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Differences in hospital attendance for anaphylaxis between immigrants and non‐immigrants: a cohort study
Author(s) -
Norredam M.,
Sheikh A.,
Dynnes Svendsen K.,
Holm Petersen J.,
Garvey L. H.,
Kristiansen M.
Publication year - 2016
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/cea.12719
Subject(s) - medicine , danish , demography , immigration , residence , attendance , incidence (geometry) , poisson regression , cohort study , cohort , pediatrics , epidemiology , population , environmental health , geography , optics , economics , philosophy , linguistics , physics , archaeology , sociology , economic growth
Summary Background The impact of migration on the risk of anaphylaxis remains unknown. We hypothesized that non‐Western immigrants have a lower incidence of anaphylaxis compared to Danish‐born. We investigated variations in hospital attendance for anaphylaxis between immigrants and Danish‐born including time‐ and age‐ trends. Methods A register‐based, historical prospective cohort design. Refugees or family reunified immigrants ( n = 127 250) who, between January 1, 1994 and December 31, 2010, obtained residency permits in Denmark were included and matched in a 1 : 6 ratio on age and sex with Danish‐born individuals ( n = 740 600). Personal identification numbers were cross‐linked to the Danish National Patient Registry identifying all first‐time hospital attendances for anaphylaxis from January 1, 1994 and December 31, 2010. Incidence rate ratios were estimated, stratified for sex and region of birth, adjusting for age using a Cox regression model including the influence of duration of residence and age when residence was obtained. Results In total 1053 hospital attendances for anaphylaxis were identified: 89 among non‐Western immigrants, 9 among Western immigrants and 955 among Danish‐born patients. Both male ( RR = 0.65; 95% CI : 0.46;0.90) and female ( RR = 0.64; 95% CI : 0.48;0.85) non‐Western immigrants had a significantly lower risk ratio of hospital attendance for anaphylaxis compared to Danish‐born. Compared to Danish‐born, non‐Western immigrants living in Denmark during the entire follow‐up period also showed a decreased risk ( RR = 0.65; 95% CI : 0.34;1.25). Compared to Danish‐born, non‐Western immigrants who obtained residence permission as children had a decreased risk of hospital attendance for anaphylaxis ( RR = 0.48; 95% CI : 0.25;0.91). Conclusion This Danish register‐based study using nationwide data revealed fewer hospital attendances for anaphylaxis among non‐Western immigrants compared to Danish‐born; however this protection was lost over time.