Socioenvironmental factors associated with shrimp allergy and shrimp sensitization in a large and diverse patient population and cohort study from metropolitan Detroit

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Background: Earlier studies have demonstrated significant differences in food allergy by race and ethnicity, particularly for seafood and shrimp. Shrimp allergy is particularly interesting given the potential for cross-reactive sensitization from other arthropods. Objectives: We characterized risk factors for shrimp allergy and shrimp sensitization. Methods: Data from electronic health records were abstracted for food allergies among patients who sought care at a large health system between October 1, 2010, and April 1, 2024. Geocoded addresses were linked to US Census data to identify characteristics associated with shrimp allergy. Non-Hispanic Black participants from the Study of Asthma-Related Phenotypes and Pharmacogenomic Interactions by Race-Ethnicity (SAPPHIRE) were assessed for allergic sensitization using an IgE array, and survey data collected from participants were evaluated for association with shrimp, cockroach, and dust mite sensitization. Results: Among 2,975,183 health system patients, 4,709 individuals reported shrimp allergy. Compared to White individuals, rates of shrimp allergy were significantly higher in Black, Asian/Pacific Islander, Native American, and Latino individuals. Shrimp allergy was higher with increasing age, female sex, and asthma, and it was inversely related to median household income. Among SAPPHIRE participants, sensitization to shrimp, cockroach, and dust mite was positively associated with total IgE levels and proportion of African ancestry, but inversely associated with head of household level of education. Conclusions: Both shrimp allergy and sensitization were associated with sociodemographic factors, suggesting that environmental exposures leading to cross-reactive sensitization may be important risk factors. Nevertheless, sensitization was also associated with ancestry, highlighting the potential importance of group-specific genetic risk factors.

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