These are the most

common—and
deadliest—allergies
Seasonal allergies hit us hard, but you might
be surprised by what kills us.
By Sara Chodosh
May 3, 2018

Data from Salo et al., 2014Infographic by Sara Chodosh

Allergies also vary by geography somewhat, though this is true

Hint: none of these are the most common allergen Deposit Photos
mostly for allergens that vary by region. People who simply
aren't exposed to rye plants probably won't experience rye
allergies.
Despite affecting some 50 million Americans, allergies aren’t
super well understood. The sparks that ignite your immune
system can range from sunlight to onions, and symptoms of an
attack are just as varied. For that reason, we’re spending
several weeks writing about allergies—what they are, how they
manifest, and how we can find relief. This is PopSci’s Allergic
Reaction.

Given how confused we all seem about what the word "allergy"
means, it's not surprising that it seems like
suddenly everyone has one. But it's not just our
perception. Allergies are on the rise, though no one is exactly
sure by how much.

One analysis from 2017, using hospital admissions for

anaphylaxis as a proxy, found that food allergy rates had
roughly doubled in the U.S. Climate change also seems to
be making pollen allergies worse, and worldwide it seems all
kinds of allergies are up, but again, it's not clear what the actual Data from Salo et al., 2014Infographic by Sara Chodosh
numbers are.

Tracking allergies is tricky. Self-reported data is notoriously
unreliable, but we also don’t have access to private diagnostic
data on individuals with the sniffles. The closest we get is the
NHANES (that’s National Health and Nutrition Examination
Survey), which asks a representative sample of Americans about
their health. It only goes out every few years, though, and the
fact that questions often get dropped or added makes it hard to
look at trends over time.
But it is useful for snapshots. The 2005-2006 version asked
specifically about various types of allergies, which researchers
analyzed and published in theJournal of Allergy of Clinical
Immunology. We used that data to create the graphs and maps
below, showing just how prevalent various types of allergies are.
Or, at least, how prevalent they were in 2005-2006—presumably
the rates have increased a bit since then, but the general trends
still hold.
It's harder still to get information on how deadly different
allergies might be. We track fatalities worldwide using ICD
codes, which is an international standardized system for
identifying diagnoses and causes of death (it stands for the
International Classification of Diseases, and we're on version
10). There are ICD-10 codes for anaphylaxis resulting from
unspecific food, peanuts, shellfish, other fish, fruits and
vegetables, tree nuts and seeds, food additives, milk and dairy
products, eggs, and other food products (T78.00-T78.09). There
are also many more codes for medication reactions and deaths
due to venom. Unfortunately, none of these are allowed as
primary causes of death, so you have to dig deeper into the data
and look at secondary codes. One group actually did this for the
data from 1999 to 2010, and though they didn't break it down
much by specific type of allergy, deaths from food-induced
anaphylaxis were the least common type of anaphylaxis death.
Reactions to medication are by far the deadliest, with a rate of
0.42 fatal cases of anaphylaxis per million people. Food reaction
come in at 0.04 per million, while venom kills 0.11 (“non-
specified” is the second-biggest, at 0.14).

That being said, it all depends on how you define “deadliest.”

Many more people take prescription medications than have
potentially deadly allergies, so this is probably in part an artifact
of that imbalance—if millions of people are exposed to new
drugs that they might be allergic to every year, that’s a lot more
opportunity to have an adverse reaction. Less than 10 percent of
the population is allergic to peanuts, and even fewer have an
anaphylactic response. Across the years of the study, 149 people
died of food allergies, while 370 died of venom-induced
anaphylaxis—those might be from bee stings, but they may also
be from other venomous creatures. Those both pale in
comparison to the 1,408 people who died from medication
reactions, but when you compare it to the number of people who
take medications versus have serious allergies, the allergies will
come out deadlier.

It may also be because Epi-Pens are now so ubiquitous. Though

they’re still quite expensive, most people in America with
anaphylactic responses to food or insect stings carry one, and
they’re effective tools to allow you enough time to get to an
emergency room where you can be treated. Allergies may be on
the rise, but they’re probably getting less deadly.