The following is a summary of “Exposure to Domestic Abuse and the Subsequent Development of Atopic Disease in Women,” published in the June 2023 issue of Allergy and Clinical Immunology by Nash et al.

Domestic violence and abuse (DVA) is a global public health problem associated with significant morbidity and mortality. Few high-quality studies have evaluated the effect of DVA exposure on the onset of atopic disease. The purpose is to investigate the relationship between DVA exposure and the subsequent development of atopy. In this population-based, retrospective, open cohort study, women without a history of atopic disease were identified between January 1, 1995, and September 30, 2019, using IQVIA Medical Research Data, an anonymized UK primary care dataset. 

We utilized clinical codes to identify exposed patients (those with a code indicating exposure to DVA; n = 13,852) and unexposed patients (n = 49,036) matched by age and quintile of deprivation. Hazard ratios (HRs) (with 95% CIs) for developing atopic diseases such as asthma, atopic eczema, and allergic rhinoconjunctivitis were calculated using Cox proportional hazards regression. During the study period, 967 exposed women developed atopic disease (incidence rate: 20.10 per 1,000 person-years), compared to 2,607 unexposed women (incidence rate: 13.24 per 1,000 person-years). 

This resulted in an adjusted HR of 1.52 (95% CI, 1.41-1.64) when important confounders were accounted for: asthma (adjusted HR = 1.69; 95% CI, 1.44-1.99), atopic eczema (adjusted HR = 1.40; 95% CI, 1.26-1.56), and allergic rhinoconjunctivitis (adjusted HR = 1.63; 95% CI, 1.45-1. Domestic violence and maltreatment is a significant public health concern on a global scale. These findings indicate a substantial risk of developing an atopic disease. There is a need for public health approaches to the prevention and detection of DVA to reduce the resulting illness burden.

Source: sciencedirect.com/science/article/pii/S2213219823003008