Background: Allergic rhinitis (AR) is the most common allergic disorder and its prevalence has significantly increased worldwide, nowadays affecting up to 40% of the population in young adults. The objective of the present survey was to evaluate the prevalence of allergic sensitization and the prevalence of clinically diagnosed AR in a sample of the Belgian population, and to estimate the effect of age and gender. Methods: We performed a cross-sectional population-based study at an annual public fair in Ghent. Participants underwent a skin prick test (SPT) to 3 aeroallergens: a mix of trees (hazel, alder, and birch), grass pollen, and house dust mite (HDM). The clinical relevance of sensitization was assessed by relating relevant symptoms of AR to the corresponding SPT. Results: A total of 2,320 participants (1,475 females, median age 44.7 years, range 3–86) were included in this study. The standardized prevalence rates of sensitization were 13.2% for tree mix, 25.9% for grass pollen, and 25.9% for HDM. Sensitization to at least one of the allergens was present in 40.3% of the subjects. Symptomatic sensitization related to trees was reported in 9.7% of cases, grass-related AR was 17.6%, and HDM-related AR was 17.1%. The overall prevalence of AR was 30.9%. Conclusion: In this study we demonstrated a 40.3% prevalence of a positive SPT to one or more common aeroallergens. A clinical diagnosis of AR was present in 30.9% of cases, peaking in the third and fourth decades of life. It is to be expected that in the next decades, when this generation grows older, the general AR prevalence will further increase.

Keywords:
Allergy, Allergic rhinitis, Symptoms, Skin prick test, Prevalence, Epidemiology, Sensitization
1.
Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, et al: Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol 2010;126:466–476.
2.
Bauchau V, Durham SR: Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J 2004;24:758–764.
3.
Bousquet J, Reid J, van Weel C, Baena Cagnani C, Canonica GW, Demoly P, et al: Allergic rhinitis management pocket reference 2008. Allergy 2008;63:990–996.
4.
Bachert C, van Cauwenberge P, Olbrecht J, van Schoor J: Prevalence, classification and perception of allergic and nonallergic rhinitis in Belgium. Allergy 2006;61:693–698.
5.
Variations in the prevalence of respiratory symptoms, self-reported asthma attacks, and use of asthma medication in the European Community Respiratory Health Survey (ECRHS). Eur Respir J 1996;9:687–695.
6.
Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, et al: Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet 2006;368:733–743.
7.
Burbach GJ, Heinzerling LM, Edenharter G, Bachert C, Bindslev-Jensen C, Bonini S, et al: GA(2)LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe. Allergy 2009;64:1507–1515.
8.
Federal Public Service of Economy Belgium: Statistics Belgium. http://economie.fgov.be/en/statistics/figures/.
9.
Fay MP, Feuer EJ: Confidence intervals for directly standardized rates: a method based on the gamma distribution. Stat Med 1997;15:791–801.
10.
Coviello E: DISTRATE: Stata module to compute direct standardized rates with improved confidence interval – Statistical Software Components, Boston College Department of Economics. 2009. http://econpapers.repec.org/RePEc:boc:bocode:s456708.
11.
Annesi-Maesano I, Didier A, Klossek M, Chanal I, Moreau D, Bousquet J: The score for allergic rhinitis (SFAR): a simple and valid assessment method in population studies. Allergy 2002;57:107–114.
12.
Bousquet PJ, Chinn S, Janson C, Kogevinas M, Burney P, Jarvis D: European Community Respiratory Health Survey I: geographical variation in the prevalence of positive skin tests to environmental aeroallergens in the European Community Respiratory Health Survey I. Allergy 2007;62:301–309.
13.
Bousquet PJ, Burbach G, Heinzerling LM, Edenharter G, Bachert C, Bindslev-Jensen C, et al: GA2LEN skin test study III: minimum battery of test inhalent allergens needed in epidemiological studies in patients. Allergy 2009;64:1656–1662.
14.
Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al: Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008;63(suppl 86):8–160.
15.
Linneberg A: The increase in allergy and extended challenges. Allergy 2011;66(suppl 95):1–3.
16.
Sears MR, Burrows B, Flannery EM, Herbison GP, Holdaway MD: Atopy in childhood. 1. Gender and allergen related risks for development of hay fever and asthma. Clin Exp Allergy 1993;23:941–948.
17.
Osman M: Therapeutic implications of sex differences in asthma and atopy. Arch Dis Child 2003;88:587–590.
18.
Govaere E, Van Gysel D, Massa G, Verhamme KM, Doli E, De Baets F: The influence of age and gender on sensitization to aero-allergens. Pediatr Allergy Immunol 2007;18:671–678.
19.
Becklake MR, Kauffmann F: Gender differences in airway behaviour over the human life span. Thorax 1999;54:1119–1138.
20.
Goldhahn K, Bockelbrink A, Nocon M, Almqvist C, DunnGalvin A, Willich SN, Keil T: Sex-specific differences in allergic sensitization to house dust mites: a meta-analysis. Ann Allergy Asthma Immunol 2009;102:487–494.
21.
Bodtger U, Poulsen LK, Malling HJ: Asymptomatic skin sensitization to birch predicts later development of birch pollen allergy in adults: a 3-year follow-up study. J Allergy Clin Immunol 2003;111:149–154.
22.
Assing K, Bodtger U, Poulsen LK, Malling HJ: Grass pollen symptoms interfere with the recollection of birch pollen symptoms – a prospective study of suspected, asymptomatic skin sensitization. Allergy 2007;62:373–377.
23.
Marinho S, Simpson A, Söderström L, Woodcock A, Ahlstedt S, Custovic A: Quantification of atopy and the probability of rhinitis in preschool children: a population-based birth cohort study. Allergy 2007;62:1379–1386.
24.
Graif Y, Goldberg A, Tamir R, Vigiser D, Melamed S: Skin test results and self-reported symptom severity in allergic rhinitis: the role of psychological factors. Clin Exp Allergy 2006;36:1532–1537.
25.
Bousquet PJ, Castelli C, Daures JP, Heinrich J, Hooper R, Sunyer J, et al: Assessment of allergen sensitization in a general population-based survey (European Community Respiratory Health Survey I). Ann Epidemiol 2010;20:797–803.
26.
Fasce L, Tosca MA, Olcese R, Milanese M, Erba D, Ciprandi G: The natural history of allergy: the development of new sensitizations in asthmatic children. Immunol Lett 2004;93:45–50.
27.
Finkelman FD, Vercelli D: Advances in asthma, allergy mechanisms, and genetics in 2006. J Allergy Clin Immunol 2007;120:544–550.
28.
Prigione I, Morandi F, Tosca MA, Silvestri M, Pistoia V, Ciprandi G, Rossi GA: Interferon-gamma and IL-10 may protect from allergic polysensitization in children: preliminary evidence. Allergy 2010;65:740–742.
29.
De Jong AB, Dikkeschei LD, Brand PL: Sensitization patterns to food and inhalant allergens in childhood: a comparison of non-sensitized, monosensitized, and polysensitized children. Pediatr Allergy Immunol 2011;22:166–171.
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2012
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