Increasing Incidence And Prevalence Of Food Allergy Diagnoses Among Us Active Duty Service Members, 2000-2017

Food allergies have risen in the past several decades, though epidemiologic data are limited. The military reflects a young adult population with access to healthcare that may help to better describe the epidemiology of food allergies. Data were obtained from the Defense Medical Surveillance System, a U.S. military personnel database containing medical encounter data from all fixed medical facilities in the Military Health System (MHS). Cases of food allergy among active component service members were identified by having record of an outpatient encounter in an MHS allergy specialty clinic with an ICD-coded diagnosis of food allergy, food anaphylaxis, or other adverse reaction to food between 2000 and 2017. Incidence and prevalence rates were calculated and stratified by military and demographic characteristics. During the 18-year surveillance period, incidence of food allergy increased from 8.2 to 108.4 cases per 100,000 person-years and prevalence increased from 20.1 to 436.0 cases per 100,000 persons. In 2017, incidence and prevalence was highest among females, non-Hispanic Blacks, service members older than 35 years, and those in the Air Force, compared to their respective counterparts. Incidence was higher among service members stationed in the Midwest, although prevalence was higher among those stationed in the South and Midwest. In the military, an IgE-mediated food allergy can be disqualifying for entry and specific career specialties. However, given the increasing numbers of service members affected by this condition, the military may wish to consider new policies to allow applicants and members with avoidable food allergies to serve successfully.