Features - Allergy in the UK

Allergy in the UK: What's being done?

We're constantly reading that allergies are on the increase, yet there seems to be a chronic lack of commitment from the health service to fight the problem. We take a look at the extent to which Britain is affected by allergies, why they are on the increase and what you can do to help.

As an allergy sufferer yourself, or as someone who lives with an allergy sufferer, you know the facts only too well. One in three of the UK population now has an allergy, an estimated six million people have eczema, nine million have hay fever…the list goes on. You're also likely to have experienced inadequate knowledge from your GP on the subject, a long wait to see an allergy specialist and a lack of other resources available to you. When you consider how damaging allergy can be to quality of life, this kind of treatment only makes matters worse.

Last summer the Royal College of Physicians (RCP) drew up a report on the provision of allergy services in the UK and found there was a 'serious deficit in the NHS allergy care services at a time when allergy is on the increase.' It found that there are only six major allergy centres in the UK, which are all concentrated in the south and south-east. Training in allergy is minimal or non-existant and there is a lack of expertise in diagnosing and dealing with allergy in General Practice, i.e at doctors' surgeries. There are also far too few allergy specialists to meet current clinical or service needs or to provide vital training.

None of it is good news, but it seems that finally someone is starting to sit up and listen. The Global Allergy and Asthma European Network, comprising of scientists from across the world, aims to find out why the number of allergy sufferers is soaring. It will bring together the fragmented information and evidence already gathered on allergies and build on it. "I hope that after two years we will already have some answers and within five years we will have final answers, " says Paul van Cauwenberge, dean of the medical faculty of the University of Ghent in Belgium who's involved in the project.

Children and Asthma in the UK

One of the key issues raised is why children in the UK have the third highest rate of asthma in the world. A report by the International Study of Asthma and Allergies in Childhood found that the UK has more teenage asthma cases than any other country in Europe, with 32.2% of 13 to 14-year-olds affected. Ireland came next with 29.1%, followed by Malta and Finland on 16%. Scientists think our genes may be partly responsible. Only two countries in the world had worse teenage asthma figures - Australia and New Zealand. "In those countries close to 50% of children are allergic," says Paul van Cauwenberge. "It has become almost more normal to be allergic than not". In the UK, he said, 40% of children have some sort of allergy.
A key part of the project is to examine whether the change in our lifestyles has affected the rise in allergies while scientists at Southampton University will coordinate the research on food allergies and ask whether a change in diet could prevent allergies developing.

Other researchers will investigate why people who work in offices are more susceptible and the issue of gender is also looked into. In infancy, boys are more likely to be asthmatic than girls, but the trend is reverse by adolescence. Pollution from diesel particles is also implicated. "People living within 50 metres of a motorway have more chance of developing allergies," said Prof Van Cauwenberge.

How Allergies have grown

One person who welcomes the projects is Muriel Simmons, Chief Executive of AllergyUK, Britain's leading charity that helps people with allergy. She knows only too well how widespread the problem is. "I've been with Allergy UK for eight years and in that time I've seen a huge increase in the numbers of people with allergy and across a wider spectrum," she says. "When I started, the hay fever season began in May and peaked in August. Now it begins in March and is still happening in September. Also people are developing allergies later in life. Sufferers usually grow out of hay fever by the time they're 21, but people over 30 are contacting us who've never had it before. We're also seeing new allergies, such as latex allergy. Over 8% of healthcare workers have a latex allergy, which results in a huge loss of skills to the NHS as these people cannot work.

In 2000, following prolonged campaigning, allergy was recognised as a specialist subject, like gynaecology for instance. But that does not mean there will be more allergy specialists, which will shorten the queue when it comes to seeking more comprehensive treatment as no additional funding was released for allergy services or for training. However, where Muriel would really like to see changes made is at the primary care level, such as with GPs and nurses.

"What's happening is someone with a skin problem will go to their GP and be referred to a dermatologist," explains Muriel. "Someone who wheezes will be sent to a respiratory specialist and someone with stomach problems will see a gastroenteritis specialist. Allergy is a multi organ disease and can appear in many forms. Until it's recognised that the patient might be suffering from a particular allergy and identifying what that allergy is can they be helped. After all, avoidance is only part of a management programme, but if you don't know what to avoid you cannot be in control.

Why are allergies on the increase?

According to Muriel there are two schools of thought. One is that the increase in pollution means the allergens aren't able to escape thus increasing our exposure to them. Another hypothesis is the marked change in our lifestyle. "The way we used to live and the way we live now is so different," she says. "Our homes used to be better ventilated but now we have double glazing, which creates a warmer environment allowing dust mites to thrive. "People are also more likely to at home on the computer or watch TV instead of going out and getting in contact with common bacteria, which helps build our immune systems," she continues. "To make matters worse we now have anti-bacterial wipes for everything in the home, when we don't need them. We have more chemicals in our cleaning products, in our food, and in our furniture that we never had before. We have plug in room fresheners and scented candles and all these products contain chemicals. The more we are exposed to them the more dramatically we are going to react to them."

So what is the answer?

Prof Van Cauwenberge of the Global Allergy and Asthma European Network, hopes that better treatments and simple diagnostic tests, particularly for food allergies in children, will emerge during the project. Closer to home, the Royal College of Physicians recommends these points.

;• That regional allergy centres be set up in each NHS region to provide  specialist expertise and training
;• More consultant allergists be appointed - an extra 32 to work in new regional centres, more to cover the workload in teaching hospitals and  district general hospitals
;• More training posts be created and funded
;• GP education to be improved

We contacted the Department of Health to ask what action they are already taking. A spokesperson came back with this statement: "We welcome the forthcoming five year research project, the Global Allergy and Asthma Network, and hope that it achieves its objectives of increasing our understanding of what has caused the dramatic increase in the incidence of allergy. The main agency through which we support medical and clinical research is the Medical Research Council (MRC). In 2001-02, the MRC spent an estimated £3 million on asthma research, including research on the relationship between allergies and asthma. Funding for research on allergies and asthma is provided from a number of different sources, including the Government. The substantial extra investment in the NHS will help deliver service improvements across the board, including allergy services."

However, as Muriel says, what the UK needs is funding spent on treatment centres now as well further research. "We have calculated that it would cost only £10m to set up an ongoing allergy service in this country," she says. "That's nothing when you consider how much is spent on treating conditions already known to be linked to allergies. It would also prevent people being on medication for the rest of their lives. The answer is so simple, it just seems to take a long time to get there."

Page Updated 15 October 2004