ABSTRACT
Allergy in the United Kingdom has now reached epidemic
proportions, with new, more complex and potentially life threatening
allergies. Allergic disorders can seriously impair quality of
life for sufferers, and in some cases, can even lead to death.
Their treatment is a significant cost to the National Health Service,
and they can have a detrimental impact upon the education of children
at school or the performance of adults at work. The burden of
allergy is borne by the allergic individual on a daily basis,
but the social and economic cost extends across the whole nation.
There is a severe shortage of allergy specialists
in the United Kingdom, so the clinical services lag far behind
those of many countries in Western Europe, and have not kept pace
with the rising prevalence of allergy. Problems with data collection
mean that statistics are imprecise, and a lack of training has
resulted in a National Health Service in which a significant proportion
of general practitioners are unable to diagnose and manage allergic
disorders, and have nowhere to refer patients with complex allergies.
The development of the immune system in the first
months of life—and the role of early exposure to allergens
such as peanuts—urgently requires further research to ensure
that public policies are underpinned by sound scientific evidence.
There is a lack of evidence-based research which has resulted
in poor public information on the everyday factors which allergy
sufferers may encounter, such as food and its labelling, housing
conditions and methods used by complementary practitioners.
We have made a number of specific recommendations
on allergy services. We recommend that allergy centres led by
a full-time allergist should be developed, where various specialists
with an interest in allergy come together to diagnose and manage
patients with complex allergic disorders. These allergy centres
should be a source of education and training for doctors, nurses
and other healthcare workers at every grade, to improve the knowledge
of those working within the primary and secondary care sectors.
They should also advance research, enabling effective treatments
to be developed, and should provide the clinical database required
for epidemiological studies. Clinicians within the allergy centre
should work together with local schools, employers, charities
and others to educate the general public, and particularly patients
and their families, on allergy matters.
But NHS allergy services are only part of the story
and we have also made a number of other recommendations covering
a broad range of issues. These include: maintaining clinical surveillance
systems to monitor allergic disease; calling for further research
into the ways in which the indoor environment influences allergy
development; reviewing how children with hayfever are supported
throughout the examination system; assessing the training that
teachers receive in dealing with allergic emergencies; assisting
individuals with occupational allergies to return to work; amending
food labelling legislation to specify the amount of allergens
contained within products; analysing the costs and benefits of
immunotherapy treatment; and withdrawing advice which recommends
peanut avoidance for pregnant women. But all our recommendations
must be underpinned by effective education and training of those
involved at every level.
We call on the Government and all those involved
in supporting people with allergy, to address these issues to
improve patients' quality of life, tackle the rising prevalence
of allergy in the future, and reduce the significant burden of
allergy in the United Kingdom.
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