4 IDENTIFICATION AND diagnosis of the most serious allergy
4.1. How the allergy was first identified
4.2. Length of time since the food allergy was first identified for the person with the most serious allergy
4.3. Who diagnosed the most serious food allergy
4.4. How the most serious food allergy was formally diagnosed
4.1 How the allergy was first identified (Q9)
Respondents were asked how the food allergy was first identified for the person with the most serious allergy. Results are shown in Table 4.1.
Table 4.1 Identification of the allergy
Q9 How was the food allergy first identified for the person with the most serious food allergy? PLEASE TICK ALL THAT APPLY
| . |
total sample | country | |
| . | Australia | New Zealand(b) | |
base: all respondents ( n) | (n=510) | (n=413) | (n=97) |
| %* | %* | %* |
Had a reaction | 93 | 92 | 95 |
From a parent | 12 | 12 | 13 |
Worked it out for myself | 9 | 8 | 11 |
Skin / prick test | 6 | 6 | 5 |
From an alternative health practitioner | 4 | a 2 | b 11 |
Paediatric immunologist | 2 | a 3 | b 0 |
Allergy specialist | 2 | 2 | 3 |
Blood test | 2 | a 1 | b 5 |
ab Indicates categories where there was a significant difference between the results in each column (significance at the 95% confidence level )
* Adds to more than 100% due to multiple responses.
In the vast majority of cases, the food allergy was identified following a reaction(93%). Around one in ten said they found out from a parent (12%) or worked it out for themselves (9%).
Less than one in twenty respondents said they found out from an alternative health practitioner [1] (4%), and this was recorded by significantly more New Zealanders than Australians in the sample (11% versus 2% respectively).
New Zealanders were also significantly more likely than Australians to say they found out via a blood test (5% versus 1% respectively), whereas Australians were significantly more likely than New Zealanders to say they found out from a paediatric immunologist (3% versus 0% respectively).
Those who had soy allergies in the household (15% of the sample, as seen in Table 3.4d) were significantly more likely than for other allergies to say they had found out from a parent (20%); whereas both wheat and ' other' allergies [2] for example, were significantly more likely than others to have been identified by an alternative practitioner (9% and 8% respectively). Where there was a sulphite or wheat allergy [3] in the household, respondents were significantly more likely to say they had worked it out for themselves (22% and 20% respectively) [4] .
Where the person with the most serious food allergy was an adult, they were significantly more likely than serious allergy sufferers of other ages to say they had worked it out for themselves (19%) [5] .
4.2 Length of time since the food allergy was first identified for the person with the most serious allergy (Q10)
Respondents were asked how long it was since the food allergy was first identified for the person with the most serious allergy. Results are shown in Table 4.2.
Table 4.2 Length of time since allergy was first identified
Q10 Approximately how long ago was the food allergy first identified for the person with the most serious food allergy?
total sample | country | ||
Australia | New Zealand(b) | ||
base: all respondents ( n) | (n=510) | (n=413) | (n=97) |
| % | % | % |
Less than 6 months ago | 5 | 4 | 7 |
More than 6 months but less than a year | 9 | 8 | 10 |
More than a year but less than two years | 15 | 15 | 18 |
More than two years ago | 71 | 72 | 65 |
Can't remember | <1 | 1 | 0 |
TOTAL | 100 | 100 | 100 |
ab Indicates categories where there was a significant difference between the results in each column (significance at the 95% confidence level )
About three-quarters of food allergies had been identified more than two years previously (71%). For 15% of respondents, the allergy had been identified between one and two years previously. Very few had been identified within the previous six months (5%), and one in ten (9%) had been diagnosed more than six months previously, but not more than a year.
The recruitment criteria for those people identified through hospitals and private clinics (see Appendix D) specifically requested that selection for the survey was to be restricted to clients that had been diagnosed less than two years previously. Accordingly, one would expect the bias to be from support groups (some of which were mailed at random). However, the sample achieved via hospital / institutional recruiters (73%) as well as the support groups sample (78%) had a significantly greater number who had been diagnosed more than two years previously compared to private clinician recruitment (61%). It is therefore, difficult to explain why there was such a variation from the recruitment criteria. One possibility is that the person with the most serious food allergy was not the person in the household who was initially selected for participation by the recruiter.
There was no significant difference in the length of time since the allergy was first identified by country.
4.3 Who diagnosed the most serious food allergy (Q11a/b)
Respondents were asked whether a formal diagnosis was made for the person with the most serious food allergy.
The majority (97%) said a formal diagnosis had been made.
The propensity to have had a formal diagnosis decreased slightly as the age of the person with the most serious food allergy increased; i.e. 91% of those aged 18 years or over had a formal diagnosis, whereas 99% of those aged under five years had their allergy formally diagnosed [6] .
Those respondents who had a formal diagnosis were then asked who had performed or undertaken this. Results are shown in Table 4.3a.
Table 4.3a Who made the formal diagnosis for the person with the most serious food allergy
Q11b Who made the formal diagnosis for the person with the most serious food allergy?
total sample | Sample source | country | ||||
Hospital (a) | Private (b) | Support Groups | Australia (d) | New Zealand | ||
base: THOSE FORMALLY DIAGNOSED ( n) | (n=496) | (n=158) | (n=168) | (n=170) | (n=403) | (n=93) |
| %* | %* | %* | %* | %* | %* |
A doctor specialising in allergies | 90 | 91 | 89 | 91 | e 92 | d 82 |
A GP / doctor / medical practitioner | 37 | 32 | 39 | 40 | 36 | 44 |
A dietitian | 5 | b 7 | a 3 | 5 | 4 | 8 |
An alternative health practitioner | 3 | 1 | 5 | 3 | e 2 | d 9 |
Not answered | 1 | 1 | 1 | 0 | 1 | 1 |
abcde Indicates categories where there was a significant difference between the results in each column (significance at the 95% confidence level)
* Adds to more than 100% due to multiple responses, that is, several avenues may have contributed to the final diagnosis.
For the total sample, the majority of diagnoses were made by a doctor who specialises in allergies (90%).
In combination with the previous question, Q9, the method of diagnosis indicates that only a very small proportion of this sample was self-diagnosed. Given that a large part of the sample was derived from hospitals or medical institutions and private specialists, it is inevitable that this would be relatively high for the sample in total. However, as indicated in the table, the level of 'official' diagnosis was consistent across the three sample sources even where the sample was derived from support groups. In fact there were only five (1%) Australians and three New Zealanders (3%) who had not been diagnosed by a medical practitioner or dietitian.
Amongst the Australian sample, there was a significantly larger proportion that had been diagnosed by a doctor who specialises in allergies than in the New Zealand sample (92% versus 82% respectively). Conversely, there was a significantly higher proportion in the New Zealand sample that had been diagnosed by an alternative health practitioner (9% versus 2% respectively).
The results are shown in Table 4.3b by the age of the person with the most serious food allergy.
Table 4.3b Who made the formal diagnosis for the person with the most serious food allergy
total sample | age of person with allergy (years) | ||||
Under 3 | 3-5 | 6-12 | 13+ | ||
base: THOSE FORMALLY DIAGNOSED ( n) | (n=496) | (n=119) | (n=143) | (n=162) | (n=69) |
| %* | %* | %* | %* | %* |
A doctor specialising in allergies | 90 | 91 | cd 96 | b 89 | b 81 |
A GP / doctor / medical practitioner | 37 | b 40 | acd 27 | b 40 | b 48 |
A dietitian | 5 | d 8 | 4 | 4 | a 1 |
An alternative health practitioner | 3 | b 4 | ad 0 | 2 | b 6 |
Not answered | 1 | 1 | 0 | 0 | 3 |
abcd Indicates categories where there was a significant difference between the results in each column (significance at the 95% confidence level )
* Adds to more than 100% due to multiple responses.
As can be seen, the older the person with the most serious allergy, the less likely they were to have been diagnosed by a doctor who specialises in allergies and the more likely they were to have been diagnosed by a GP or medical practitioner.
4.4 How the most serious food allergy was formally diagnosed (Q11c)
Respondents were asked how the food allergy was formally diagnosed for the person with the most serious allergy. Results are shown in Table 4.4.
Table 4.4 How the allergy was formally diagnosed
Q11c How was the formal diagnosis made for the person with the most serious food allergy? PLEASE TICK ALL THAT APPLY
total sample | country | ||
Australia | New Zealand(b) | ||
base: THOSE FORMALLY DIAGNOSED ( n) | (n=496) | (n=403) | (n=93) |
| %* | %* | %* |
Skin prick test | 91 | b 93 | a 83 |
RAST (Blood test) | 36 | b 30 | a 61 |
Elimination diet | 20 | 19 | 23 |
Reaction | 2 | 2 | 3 |
Challenge test | 2 | 1 | 3 |
Description of symptoms | 1 | 1 | 2 |
Medical history | 1 | 1 | 0 |
Other | 1 | 1 | 4 |
ab Indicates categories where there was a significant difference between the results in each column (significance at the 95% confidence level )
* Adds to more than 100% due to multiple responses.
The major diagnostic method was the skin prick test, with nine in ten respondents (91%) saying this was how they were tested. The second most frequent method was the radioallergensorbent test (RAST) or blood test, with a third (36%) saying this test was used. An elimination diet was mentioned by one in five (20%).
By country, Australian respondents were significantly more likely than New Zealandrespondents to say they had been diagnosed with a skin prick test (93% versus 83% respectively). Conversely, New Zealanders were significantly more likely to say they had been diagnosed via a RAST or blood test (61% versus 30% respectively).
Those who belonged to a support group were significantly more likely than those who were not members to say they were diagnosed with a RAST or blood test (42% versus 30% respectively).
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[1] No specific definition was included for an alternative health practitioner, however the question gave as an example a naturopath.
[2] 10% and 16% of the sample, respectively, as seen in Table 3.4d.
[3] 9% and 10% of the sample, respectively, as seen in Table 3.4d.
[4] Note that these data are not shown in the tables included in this report. The reader is directed to the full set of data tables for more information.
[5] These data are not shown in the report tables.
[6] Not shown in a table.