Alcoholic drinks: Important triggers for asthma

Background: Although anecdotally alcoholic drinks seem to be common triggers for asthma, little is known of the prevalence, the characteristics, or the mechanisms underlying these reactions. Objectives: The primary aim of this study was to determine the frequency and characteristics of asthmatic reactions triggered by alcoholic drinks in a community-based cohort of asthmatic subjects, Investigations of other food sensitivities were also completed to explore some of the possible components of alcoholic drinks that may be responsible for these asthmatic responses, Methods: A validated food allergy questionnaire was used to assess the characteristics of alcoholic drink-induced asthma in 366 adult patients recruited from the Asthma Foundation of Western Australia, The food allergy questionnaire was sent out by mail and self-administered by recipients. Results: Thirty-three percent of respondents indicated that alcoholic drinks had been associated with the triggering of asthma on at least 2 occasions. Wines were the most frequent triggers, with responses being rapid in onset (<1 hour) and of mild to moderate severity. Logistic regression analysis indicated that wine-induced asthmatic reactions were reported more often by women (P = .032), by those taking oral steroids (P = .021), by individuals who had reported their first asthma attack at a younger age (P < .001), and by those who had previously visited an alternative health practitioner for asthma (P = .041). A significant association between wine-induced asthma and asthma triggered by sulfite-containing foods (P < .001) and by aspirin and nonsteroidal anti-inflammatory medicines (P = .01) was also observed. Conclusion: Alcoholic drinks, and particularly wines, appear to be important triggers for asthmatic responses. Sensitivity to the sulfite additives in wines seems likely to play an important role in many of these reactions. Sensitivities of individuals to salicylates present in wines may also play a role.