of sensitization and disease caused by regional and local indoor allergens would be useful in this regard. The following recommendations for research and data collection will be useful in accurately determining the magnitude and dimensions of sensitization and disease caused by indoor allergens.
Research Agenda Item: Determine prevalence rates of sensitization, allergic diseases, and respiratory morbidity caused by regionally and locally relevant indoor allergens and assess the contributions of different allergens to these conditions.
Socioeconomic status seems to contribute to asthma prevalence rates and to indices of disease severity. Similarly, several studies have reported racial differences in the prevalence and severity of asthma in the United States, but such results are inconsistent. In order that these differentials can be translated into effectively targeted public health interventions, additional research is needed to clarify these relationships.
Research Agenda Item: Conduct studies to clarify the relationships that exist between socio- economic status, race, and cultural environment and the incidence, prevalence, severity, and mortality associated with allergic disease including asthma.
The annual costs (direct and indirect) associated with asthma have been estimated at more than $6.2 billion—an increase of 39 percent since 1985. The size of these costs and the trend towards even greater costs argue for careful attention not only to the effects of allergy in causing asthma but also to the litany of other conditions that are more commonly thought to be associated with "allergies." Accurate assessments of the costs associated with asthma and other allergic diseases would be useful in the development of health policy initiatives and the implementation of appropriate and cost effective interventions.
Research Agenda Item: Determine the economic impact of asthma and other allergic diseases.
Allergic disease occurs when a genetically predisposed or susceptible individual is exposed to an allergen and becomes immunologically sensitized. In the early stages of sensitization, people who are sensitized have not developed symptoms of disease. The magnitude of this group within the population is of interest, however, because it reflects the proportion of the population at greatest risk of developing allergic disease. Additional exposure to the sensitizing allergen leads to the development of an allergic reaction (disease) that can be mild, moderate, or severe, depending on the amount of exposure.
The relationship between exposure, sensitization, and disease, and the