A report released yesterday suggests that the UK is in the grip of an allergy epidemic and is failing to manage the situation.
The report comes from the House of Lords Science and Technology Committee and states that the numbers affected by allergies have trebled over the past 20 years. It goes on to say that a third of the population, that's 18 million people, will develop an allergy with the symptoms ranging from trivial to life-threatening. These figures put the UK incidence amongst the highest in the world, a situation made worse by the fact that the UK is lagging behind the rest of Europe in tackling the problem.
Official figures show just how much of a problem allergies have become. The number of people having visit a hospital as a result of anaphylactic shock, the most severe and potentially life-threatening allergic reaction, rose by 700% from 1990 to 2004. In 2004 more than 30,000 people suffered a life-threatening attack. Of this number, half were treated in accident and emergency departments and 3,171 were admitted to hospital.
Another indicator of the increasing prevalence of allergic diseases is the increase in asthma cases. The explosion in the number of asthma sufferers started in the 1950s and the number of people affected roughly doubled every 14 years until the mid-1990s when there was a slight plateauing. Research figures published in 2004 research showed that 39 per cent of children and 30 per cent of adults had been diagnosed with one or more of asthma, hay fever and eczema.
Allerges have increased across the board with one of the largest increases being that of peanut allergy which increased by 117% in just 4 years between 2001 and 2005. It is estimated that 25,000 people in England are affected, and many are at risk of a severe reaction if they are exposed to the nuts. The report states that 2% of the adult population have a food allergy and up to 7% of infants do. These figures are strictly for the classical IgE-mediated form of allergy where symptoms are immediate. Conditions that might be termed food intolerances or food sensitivities are not included.
One section of the report that has grabbed headlines is the recommendation that the guidance to pregnant women and children not to eat peanuts should be withdrawn because it may actually be exacerbating the problem of peanut allergy. Athough to a lot of people this may seem counter-intuitive, in cultures where peanuts and peanut derived foods are routinely fed to infants and children the problem of peanut allergy does not exist. The authors of the report therefore suggest that depriving children of exposure to peanuts early in life might increase the risk of an allergic reaction later.
One theory that can explain this aspect of peanut allergy which is also the most popular theory of why allergies as a whole are rising is the 'hygiene hypothesis'. The theory was devised by David Strachan in the 1980s and essentially it says that as we lead cleaner, germ-free lives, and are exposed to fewer illnesses in childhood because of smaller families, our immune systems are under-developed and over-react when exposed to allergens such as grass pollen, house dust mites and cat hairs (and peanuts). Theory has been well studied and much research now backs it up. A key validating fact is that children raised on farms with livestock have a third fewer allergies than those who are not.
One problem for the hygiene hypothesis is that allergies also seem to be increasing in countries and regions that are less developed and do not have the modern germ-free, hygiene obsessed lifestyle that we have in developed nations. Of course we live on one planet with pollution being blown over vast areas. Air pollution has been implicated in increases in allergic conditions so perhaps this could account for allergy increases in less developed areas.
The report concludes by drawing attention to the poor state of allergy care in the UK. Baroness Finlay of Landaff, who chaired the committee's review, said the UK was "the laughing stock of Europe" for not providing treatments that are routinely available in other countries. An example of this is Immunotherapy, a treatment which uses increasing doses of an allergen to slowly desensitize a patient. The treatment was stopped 20 years ago in the UK after its misuse led to a number of deaths. The report recommends that immunotherapy should be reintroduced in light of its proven effectiveness.
Another area that came in for criticism is the provision of allergy clinics and specialist allergy doctors. There are currently 94 allergy clinics in the UK but only six are headed by a full-time consultant in allergy. The report says there should be 10 and that they should provide training for family doctors, nurses and schools in the local area.
It's not just the UK where allergies are on the increase, it is a worldwide phenomenon. Figures published by the World Health Organization in May 2007 show increasing allergy rates in the majority of European countries.