Pollen Food Allergy Syndrome in Black and White Children with Food Allergies in the FORWARD Study

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Pollen Food Allergy Syndrome (PFAS) and allergic rhinitis (AR) have not been well documented in the pediatric population with reference to race. The aim was to determine the prevalence of PFAS and AR by race in children with food allergies. FORWARD is a prospective, multi-center, cohort study, recruiting black and white children 0-12 years of age with allergist-diagnosed IgE-mediated food allergies. Guardians of enrolled participants completed an intake survey, which assesses food allergy in association with PFAS and AR. Of 492 children [170 (34.6%) black] with complete surveys, 9.2% reported PFAS (11.5% of blacks, 8.0% of whites). There was no observed association between race and PFAS (p>0.05). However, there was a significant association between age and PFAS (p<0.01) in whites, with children >5 years old more likely to have PFAS than those <5 years. There was no significant association between age and PFAS in black children. Black children allergic to tree nut, shellfish, soy, and sesame were more likely to have PFAS (p<0.05). White children allergic to fin fish and sesame were more likely to have PFAS (p<0.05). White children with PFAS were more likely to have AR (p<0.001). In this cohort, 9.2% of children with food allergy also have PFAS, but there was no association by race. PFAS was associated with older age in white children. Interestingly, specific food allergens associated with PFAS differed by race.