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Listen to this siteTuesday 2 March 2004
This research aims to determine the incidence and the trigger factors of fatal acute asthma in subjects up to the age of 32.
Study Duration : April 2003 to March 2004
Contractor : Central Manchester and Manchester Children's University Hospitals
Deaths from acute asthma outnumber those from food anaphylaxis by 60:1. However, an unknown number of these fatal asthma attacks may be actually triggered by food allergy. Since asthma is regarded as a natural cause of death, the cause of the fatal asthma attack is not investigated.
Cases where individuals under the age of 32 have died from acute asthma will be investigated, with a free service being offered to coroners to identify a possible allergic cause for the death. Medical history and the circumstances of the fatal attack will be collected via the Coroner's Officer investigating the death. Autopsy and any available pre-mortem blood samples will be analysed for mast cell and basophil-specific proteins and specific IgE against any suspected allergens.
Background
Deaths from acute asthma reportedly outnumber those from food anaphylaxis by 60:1. However, an unknown number of these fatal asthma attacks may be actually triggered by food allergy. Since asthma is regarded as a natural cause of death, the cause of the fatal asthma attack is not investigated.
This project aimed to investigate and classify the true cause of fatal asthma attacks in all recorded cases during a 12 month period in the UK, in order to determine what proportion of these were in fact triggered by food allergy.
Research Approach
In the year studied (August 2003 – July 2004), 22 UK deaths in those aged 0-32 which were recorded as fatal asthma attack on the coroners report were investigated further, to establish any possible link with food allergy.
Blood samples were analysed for allergen specific IgE to foods and for mast cell tryptase.
Information about the deceased and the circumstances of the asthma attack were collected through the Coroner’s Officer in charge of the case, the pathologist, next of kin, General Practitioners and others who had witnessed the asthma attack.
Appropriately matched non-asthmatic fatality case controls were identified and used to compare with the cases.
Results
The project found that of the 22 deaths recorded as fatal asthma in England and Wales during the period studied, 3 deaths were likely to have been triggered by food allergy.
In addition, two other fatal asthma attacks were found to be triggered by milk and peanut allergy just before the start of the study.
Complete data from UK pathologists suggests that food allergy may be a cause for fatal asthma in young people in somewhere between 10 and 25% of cases.
This study highlights the need for coroners and pathologists to investigate fully the true cause of death from a fatal asthma attack, as a substantial fraction of asthmatic deaths may have been in fact triggered by food allergy.
The final report is available from the Agency’s Information Centre.
To obtain a copy, please contact the Enquiry Desk, Information Services, Food Standards Agency (tel: 020 7276 8181/8182 or email: library&infocentre@foodstandards.gsi.gov.uk)
For any enquiries concerning this research project, please contact the relevant Programme contact or email: mailto:science@foodstandards.gsi.gov.uk
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