexes

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . .

12-17years . . . . . . . . . . . . . . . . . . . . . . .

18-24years . . . . . . . . . . . . . . . . . . . . . . .

2%34years . . . . . . . . . . . . . . . . . . . . . . .

3FA4years . . . . . . . . . . . . . . . . . . . . . . .

46-54years . . . . . . . . . . . . . . . . . . . . . . .

55-64years . . . . . . . . . . . . . . . . . . . . . . .

65-74years . . . . . . . . . . . . . . . . . . . . . . .

Male

Ali agea . . . . . . . . . . . . . . . . . . . . . . . . . .

6-n years . . . . . . . . . . . . . . . . . . . . . . . .

12-17years . . . . . . . . . . . . . . . . . . . . . . .

18-24years . . . . . . . . . . . . . . . . . . . . . . .

25-34years . . . . . . . . . . . . . . . . . . . . . . .

35-44years . . . . . . . . . . . . . . . . . . . . . . .

45-54years . . . . . . . . . . . . . . . . . . . . . . .

55-64years . . . . . . . . . . . . . . . . . . . . . . .

65-74years . . . . . . . . . . . . . . . . . . . . . . .

Female

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . .

8-n yeara . . . . . . . . . . . . . . . . . . . . . . . .

12-17years . . . . . . . . . . . . . . . . . . . . . . .

J8-24years . . . . . . . . . . . . . . . . . . . . . . .

25-34years . . . . . . . . . . . . . . . . . . . . . . .

3544years . . . . . . . . . . . . . . . . . . . . . . .

45-54years . . . . . . . . . . . . . . . . . . . . . . .

55-64years . . . . . . . . . . . . . . . . . . . . . . .

66-74yearti . . . . . . . . . . . . . . . . . . . . . . .

16,204

1,725

1,975

2,054

2,237

1,589

1,453

2,556

2,615

7,840

885

1,039

988

1,067

745

690

1,227

1,199

8,364

840

936

1,066

1,170

844

763

1,329

1,416

186,692

20,880

24,084

27,448

32,752

23,651

23,032

20,350

14,496

90,441

10,646

12,241

13,275

15,895

11,367

11,114

9,607

6,297

11;843

14,173

16,856

12,284

11,916

10,743

6,198

13,841

1,397

1,610

1,73a

1,901

1,379

1,264

2,262

2,280

6,726

725

853

846

901

653

617

1,086

1.045

7,115

672

757

892

1,OQo

726

647

1,176

1,245

160,785

17,264

20,027

23,362

28,457

20,392

20,235

18,242

12,906

76,099

8,768

10,133

11,442

13,864

9,808

9,665

8,642

5,576

82,686

8,486

9,893

11,919

14,494

10,584

10,369

9,601

7,329

2,040

288

321

268

284

173

162

264

260

942

136

157

121

139

70

62

129

128

1,098

152

164

147

145

103

100

135

152

21,269

3,094

3,435

3,406

3,499

2,527

2,259

1,760

1,288

9,864

1,554

1,718

1,533

1,546

1,112

1,044

601

555

11,404

1,540

1,717

1,873

1,953

1,415

1,215

959

733

1Includes other racas not stuwin sepsrately.

2Estimstsd po@iionasofthem idpAtof thssuwsy,Marchl, 1978.

A more complete description of thesurvey design is includedin ’’Pkm and Operationof the Second National Health

andNutrition Examination Survey, 1976-80,” VitalandHealdz

Statistics, Series l, No. 15.29

Estimation procedures

Because the design of NHANES is a complex multistage

probability sample, national estimates are derived through

a multistage estimation procedure. The procedure has three

basic components: (l) inflation bythe reciprocal oftheprobability of selection, (2) adjustment for nonresponse, and (3)

poststratification by age, sex, and race. A brief description

of each component is as follows:

● Injlationby thereciprocaloftheprobabilizy ofselection—

The probability of selection is the product of theprobabilities of selection from each stage of selection in the

design—PSU, segment, sample person, and subsample.

. Adjustmentfor nonresponse—The estimates are inflated

NOTE. AlistofreferencesfolIowsthetext.

by a multiplication factor that brings estimates based on

examined persons up to a level that would have been

achieved ifall sample persons had been examined. The

nonresponse adjustment factor was calculated by dividing

the sumofthe reciprocals of the probability of selection

forall selectedsample persons within each offiveincome

groups (less than $6,000; $6,000-9,999; $10,000-14,999;

$15,000-24,999, and $25,000 and more), three age groups

(6 months-5 years; &59 years; 60-74 years), four geegraphic regions, and within or outside standard metropolitan statistical areas (SMSA’S) by the sum of the reciprocals

of the probability of selection for examined sample persons

in the same income, age, region, and SMSA groups.

The percent distribution of the nonresponse adjustment

factors is shown in table II.

● Poststratij$cation by age, sex, and race-The estimates

were ratio adjusted within each of 76 age-sex-race cells

to independent estimates, provided by the U.S. Bureau

of the Census, of the population as of March 1, 1978,

the approximate midpoint ofthesurvey. The ratio adjustment used a multiplication factor in which the numerator

was the U.S. population and the denominator was the

63
Tabtell. Percent distnbutionof nonresponse-adjustment factors:

Second National Health and Nutrition Examination Suwey, 1976+Nl

Sizeoffactor Percent distribution

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0

1.00-1.24 . . . . . . . . . . . . . . . . . 26,8

1.25-1.49 . . . . . . . . . . . . . . . . . . . . . . . . . 548

1,50-1.74 . . . . . . . . . . . . . . . . 10.9

1,75-1.99 . . . . . . . . . . . . . . . . . . . . . . . . . 44

2.00-2,49 . . . . . . . . . . . . . . . 22

2.5C-2.99, , . . . . . . . . . . . . . . . 0,$)

sum of the weights adjusted for rrrmresponse for examined

persons. This ratio estimation procedure brings the population estimates into close agreement with the U.S. Census

Bureau’s estimates of the U.S. civilian ncminstitutionalized population, and irr general reduces sampling

errorsofNHANES Ilestimates.

Nonresponse bias

In any health examination survey there exists thepr.rtential

for three levels of nonresponse: ( 1) Household interview nonresponse, (2) examination nonresponse, and (3) item nonresponse. Household interview nonresponse is defined as the

proportion of those sample persons who do not complete

thehousehold medical historyquestionnaire . Examinationnonresponse is the proportion of those sample persons who initiaily

respond to the household demographic questions and some

or all of the medical history questionnaire, but who subsequentlydo not come to the examination center. Item nonresponse results from sample persons who do not complete

some portion of either the household interview questionnaires

or the examination protocol. Intense efforts were undertaken

during NHANES 11 to develop and implement procedures

and inducements that would reduce all types of nonresponse

and thereby reduce the potential for bias in the survey estimates. These procedures are discussed in Vital and Health

Statistics Series l, No. 15.29

In NHANES II the total sample size was 27,801; of

these sample persons, 25,286 (91. Opercent) were interviewed

and 20,322 (73. I percent) were examined. In the skin-test

sample (6-74 years of age), there were 22.732 sample persons;

20,410 (89.8 percent) were interviewed and 16,204 (71.3

percent) were examined. Overall, 95.8 percent of the examined

sample received 5 to 8 skin tests, 0.2 percent received I

to 4 skin tests, and 3.9 percent received O skin tests. These

percents remained fairly constant when examined by selected

demographic variables (see table III).

Acomparison of the 1976 National Health InterviewSurvey (NHIS)105 and NHANES 11106suggests that there is no

large nonresponse bias in some health-related variables (such

asperceived health status, diabetes, andheart attacks )because

of the close agreement on selected interview items in NHANES

II data with comparable items in the 1976 NHIS data. The

1976 NHIS data were used for the comparison because the

NOTE: A list ofreferences follows the text,

64
Table Ill. Sample size end percent response for akwgy skin-test subsample, by selected charecteriatkzx Second National Health and Nutritiin Examination

Survey, 1976-S0

Sample /nterviewe& Examined Sample

Skin test23

Selected characteristics size percent percent size o 1-4 5-s

Total . . . . . . . . . . . . . . . . . . . . . . .

Age

B-n years . . . . . . . . . . . . . . . . . . .

12-17 years . . . . . . . . . . . . . . . . . .

16-24 years . . . . . . . . . . . . . . . . . .

25-34 years . . . . . . . . . . . . . . . . . .

3+14years . . . . . . . . . . . . . . . . . .

45-54years . . . . . . . . . . . . . . . . . .

55-64years . . . . . . . . . . . . . . . . . .

65-74years . . . . . . . . . . . . . . . . . .

Sex

Female . . . . . . . . . . . . . . . . . . . . .

Male . . . . . . . . . . . . . . . . . . . . . . .

Race

White . . . . . . . . . . . . . . . . . . . . . .

Black . . . . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . .

Geographic region

Northeast . . . . . . . . . . . . . . . . . . . .

!Wdwest . . . . . . . . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . .

Residence

Urban . . . . . . . . . . . . . . . . . . . . . .

Rural . . . . . . . . . . . . . . . . . . . . . .

Poverty level

Belowpovertylevel . . . . . . . . . . . . . . .

Atorabovepoverly level. .,... . . . . . .

Unknown . . . . . . . . . . . . . . . . . . . .

Familymcome

o-$5,999 . . . . . . . . . . . . . . . . . . . .

$6,000-$9,9% 3 . . . . . . . . . . . . . . . .

$10,000-$14,988 . . . . . . . . . . . . . . . .

$15,000-324,999 . . . . . . . . . . . . . . . .

$25,0000rmore . . . . . . . . . . . . . . . .

Unknown . . . . . . . . . . . . . . . . . . . .

22,732

2,085

2,438

2,713

3,031

2,236

2,149

3,668

4,212

11,946

10,786

19,472

2,807

453

5,499

6,029

6,043

5,161

14,937

7,795

3,213

17,219

2,300

4,116

4,432

4,005

5,147

2,734

2,298

89.8

94.2

94.5

93.5

91.5

89.7

86.8

86.1

86.2

90.1

89.4

89.6

91.5

87.4

86.2

90.6

91.7

90.1

68.0

93.3

96.7

94.9

41.5

96.2

94.9

94.9

95.4

94.4

41.5

71.3

82.7

81.0

75.7

73.8

71.1

67.6

66.1

62.1

70.0

72.7

71.1

72.7

71.3

65.7

71.8

72.2

75.5

69.4

75.0

76.9

76.1

27.4

74.1

74.0

77.5

79.1

75.7

27.4

18,204

1,725

1,975

2,054

2,237

1,589

1,453

2,556

2,615

8,364

7,840

13,841

2,040

323

3,615

4,332

4,362

3,895

10,360

5,844

2,472

13,101

631

3/349

3,278

3,105

4,073

2,070

629

3.9

5.5

3.6

4.2

3.3

3.8

4.3

3.5

3.8

4.3

3.6

3,9

4.5

3.7

4.3

3.7

4.5

3.3

4.5

3.0

4.4

3.8

5.5

4.7

3.3

3.4

4.0

4.0

5.2

0.2

0.3

0.4

0.2

0.4

0.4

0.4

0.1

0.1

0.2

0.3

0.2

0.3

0.1

0.1

0.5

0.2

0.3

0.1

0.2

0.2

0.2

0.3

0.2

0.1

0.3

0.2

0.2

95.8

94.2

96.0

95.6

96.4

!35,0

9s.3

96.4

96.1

95.5

96.2

95.9

95.2

96.3

95.7

96.2

95.0

96.5

95.2

96.8

95.3

96.0

94.6

95,1

96.4

96.4

95.6

95.8

94.6

WOmpletadmediial history interview.

2Numbsrof skin tesls received.

‘Fgures do not add to lrM because of roundiig,

TatrklV. Reportedprwmkmceofeefec tedallergi esforparaons eges6-74yeerq byrnterviewed-nonexanimsdvaraus interviawed-exemined eample

peraon.x Sacond National Health and Nutrition Examination Survey, 1976-S0

hrterviewad

Nonexaminad Examined

Selected Sample Standard Sample Standard

allergy

P

size Percentl error size Percent’ error value

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,206 5.5 0.38 16,204 6.5 0.32 <0.05

Hayfever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,206 6.0 0.61 16,204 9.1 0.34

Otherallergies . . . . . . . . . . . . . . . . . . . . . . . . . .

0.06

4,206 9.6 0.54 16,204 11.4 0.36 ‘=0.05

‘Age-adjusled to US. population, Marchl, 1978.

65
Table V. Re~tied ~evabnce ofsekct4alleqies tir~rwn!; agea&74yei~rq byexamind nonsKn-tested versus examind sMn-teMed~mple

peraona: Seeond Netionsl Health and Nutrition Examination Sunrey, 1978-S0

Examined

Nonskin-tested Skin-tested

Selected Sample Standard Sample Standard P

allergy size P6rcent1 error size Percent’ error value

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,822 14.2 1.49 14,382 5.4 0.33 <0.05

Haytever . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,822 18.0 1.83 14,382 7.9 0.39 <0.05

Otherallergies . . . . . . . . . . . . 1,822 17.8 1.62 14,382 10.7 0.38 <0.05

‘Age-adjustedtoUS. population, March 1, 1976.

and other allergies than the skin-tested individuals (table V).

Thus, it is likely that theexclusion of these individuals from

our survey decreased the rates of reactivity found. Their absence did not introduce any significant amount ofbias when

making subgroup analyses, as it was spread fairly evenly

over all age, race, sex, urban or rural, and poverty-level

groups.

Standard deviations

The standard deviation is the square root of the sample

variance. It is ameasure ofdispersionof sample observations

about the sample mean. If the observations are distributed

normally (that is, as in a Gaussian distribution), then the

standard deviation is useful in describing how an individual

observation compares with the sample mean: One standard

deviation above and below the mean includes approximately

68 percent of the observations; two standard deviations, approximately 95 percent; and two and a half standard deviations,

approximately 99 percent.

Standard errors

Because the statistics presented in this report are based

on a sample, they will differ somewhat from the figures that

would have been obtained had a complete census been taken

using the same survey instruments, instructions, interview

and examination personnel, and procedures. The probability

design of this survey permits the estimation of standard errors

that are appropriate for the estimates shown in this report.

The standard error is primarily a measure of sampling

variability, that is, the variation that might occur by chance

because only a sample of the population is surveyed. As

calculated for this report, the standard error also reflects part

of the variation that arises in the measurement process. It

does not include estimates of any bias that might be contained

in the data. The chances are about 68 in 100 that an estimate

based on a sample using the same procedures and instruments

would differ from the value obtained from a complete census

by less than the standard error. The chances are about 95

in 100 that the difference would be less than twice the standard

error and about 99 in 100 that it would be less than two

and a half times as large.

The estimates of sampling variability for the detailed tables

in this report were calculated using the pseudoreplication

method, a balanced half-sample replication technique that is

based on variability among random subsamples of the total

sample,48 The estimates of standard errors for the age-adjusted

values in the text were calculated by a two-stage method:

First, SURREGR49 was used to calculate the variancecovariance matrix using Taylor series linearization, and second, the variance-covariance matrix was passed into GENCAT,50>5i a program for generalized least-squares categorical

data analysis. It should be noted that the estimates of standard

errors are themselves subject to error that may be large if

the number of sample persons on which an estimate is based

is small or if these persons are concentrated in a few strata.

Data limitations and reliability

The criteria for reliability of estimates shown in this report

consisted of the following: (1) that the sample size on which

the estimate is based be at least 30 persons; and (2) that

the estimated coefficient of variation (that is, the standard

error of the mean divided by the mean) be less than 30

percent. Thus, if the sample size was too small or if the

variation regarding the mean was too large, an asterisk was

placed next to the value on the table. Estimates with asterisks

are considered neither precise nor stable enough to meet reliability standards. However, the values are shown to give an

impression of the observed distribution and to permit users

to combine data into useful categories.

Analytic methodology

The procedure used in this report for testing the significance of the difference between two means or two rates consisted of dividing the difference between the two means or

rates by the standard error of the difference; that is, at-statistic

was computed. The standard error of a difference of estimates

can be calculated as follows: Let s be the standard error

of the difference, SI and S2the standard errors of the estimates

x’ and ~, then

s = sqrt (sqr (sl) + sqr (s2) – 2(cov(xI,xJ) ).

All statistical testing in this report used the calculated

covariance in the estimation of the standard error of the difference. However, covariances are not given in this report because

they would take a great deal of space. Readers, therefore,

NOTE. A listof referencesfollows thetext.

66

h
will have to perform their statistical testing without the use

of the covariance term. Thus, where the two groups or measures are correlated positively or negatively, the standard error

of the difference computed without the benefit of the

covariance term will give an overestimate or underestimate,

respectively, of the actual standard error of the difference.

The use of this standard error will affect the calculated &statistic, either decreasing it, if the calculated standard error is

increased, or increasing it, if the calculated standard error

is decreased. This in turn could cause the reader to come

to differing conclusions concerning the statistical significance

of a finding, if the p value is near 0.05. The standard errors

given in this report will, however, allow the reader to calculate

confidence intervals around point estimates. Unless otherwise

specified, tests for statistical significance are two-sided tests

and use ap value of 0.05 as the limit for statistical significance.

67
Appendix II

Data quality

Inter-examiner variability

More than 31 temporary and permanent examiners participated in the NHANES II skin-test examination. Each examiner

was assigned a separate identification number except for the

temporary examiners, who shared numbers 75 through 79.

Thirteen examiner numbers, including the temporary ones,

accounted for 95.7 percent of the skin-test eligible sample

persons. These examiners will be referred to as the major

examiners in this section, Variability in the reporting of skintest reactivity was investigated within this group of 13 examiners. Inter-examiner variability was estimated by evaluating

the responses in the population to the negative and positive

control skin-test solutions. Because replicate skin testing was

not performed, intra-examiner variability could not be

evaluated.

Ideally, the response of the study participants to the negative control (diluent) should be zero. However, because approximately 2 percent of the general population is demographic (having the tendency to form elevated reddish marks

secondary to any manipulation of the skin), the anticipated

prevalence of reactivity to the diluent is not zero.’1 ] Two

cut points based on mean erythema diameter at the 20-minute

reading were used to define reactivity for the diluent: Greater

than Omillimeters and greater than or equal to 10.5 millimeters.

Overall reactivity was 0.7 percent and 0.3 percent respectively

(table VI). No examiner reported over 2 percent reactivity

to the diluent except Examiner 16, who reported 2.2 percent

reactivity ,at the greater than the O mm cutoff. Thus, it appears

that there was no excessive reactivity within the negative

control.

The positive control (histamine phosphate) was used in

two concentrations during the survey. For the first 48 stands,

0.1 mg/mL histamine base was used. During the last 16 stands,

the histamine base concentration was changed to 1.0 mg/mL

to increase the rate of reactivity to the positive control. The

recommended histamine base concentration for prick–puncture

skin testing is 1 mg/mL. 32 At the lower concentration, the

expected biologic variability of the histamine response is so

great that it makes any analyses of this data meaningless.

Therefore, the inter-examiner variability was examined only

within the stands using 1.0 mg/mL histamine base. Table VH lists major examiner participation by stand and histamine use.

NOTE: A list ofreferencesfollows[hetext

68

Table W. Sie of reaction to the negative oontrol (diluent) at the

20-rninute reading and number of teats given, for pereons ages 6-74

years, by examiner numbe~ Unled States, 1976-S0

Examiner

Size of reaction

> 0 mml Number of _S 10.5 md

number testa given Percent Percent

Totst . . . . . . . . . . . . . . . . 15,066 0.7 0.3

2 . . . . . . . . . . . . . . . . . . 847 0.5 0

5 . . . . . . . . . . . . . . . . . . 972 0.2 0.2

6. . . . . . . . . . . . . . . . . . 1,918 0.6 0.4

7 . . . . . . . . . . . . . . . . . . 1,339 0.1 0.1

9 . . . . . . . . . . . . . . . . . . 2,371 0.3 0.2

13 . . . . . . . . . . . . . . . . . 450 0.7 0.7

15 . . . . . . . . . . . . . . . . . 1,128 0.3 0.1

16 . . . . . . . . . . . . . . . . . 820 2.2 0.5

17 . . . . . . . . . . . . . . . . . 885 0.8 0.2

18 . . . . . . . . . . . . . . . . . 647 0.3 0.3

20 . . . . . . . . . . . . . . . . . 562 0.2 0.2

21 . . . . . . . . . . . . . . . . . 430 1.9 1.6

75-793 . . . . . . . . . . . . . . 2,697 1.2 0.3

1Mean erythema diameter greater than O mm.

‘Mean diameter of the erythema reaction greater than or equal to 10.5 mm.

3Temporary examiner numbers,

NOTE: mm= millimeter,

Tebfe V1l. Major examiners for persons ages 6-74 yea~ by stand and

histamine base use United Stetea, 1976-60

0.1 mglmL 1.0 mg/mL

histamine histamine

Total survey baee base

Stands . . . . . . . . . . . . . . 64 48 16

Number of sample pereons’ . 16,204 11,612 4,592

Major examiners . . . . . . . 2567 ,,, , 2,5,6,7, 6,9,17,16,

9,13,15,16, 9,13,15,16, 20,21,

17,16,20,21, 17,16, 75-792

75-792 75-792

Percent of exams done

by major examinere . . . . . 95.7 96.1 92.3

lTotal number of sample persona within the stands regardlessof examiner.

~emporary examiner numbers.

The erythema reaction was used to measure inter-examiner

variability because the analyses of allergenic reactivity were

based on the erythema reaction. Reactivity to histamine was defined as a mean erythema diameter at the 20-minute reading of

greater than O mm. The purpose of the positive control was to

establish cutaneous end-organ reactivity to one important inflammatory mediator of the immedlat~ hypersensitivity reaction (histamine), l%us, no cut point other than the presence or absence of a reaction was felt to be appropriate.
-;: 

. . 

Table VIIL Prevalenca ol akin-test macw~y ICI t .i) mg/rnC histamine 

base at the 20-minlrte r’eading and r~un~ber cii Qtsts given for persons 

ages 6-74 years, by major exarnimrs: United States, 197680 

Examitwr number of tdds yven Percent positive 1 

Total . . . . , 4,125 90.6 

20 . . 

18 . 

75-7gL . . . . 

21 . . . . . I . . . 

9 . . . * . . . , 

17 . . . * . , , , 

6 . s . . . . . . . , 

56-1 al.6 

328 136.3 

I ,566 89.4 

-126 93.7 

570 93.9 

285 98.2 

386 90.7 

‘Mean etythema diarnutur qesr 

qemporary examiner numbws. 

Table IX. Change in ;eucii*/ti;, tri i 0 myl’rd. histarnme base at the 20- 

minute reading by chronolcgical order for seiected examiners for persons 

ages 6-74 years: United States, 1976-W 

----- 

First half’ Second half 

Exammer 

number 

--. 

PerCX;t Numbar df Perw7t 

tests gl ven positive ’ tests gwen positAd 1--__1_1_- c. -- 

6 ........ ..... 

9 ............. 

17 ............. 

20 ............ 

21 ............ 

121 96.7 265 99.6 

324 94 a 246 92.7 

82 100 0 203 97.5 

380 75 5 184 94.0 

80 90 0 346 94.5 

‘Eight stands in each nalf 

‘Mean diameter of tht, ary/tttemd 

The prevalence ol’skin xactivity by il;tij(>l* examiner for I .O mgl 

mL histamine base is presented in table VIIl. Inter-examiner 

differences in reporting reactivity to histamine ranged from 

.8 I .6 percent to 98.7 percent. 

In any examination ~rformt:ci repeatedly over an extended 

period of time, techniques can chance unintentionally. The authors examined thz data for this Yr~t” in technique by looking 

at the reported results o\#‘er time for j&cted examiners. The 

stands using I .O n-@n~I, histamine: were divided in half, 

based on chron&@cal order (8 stands in each half, tabis IX). 

Note that the prevalence of‘ rescti iii ty , altho\lgh not consistent for 

each examiner, was generally zquivalsnt between the halves except for Examiner 20, \s*tiilst: reportcil r-;ltt’ of reactivity increased 

from 75.5 percent to 9-i percent. 

seen among ~xannl111(:1-5, 

Skin color 

reaction, the histamine reactivity for black persons as compared 

with white persons was slightly lower in both percent positive 

(83.6 percent versus 92.2 percent, respectively) and mean 

size of the positives (17.8 millimeters versus 18.4 millimeters, 

respectively), but in no case did this difference reach statistical 

significance. A similar finding was noted for the wheal reaction: Black persons again had a lower rate of reactivity (90.9 

percent versus 95.4 percent, respectively) and a smaller size 

(4.2 millimeters versus 4.4 millimeters, respectively) than 

white persons, but in no case did this difference reach statistical 

significance. 

The observed tendency for a lower rate of reactivity in 

black persons may be due, in part, to hyporesponsiveness 

to histamine and/or the tendency to underread the dimensions 

of the erythema and wheal reaction in dark-skinned individuals. 

No data on skin color were available in the population tested. 

Thus, the relation between skin color and cutaneous reactivity 

cannot further be evaluated. 

Histamine reactivity 

The size of the wheal and erythema reactions to 1 .O 

mg/mL histamine are shown in table XT. The data collected 

on skin-test reactivity to 1 .O mg/mL histamine base in the 

NHANES II skin-test sample can be used by others as a 

population standard for histamine reactivity. 

. 

Variations in histamine reactivity by age, sex, urban or 

rural, and poverty level were examined in stands using 

l .O mg/mL histamine (table XII). Reactivity rates were fairly 

constant within the age groupings used in this study. They 

ranged from 92.7 percent in persons 6-f 1 years of age to 

86.1 percent in persons 65-74 years of age. The rate of 

reactivity dropped slightly in the age groups 55. years and 

over, but this change did not reach statistical significance. 

Females had a higher rate of reactivity than males (92.0 percent 

versus 89.9 percent). No difference in reactivity was noted 

for urban or rural residency or for poverty status. 

Method of allergen manufacture 

Allergens selected for NHANES II W.&-e purchased initially from a single U.S. Food and Drug Administration (FDA) 

licensed manufacturer (Nelco Labs) as 1:20 weight per volume 

(W/V) extracts in 50 percent glycerin. Later in the survey 

I :20 W/V freeze-dried extracts, obtained from a different 

FDA licensed manufacturer (Greer Labs), were used. The 

use of two different sets of allergens allowed the researchers 

to determine the variability in the prevalence estimates because 

of differences in allergenic potency between two commercially 

available allergenic extracts. The use of the glycerinated and 

freeze-dried extracts are described fully in the Source and 

limitations of the data section. In brief, the glycerinated kxtracts were used exclusively in 38 stands. Freeze-dried extracts 

were used exclusively in 4 stands and both extracts were 

useci In 22 stands. To estimate the variability in the prevalence 

of allergic skin reactivity due to differences in allergenic potency between the two batteries of allergens, reactivity rates 

were compared in the 22 stands in which both extracts were 

69 
Table X. Percent positiie and size of erythema and whesl reaction at the 20-rnlnute reading for 1.0 mg/mL hiatemine base for persons ages 6-74 yeare,

by race and sex: United State% 197G80

Sample Percent Standard P Mean”2 Standard P

Reaction, race, and sex size positive’,2 error value in mm error value

Erythemareaction

White:

Both sexes . . . . . . . . . . . . . . . . . . . . . . . . . 3,801 92.2 0.94 ... 18.4 0.55 ...

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,862 91.6 1.48 .. 18.2 0.74

Female . . . . . . . . . . . . . . . . . . . . . . . . . .

...

1,939 92.9 0.79 ... 18.7 0.43 ..

Black:

Both sexes . . . . . . . . . . . . . . . . . . . . . . . . . . 608 83.6 5.87 0.15 17.8 0.62 0.45

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289 79.3 8.39 0.20 17.4 0.88 0.45

Female . . . . . . . . . . . . . . . . . . . . . . . . . . 319 87.7 3.73 0.15 18.3 0.50 0.58

Wheal reaction

White:

Both sexes . . . . . . . . . . . . . . . . . . . . . . . . . 3,801 95.41 1.42 ... 4.4 0.11 ...

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,862 95.4 1.57 ... 4.6 0.12

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . .

...

1,939 95.4 1.56 ... 4.2 0.10 ...

Black:

Both sexes . . . . . . . . . . . . . . . . . . . . . . . . . . 608 90.9 3.69 0.15 4.2 0.23 0.33

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289 91:? 4.11 0.30 4.4 0.31 0.54

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3? 9 90.6 3.57 0.15 4.0 0.17 0.20

lMean erythemaorwheal diameter greater than Omm mean diameter.

2Age-adjuatedioU.S. population, Marchl, 1978.

NOTE: mm = millimeter.

Table Xl. Sueofwheal ande@hema raation inmilhmeters atthe2Mntia raadngfor l. Omg/mLMstimine base forpersons ages &74years, by sex

United States, 1976-S0

Sample Standard Percent distribution

Reaction and sex size Mean Median devi,?tion 5 10 25 50 75 90 95

Wheal

Bothaexes . . . . . . . . . . . . . . 4,199 4.4 4.5 1.65 2.0 2.5 3.0 4.5 5.0 6.5 7.0

Male . . . . . . . . . . . . . . . . . . 2,039 4.5 4.5 1.72 2.0 2.5 3.0 4.5 5.5 6.5 7.5

Female . . . . . . . . . . . . . . . . 2,160 4.2 4.0 1.!57 2.0 2.5 3.0 4.0 5.0 6.0 7.0

Erythema

Both sexes . . . . . . . . . . . . . . 3,992 18.4 18.5 8.!55 4.5 6.5 12.0 18.5 24.5 29.5 32.5

Male . . . . . . . . . . . . . . . . . . 1,915 16.2 18.0 8;76 4.5 6.0 11.0 16.0 24.5 3CI.O 32.5

Female, . . . . . . . . . . . . . . . 2,077 18.7 19.0 8;36 4.5 7.5 12.5 19.0 24.5 29,5 32.0

used. In these 22 stands the sample persons were divided

into two groups based on their sample numbers. Those with

odd sample numbers received glycerinated extracts artd those

with even sample numbers received freeze-dried extracts .This

selection process was equivalent to random assortment of

the sample persons, It was necessary to limit the analyses

tothesestands,to controlforanumber ofpotentialconfounders

(such as geography, examiner, age, race, and sex) for skin-test

reactivity.

Reactivitytothetwo batteriesofallergens wasdetermined

basedon themean diameter of the erythema reaction at the

20-minute reading. (See table XIII.) A mean diameter of

the erythema reaction greater than Omm was considered positive. The freeze-dried extracts had increased rates of reactivity

70

forhouse dust, oak, and Bermuda grass (p<0.05). Theabsolute increase in reactivity ranged from 3,5 percent through

4.7 percent. Only for the dog extract did the glycerinated

extracts have a higher rate of reactivity (absolute increase

2,2 percent, pcO.05), No differences in reactivity were found

for altemaria, cat, ragweed, and rye grass. In the dual-use

stands, the distribution of reaction sizes are equivalent for

all allergens except Bermuda grass, where the freeze-dried

allergen produced larger reactions than the glycerinated extract

@< O.05). The small observed differences in reactivity demonstrated that variations in allergenic potency between the two

allergen batteries had relatively small effects on the prevalence

estimates of the NHANES II survey.

Intheabsence ofstandardized extracts, itis notpossible
Tabb X11. Prevalence of skin-test react”~ to 1.0 mg/mL histamine bSSe at the $?O-minutereading for persons ages 6-74 years, by seleoted

charecteristicw United State~ 1976-60

Sample Percent Standard

Selected characteristic

P

size positive’ error value

Age

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,443 91.0 2.33

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

...

425 92.7 2.26

12-17years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

...

502 91.9 2.49

16-24years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

...

642 92.5 2.08

26-34years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

...

671 93.1 1.45

35-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

...

439 91.5 2.46

45-54years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

...

370 90.6 4.24

55-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

...

696 85.7 3.74

65-74years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

...

698 86.1 3.18 ...

Sexz

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,167 69.9

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1.35 ...

2,276 92.0 1.06 0.03

Residencez

Urban . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,391 90.3 2.76

Rural . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

...

2,052 91.9 2.25 0.75

Poverty level

Belowpovertyincomeratio(PlR)?,3.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 767 67.5

Atorabove PIf32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.35 ,..

3,512 91.4 1.05 0.08

‘Meandiameter of the erythema reaction greater than Omillimeters.

‘Age-adjuated to U.S. population, March1, 197S.

3Povarty Inmm.a ratio.

TebbXlll. Prevsbncsofskin-tastreatiiforparaonsages&74yesrq bysslectedsilergensandellergen menufectureinstsndsuaingbothbstieties

ofextrsct8 UnitedSteta$ 1976-S0

G/ycerinafad’ Fraezedriedz

Percent Percent

Selected allergen positive3 Tota14 posr?ive3 Tots/4 p value

Housedust . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.3 2,871 15.0

Alternaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,922 <0.001

5.8 2,873 5.5

Cat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,926 0.60

5.0 2,863 5.5 2,918 0.44

Dog . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.5 2,883 4.3

Ragweed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,914 <0.001

15.5 2,861 16.8

Oak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,919 0.17

7.2 2,86S 10.7

Ryegraes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,926 <0.001

12.0 2,871 12.7

Bermudagraas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,930 0.43

5.6 2,872 9.6 2,925 <0.001

‘ManufactureNelm Iaba, N.Y. (1:20 w/v In 50 percent glycerin).

2Manufacfur.xGrearlabs, Lenolr, N.C. (freeze4dW, remnstitutd witi W~rmntglymrin, l:20wiv, phrtiu~).

‘ReacfivHy is mean diameter of the erythema reaction greater than Omillimetersat 20-minute reading.

~otal number of akin-taatad Indivlduala.

to ascertain whether the rate observed would be equivalent

to the rates with standardized extracts. Because this study

wasperformed with unstandardized extracts, itcanbe assumed

that some of the observed rates are lower than would be

found with currently available standardized extracts, To determine the precise discrepancy in rates, if any, a replicate study

with standardized extracts must be performed, The

methodological concern with the observed difference in rates

ofreactivity for this reportliesin thepossibilityof the unequal

use of the two allergen batteries from different manufacturers

within differing levels of the variables examined in the

analyses. If this occurred, any difference found between groups

could possibly be explained, at least to a partial degree, by

a difference in allergen potency between the batteries. The

use of the two batteries of extracts was evaluated by age,

race, sex, family income,poverty level, region, whether urban

or ruralp and head of household education, No differential

usage was noted except for region. The glycennated extracts

were usedon approximately 80 percent of the sample persons

in the Northeast, South, and West, and on only approximately

50percentofthe sample personsin the Midwest. Thus,during

inter-regional comparisons, it is necessary to account for the

differentialuseofthe twotypesofextracts amongtheregions,
Appendix 111

Definition of terms

Age—Two ages were recorded for each examinee: Age

at last birthday prior to the time of examination and age

at the time of the Census interview. The age criterion for

inclusion in the sample used in this survey was defined as

age at the time of Census interview. The adjustment and

weighting procedures used to produce national estimates were

based on age at the interview. Data in the detailed tables

and text of the report also are shown by age at the time

of interview.

Race—For each individual the observed race was recorded

as “white, “ “black,” or “other.” Other includes Jajpanese,

Chinese, American Indian, Korean, Eskimo, and all races

other than white and black. Persons of Mexican descent were

included with “white” unless definitely known to be American

Indian or of another race. Black persons and persons of mixed

black and other parentage were recorded as black. When

persons of mixed racial background were uncertain about their

race, the race of the father was recorded.

Sex—Sex was recorded by the interviewers and examiners.

Poverty Index—The poverty index was determined by

the poverty income ratio (PIR). Poverty statistics published

in U.S. Bureau of the Census reports] 12-116were based on

the poverty index developed by the Social Security Administration (SSA) in 1969.

The two components of the PIR are as follows: Numerator—the total income of the household as defined by the

median income for income groups with incomes of $7,000

and above, or the sum of the component parts of the income

questions for income groups below $7,000; and denominator—

a multiple of the total income necessary to maintain alfamily

with given characteristics on a nutritionally adequate food

plan. 112–16The doll~ value of the diet in the denominator

of the PIR is constructed from a food economy plan necessary

to maintain minimum recommended daily nutritional

requirements.

Poverty thresholds are computed on a national basis only.

No attempt has been made to adjust these thresholds for regional, State, or other variations in the cost of living (except

for the farm or nonfarm difference). None of the noncash

public welfare benefits such as food-stamp bonuses are included in the income of the low-income families receiving

these benefits. PIR has been adjusted by year and accounts

in some part for inflation.

Tables of weighted average threshold poverty cutoffs for

1976-80 have been published. 1‘7

Family income group—The respondent was given a card

listing categories and was instructed to select the one that

represented his or her total combined family income for the

past 12 months. Respondents were asked to include income

from all sources such as wages, salaries, social security or

retirement benefits, help from relatives, rent from property,

and the like.

Place of residence—The place of residence of a member

of the U.S. civilian noninstitutionalized population is classified

as inside a standard metropolitan statistical area (SMSA) or

outside of an SMSA,

Standard metropolitan statistical areas—The definitions

and titles of SMSA’s are established by the U.S, Office of

Management and Budget with the advice of the Federal Committee on Standard Metropolitan Statistical Areas, The definition of an individual ShlSA involves two considerations: First,

a city or cities of at least 50,000 inhabitants that constitute

a central city and identify the county in which they sirelocated

as a central county; second, economic and social relationships

with contiguous counties (except in New England) that are

metropolitan in character so that the periphely of the specific

metropolitan area may be determined. SMSA’s are not limited

by State boundaries. In New England, SMSA’S consist of

towns and cities rather than of counties.

Urban or ruraASize of place classification was derived

from the 1970 Decennial Census of the Population. According

to the definition used in the 1970 census, the urban population

consisted of all persons living in (a) places of 2,500 inhabitants

or more incorporated as cities, boroughs (except Alaska),

villages, and towns (except towns in New York, New England

States, and Wisconsin), but excluding those persons living

in the rural portions of extended cities; (b) unincorporated

places of 2,500 inhabitants or more; and (c) other territories

included in urbanized areas. The remaining population was

classified as rural.

NOTE: A list of referencesfollowsthe text.

72
Geographic region—The United States was divided into south . . . . . . . .

four broad geographic regions of approximately equal population. The regions, which deviate somewhat from the groups

used by the U.S. Bureau of the Census, areas follows: ...

Region

Northeast . . . . . .

Midwest . . . . . . .

west. . . . . . . .

Statesincluded

Maine, New Hampshire, Vermont, Massachusetts,

Connecticut, Rhode Island, New York, New Jaraey,

Pennsylvania

Ohio, Michigan, Indiana, Illinois, Wisoonsin,

Minnesota, Iowa, Missouri

Delaware, Maryland, Virginia, West Mrginia, Kentucky,

Arkansas, Tennessee, North Carolina, South Carolina,

Georgia, Florida, Alabama, Mississippi, Louisiana,

District of Columbia

Washington, Oregon, Idaho, Montana, Wyoming,

Colorado, Utah, Nevada, California, Arizona, New

Mexico, Texas, Oklahoma, Kansas, Nebraska, South

Dakota, North Dakota, Alaska, Hawaii.

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Vital and Health Statistics

series descriptions

SERIES I.

SERIES 2.

SERIES3.

SERIES4.

SERIES 5.

SERIES 10.

SERIES 11.

SERIES 12.

SERIES 13.

Programs and Collection Procedures-Repoms describing

the general programs of the National Center for Health

Statistics and its offices and divisions and the data collection methods used. They also include definitions and

other material necessary for understanding the data.

Data Evaluation and Methods Research–Studies of naw

statistical methodology including experimental tests of

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methods, new analytical techniques, objective evaluations

of reliability of collected data, and contributions to

statistical theory. Studies also include comparison of

U.S. methodology with those of other countries.

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and health statistics, carrying the analysis further than

the expository types of reports in the other series.

Documants and Committee Reports-Final reports of

major committees concerned with vital and health statistics and documents such as recommended model vital

registration laws and revised birth and death certificates.

Comparative International Vital and Health Statistics

Repotis-Analytical and descriptive reports comparing

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Data From the National Health Interview Survey –Statistics on illness, accidental injuries, disability, use of hospital, medical, dental, and other services, and other

health-related topics, all based on data collected in the

continuing national household interview suwey.

Data From the National Haalth Examination Suwey and

the National Health and Nutrition Examination Survey–

Data from direct examination, testing, and measurement

of national samples of the civilian noninstitutional ized

population provide the basis for (1) estimates of the

medically defined prevalence of specific diseases in the

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with respect to physical, physiological, and psychological characteristics and (2) analysis of relationships

among the various measurements without reference to

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utilization of health manpower and facilities providing

long-term care, ambulatory care, hospital care, and family

planning services.

SERIES 14.

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Data on Health Resources: Manpower and Facilities–

Statistics on the numbers, geographic distribution, and

characteristics of health resources including physicians,

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nursing homes, and outpatient facilities.

Data From Special Suweys-Statistics on health and

health-related topics collacted in special suweys that

are not a part of the continuing data systems of the

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than as included in regular annual or monthly reports.

Special analyses by cause of death, age, and other demographic variables; geographic and time series analyses;

and statistics on characteristics of deaths not available

from the vital records based on sample suweys of those

records.

Data on Natality, Marriage, and Divorce-Various statistics on natality, marriage, and divorce other than as

included in regular annual or monthly reports. Special

analyses by demographic variables; geographic and time

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characteristics of births not available from the vital

records based on sample suweys of those records.

Data From the National Mortality and Natality SurveysDiscontinued in 1975. Reports from these sample suweys

based on vital records are included in Series 20 and 21,

respective y.

Data From the National Suwey of Family GrowthStatistics on fertility, family formation and dissolution,

family planning, and related maternel and infant health

topics derived from a periodic suwey of a nationwide

probability sample of ever-married women 1544 years

of age.

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