Allergy is a public health crisis. In the absence of a cure, we must educate to increase awareness and treatment
Episodes of anaphylaxis may lead to PTSD | Alamy
A national programme of public allergy education should include increased awareness in the catering industry – and training in schools to help recognise and treat severe reactions
Around one in three people, more than 20 million in the UK, have an allergy-related disorder. A significant amount of allergic disease is severe or complex so that a patient suffers several disorders, each triggered by different allergies.
Fatal and near-fatal reactions occur due to foods, drugs and insect stings, and have been increasing over recent years with hospital admissions for anaphylaxis rising by 615% in the 20 years to 2012.
Despite this, allergy has largely been ignored and is poorly managed across the NHS due to lack of training and lack of manpower with expertise. It is therefore essential that we see allergy as a public health priority and roll out a national programme of education.
Allergy is a “hypersensitivity” reaction, or exaggerated sensitivity, to substances which are normally harmless and ignored. Such substances are known as allergens and common examples include peanuts, milk, cats, dust mites, some medicines, and grass pollens.
These allergens trigger the production of a harmful antibody, immunoglobulin E (IgE). In an allergic reaction, the interaction between the IgE and the allergen causes the release of inflammatory chemicals such as histamines. These cause symptoms such as sneezing, itches and rashes but in severe cases, they may also cause blood pressure to drop or airway narrowing, which leads to shortness of breath and wheezing.
Severe reactions, known as anaphylaxis, can be fatal.
For people living with food allergy there are many risk factors including ensuring those around you are aware of the potential risks. In peanut allergy, mistaken exposure, with a further allergic reaction, occurs in between 14% and 50% of patients each year.
Despite changes in the law which now require all food outlets to list allergens contained within the food they serve, eating out can still increase anxiety and make socialising difficult. Coroners’ cases of food allergy deaths reveal the failure of food outlets to correctly identify allergens in the food being served; and the death of Natasha Ednan-Laperouse following a reaction to sesame in a baguette from Pret a Manger, highlighted the difficulties faced by patients with food allergy in choosing their food safely.
Allergy has largely been ignored and is poorly managed across the NHS
This has prompted swift action by the Department for Environment, Food and Rural Affairs to find ways to improve the information provided on food packed on a food outlets’ premises and led to legislation that requires all food businesses to include full ingredients labelling on pre-packaged food.
Allergy doesn’t just pose a risk to health; it also makes it difficult to live a normal life. Allergy UK surveyed 6,000 allergy sufferers and found that more than 62% of them felt their allergy “significantly affected all aspects of their lives”.
For children in particular, it has an effect on all aspects of their lives, such as playing outside and attending parties. One study shows that children with peanut allergy had higher anxiety levels and had their quality of life impaired to a greater extent than children with insulin-dependent diabetes.
It is also being increasingly recognised that an episode of anaphylaxis may lead to post-traumatic stress disorder, and has been shown to do so in more than 40% of adults who suffered an anaphylaxis.
We must make allergy a public health priority and create a national programme of education to include:
• increased understanding for caterers to improve awareness of allergies and the potential for reactions
• training in schools around recognising and treating severe reactions
• better training for health care workers in how to manage and treat allergies
• widespread commissioning of accessible services
• public awareness on how to treat allergies
• patient education on how to manage their conditions and treat potential reactions
• increased understanding for industry to address the issue of the need for cleaner air
It is not just healthcare professionals and catering companies who require education, we would all benefit from increased knowledge on the risks associated with allergic disease and how best to prevent reactions and in some cases the tragedy of death.
Jon Cruddas is Labour MP for Dagenham and Rainham and chair of the APPG on Allergy