ALLERGY SKIN TEST Allergy skin reactivity testing was conducted on all examinees aged 6-19 years and on a random half-sample of examinees aged 20-59 years by a trained examiner in the mobile examination center (MEC). Before skin testing, screening questions were asked to determine medical safety exclusions. Those excluded from testing were examinees who: usually did not have trouble breathing in their chest or lungs but who were having trouble breathing at the time of the examination (this trouble was NOT due to nasal congestion from a cold), usually had trouble breathing in their chest or lungs and had more trouble breathing at the time of the exam, had a severe response to allergen skin testing previously, or had severe eczema or infection on both arms. Because this examination was administered to a selected subsample in the examination center, the allergy sample weight (WTPFALG6) should be used for data analysis. For more information on the use of sample weights in NHANES III data analysis, refer to the NHANES III Analytic and Reporting Guidelines (U.S. DHHS, 1996b). The allergy skin test consisted of the evaluation of immediate hypersensitivity reactions to any of 10 licensed, commercially available, FDA-approved, standardized allergens as well as positive and negative controls. The extracts were indoor allergens (Dermatophagoides farinae (house mite), cat, German cockroach), outdoor allergens (short ragweed, perennial rye, Alternaria alternata, Bermuda grass, Russian thistle, white oak), and a food allergen (peanut). The positive control was histamine, and the negative control was the glycerinated diluent. Examiners prepared fresh allergen solutions upon arrival at each MEC site. Hypersensitivity reactions were evaluated after administering the allergens on an examinee's forearms. Allergens were applied using the prick-puncture technique at 12 skin sites (one for each allergen and the positive and negative controls) determined by a clear, plastic template. The flare and wheal areas were delineated with a marking pen 15 minutes after the skin was punctured and the allergens were applied. The length and width of the flare and wheal were measured with a 100- mm flexible, clear, plastic ruler. Length was defined as the longest diameter of the reaction, and width was defined as the diameter perpendicular to the length at its midpoint. If a reaction had any dimension 3 mm or greater, all four dimensions (length and width of flare and wheal) were measured and recorded. If all four dimensions were less than 3 mm, zeroes were recorded for all the measurements. Confluence was noted for both allergens if two reactions overlapped. For details of the allergy testing protocol, see the Training Manual for Allergy Component (U.S. DHHS, 1996b). The NHANES III allergy skin test was administered by health technicians who were trained to perform the testing. Training occurred before the examination period at special training sessions held at NCHS or at the offices of the contractor responsible for survey operations. The component was monitored on a regular basis by the component consultant, and retraining was conducted annually. In addition to data collection training, the technicians were trained to recognize and respond to generalized hypersensitivity reactions. A physician was in the MEC during all examinations, and drugs for treating systemic allergic reactions were available. Information on respiratory symptoms related to allergies can be found in the Household Adult Data File (for examinees aged 17 years and over) and the Household Youth Data File (for examinees aged 2 months-16 years). The allergen data fields are blank for examinees who were excluded for safety reasons. For those examinees who were eligible for the allergy skin test but for whom allergen data were not collected, the allergen measurement fields have "888 Blank but applicable" values. In most cases, these missing data were due to examinees not participating in the allergy skin test, usually due to time constraints. In other cases, however, data on some but not all allergens were collected. These gaps in the data were due to refusals to continue the testing or to receive specific allergens. All measurements were taken within the acceptable time of 15 plus or minus 5 minutes except for one examinee who was measured at 23 minutes after the administration of the allergens and the controls. Therefore, the variables indicating the minutes from administration to reading for each allergen were not included on this data file. Data processing and editing were performed to ensure internal data consistency. NHANES III Examination Data File ------------------------------------------------------------------------ ALLERGY SKIN TEST ------------------------------------------------------------------------ SCREENING QUESTIONS AND GENERAL INFORMATION ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 2876 Are you now having problems breathing in ALPQ1 your chest or lungs? 198 1 Yes 10782 2 No (ALPQ4) 1126 8 Blank but applicable 19205 Blank 2877 Do you usually have breathing problems ALPQ2 in your chest or lungs? 110 1 Yes 88 2 No - exclude 1126 8 Blank but applicable 29987 Blank 2878 Is your current breathing problem worse ALPQ3 than usual in your chest or lungs? 25 1 Yes - exclude 84 2 No 1127 8 Blank but applicable 30075 Blank 2879 Have you had a past severe reaction to ALPQ4 allergen skin testing? 50 1 Yes - exclude 10812 2 No 1131 8 Blank but applicable 19318 Blank 2880 Does sample person have severe eczema or ALPQ5 infection on both arms? 11 1 Yes - exclude 10800 2 No 1132 8 Blank but applicable 19368 Blank NHANES III Examination Data File ------------------------------------------------------------------------ ALLERGY SKIN TEST ------------------------------------------------------------------------ TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 2881 Negative control - arm ALPNEGAR 12 1 Right arm 10850 2 Left arm 1070 8 Blank but applicable 19379 Blank 2882-2884 Negative control - flare length (mm) ALPNEGFL 10863 000-067 1069 888 Blank but applicable 19379 Blank 2885-2887 Negative control - flare width (mm) ALPNEGFW 10863 000-033 1069 888 Blank but applicable 19379 Blank 2888 Negative control - confluent ALPNEGCN 3 1 Yes 10860 2 No 1069 8 Blank but applicable 19379 Blank 2889-2891 Negative control - wheal length (mm) ALPNEGWL 10863 000-012 1069 888 Blank but applicable 19379 Blank 2892-2894 Negative control - wheal width (mm) ALPNEGWW 10863 000-006 1069 888 Blank but applicable 19379 Blank 2895 White oak - arm ALPWHIAR 5 1 Right arm 10854 2 Left arm 1073 8 Blank but applicable 19379 Blank NHANES III Examination Data File ------------------------------------------------------------------------ ALLERGY SKIN TEST ------------------------------------------------------------------------ TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 2896-2898 White oak - flare length (mm) ALPWHIFL 10858 000-075 1074 888 Blank but applicable 19379 Blank 2899-2901 White oak - flare width (mm) ALPWHIFW 10858 000-065 1074 888 Blank but applicable 19379 Blank 2902 White oak - confluent ALPWHICN 61 1 Yes 10797 2 No 1074 8 Blank but applicable 19379 Blank 2903-2905 White oak - wheal length (mm) ALPWHIWL 10859 000-037 1073 888 Blank but applicable 19379 Blank 2906-2908 White oak - wheal width (mm) ALPWHIWW 10859 000-018 1073 888 Blank but applicable 19379 Blank 2909 Cat - arm ALPCATAR 5 1 Right arm 10850 2 Left arm 1077 8 Blank but applicable 19379 Blank 2910-2912 Cat - flare length (mm) ALPCATFL 10855 000-078 1077 888 Blank but applicable 19379 Blank NHANES III Examination Data File ------------------------------------------------------------------------ ALLERGY SKIN TEST ------------------------------------------------------------------------ TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 2913-2915 Cat - flare width (mm) ALPCATFW 10855 000-049 1077 888 Blank but applicable 19379 Blank 2916 Cat - confluent ALPCATCN 96 1 Yes 10758 2 No 1078 8 Blank but applicable 19379 Blank 2917-2919 Cat - wheal length (mm) ALPCATWL 10855 000-030 1077 888 Blank but applicable 19379 Blank 2920-2922 Cat - wheal width (mm) ALPCATWW 10855 000-017 1077 888 Blank but applicable 19379 Blank 2923 Mite - arm ALPMITAR 5 1 Right arm 10850 2 Left arm 1077 8 Blank but applicable 19379 Blank 2924-2926 Mite - flare length (mm) ALPMITFL 10854 000-104 1078 888 Blank but applicable 19379 Blank 2927-2929 Mite - flare width (mm) ALPMITFW 10854 000-064 1078 888 Blank but applicable 19379 Blank NHANES III Examination Data File ------------------------------------------------------------------------ ALLERGY SKIN TEST ------------------------------------------------------------------------ TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 2930 Mite - confluent ALPMITCN 162 1 Yes 10692 2 No 1078 8 Blank but applicable 19379 Blank 2931-2933 Mite - wheal length (mm) ALPMITWL 10855 000-073 1077 888 Blank but applicable 19379 Blank 2934-2936 Mite - wheal width (mm) ALPMITWW 10855 000-016 1077 888 Blank but applicable 19379 Blank 2937 Alternaria - arm ALPALTAR 5 1 Right arm 10850 2 Left arm 1077 8 Blank but applicable 19379 Blank 2938-2940 Alternaria - flare length (mm) ALPALTFL 10855 000-110 1077 888 Blank but applicable 19379 Blank 2941-2943 Alternaria - flare width (mm) ALPALTFW 10855 000-054 1077 888 Blank but applicable 19379 Blank 2944 Alternaria - confluent ALPALTCN 148 1 Yes 10706 2 No 1078 8 Blank but applicable 19379 Blank NHANES III Examination Data File ------------------------------------------------------------------------ ALLERGY SKIN TEST ------------------------------------------------------------------------ TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 2945-2947 Alternaria - wheal length (mm) ALPALTWL 10855 000-027 1077 888 Blank but applicable 19379 Blank 2948-2950 Alternaria - wheal width (mm) ALPALTWW 10855 000-018 1077 888 Blank but applicable 19379 Blank 2951 Rye grass - arm ALPRYEAR 5 1 Right arm 10850 2 Left arm 1077 8 Blank but applicable 19379 Blank 2952-2954 Rye grass - flare length (mm) ALPRYEFL 10854 000-120 1078 888 Blank but applicable 19379 Blank 2955-2957 Rye grass - flare width (mm) ALPRYEFW 10854 000-083 1078 888 Blank but applicable 19379 Blank 2958 Rye grass - confluent ALPRYECN 164 1 Yes 10691 2 No 1077 8 Blank but applicable 19379 Blank 2959-2961 Rye grass - wheal length (mm) ALPRYEWL 10855 000-061 1077 888 Blank but applicable 19379 Blank NHANES III Examination Data File ------------------------------------------------------------------------ ALLERGY SKIN TEST ------------------------------------------------------------------------ TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 2962-2964 Rye grass - wheal width (mm) ALPRYEWW 10855 000-038 1077 888 Blank but applicable 19379 Blank 2965 Peanut - arm ALPPEAAR 10842 1 Right arm 7 2 Left arm 1083 8 Blank but applicable 19379 Blank 2966-2968 Peanut - flare length (mm) ALPPEAFL 10849 000-077 1083 888 Blank but applicable 19379 Blank 2969-2971 Peanut - flare width (mm) ALPPEAFW 10849 000-044 1083 888 Blank but applicable 19379 Blank 2972 Peanut - confluent ALPPEACN 18 1 Yes 10830 2 No 1084 8 Blank but applicable 19379 Blank 2973-2975 Peanut - wheal length (mm) ALPPEAWL 10849 000-031 1083 888 Blank but applicable 19379 Blank 2976-2978 Peanut - wheal width (mm) ALPPEAWW 10849 000-011 1083 888 Blank but applicable 19379 Blank NHANES III Examination Data File ------------------------------------------------------------------------ ALLERGY SKIN TEST ------------------------------------------------------------------------ TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 2979 Russian thistle - arm ALPTHIAR 10841 1 Right arm 7 2 Left arm 1084 8 Blank but applicable 19379 Blank 2980-2982 Russian thistle - flare length (mm) ALPTHIFL 10848 000-076 1084 888 Blank but applicable 19379 Blank 2983-2985 Russian thistle - flare width (mm) ALPTHIFW 10848 000-052 1084 888 Blank but applicable 19379 Blank 2986 Russian thistle - confluent ALPTHICN 57 1 Yes 10790 2 No 1085 8 Blank but applicable 19379 Blank 2987-2989 Russian thistle - wheal length (mm) ALPTHIWL 10848 000-030 1084 888 Blank but applicable 19379 Blank 2990-2992 Russian thistle - wheal width (mm) ALPTHIWW 10848 000-016 1084 888 Blank but applicable 19379 Blank 2993 German cockroach - arm ALPCOCAR 10839 1 Right arm 7 2 Left arm 1086 8 Blank but applicable 19379 Blank NHANES III Examination Data File ------------------------------------------------------------------------ ALLERGY SKIN TEST ------------------------------------------------------------------------ TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 2994-2996 German cockroach - flare length (mm) ALPCOCFL 10846 000-082 1086 888 Blank but applicable 19379 Blank 2997-2999 German cockroach - flare width (mm) ALPCOCFW 10846 000-058 1086 888 Blank but applicable 19379 Blank 3000 German cockroach - confluent ALPCOCCN 99 1 Yes 10746 2 No 1087 8 Blank but applicable 19379 Blank 3001-3003 German cockroach - wheal length (mm) ALPCOCWL 10846 000-034 1086 888 Blank but applicable 19379 Blank 3004-3006 German cockroach - wheal width (mm) ALPCOCWW 10846 000-016 1086 888 Blank but applicable 19379 Blank 3007 Bermuda grass - arm ALPBERAR 10841 1 Right arm 6 2 Left arm 1085 8 Blank but applicable 19379 Blank 3008-3010 Bermuda grass - flare length (mm) ALPBERFL 10847 000-094 1085 888 Blank but applicable 19379 Blank NHANES III Examination Data File ------------------------------------------------------------------------ ALLERGY SKIN TEST ------------------------------------------------------------------------ TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3011-3013 Bermuda grass - flare width (mm) ALPBERFW 10847 000-079 1085 888 Blank but applicable 19379 Blank 3014 Bermuda grass - confluent ALPBERCN 216 1 Yes 10631 2 No 1085 8 Blank but applicable 19379 Blank 3015-3017 Bermuda grass - wheal length (mm) ALPBERWL 10847 000-037 1085 888 Blank but applicable 19379 Blank 3018-3020 Bermuda grass - wheal width (mm) ALPBERWW 10847 000-019 1085 888 Blank but applicable 19379 Blank 3021 Ragweed - arm ALPRAGAR 10841 1 Right arm 7 2 Left arm 1084 8 Blank but applicable 19379 Blank 3022-3024 Ragweed - flare length (mm) ALPRAGFL 10847 000-120 1085 888 Blank but applicable 19379 Blank 3025-3027 Ragweed - flare width (mm) ALPRAGFW 10847 000-075 1085 888 Blank but applicable 19379 Blank NHANES III Examination Data File ------------------------------------------------------------------------ ALLERGY SKIN TEST ------------------------------------------------------------------------ TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3028 Ragweed - confluent ALPRAGCN 329 1 Yes 10518 2 No 1085 8 Blank but applicable 19379 Blank 3029-3031 Ragweed - wheal length (mm) ALPRAGWL 10848 000-060 1084 888 Blank but applicable 19379 Blank 3032-3034 Ragweed - wheal width (mm) ALPRAGWW 10848 000-025 1084 888 Blank but applicable 19379 Blank 3035 Positive control - arm ALPPSCAR 10839 1 Right arm 7 2 Left arm 1086 8 Blank but applicable 19379 Blank 3036-3038 Positive control - flare length (mm) ALPPSCFL 10847 000-120 1085 888 Blank but applicable 19379 Blank 3039-3041 Positive control - flare width (mm) ALPPSCFW 10847 000-070 1085 888 Blank but applicable 19379 Blank 3042 Positive control - confluent ALPPSCCN 301 1 Yes 10546 2 No 1085 8 Blank but applicable 19379 Blank NHANES III Examination Data File ------------------------------------------------------------------------ ALLERGY SKIN TEST ------------------------------------------------------------------------ TEST RESULTS ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 3043-3045 Positive control - wheal length (mm) ALPPSCWL 10847 000-065 1085 888 Blank but applicable 19379 Blank 3046-3048 Positive control - wheal width (mm) ALPPSCWW 10847 000-012 1085 888 Blank but applicable 19379 Blank 3049-3053 Examiner number 1 See note ALPTECH1 10930 01001-09018 1176 88888 Blank but applicable 19205 Blank 3054-3058 Examiner number 2 See note ALPTECH2 11446 01001-09018 660 88888 Blank but applicable 19205 Blank NOTES ALPTECH1 and ALPTECH2: Examiners number 1 and 2 Because of the time interval between allergen placement and reading, the examiner number was entered twice. Examiner number 1 placed the allergens, and examiner 2 measured the reactions.