Allergy Awareness week runs from 24th to 30th April 2017. It is organised by Allergy UK to raise awareness about allergies and highlight the many difficulties that people with allergies experience. We are all likely to be affected by an allergy in some form by personally suffering from, or knowing somebody who suffers from, an allergy and it is important that we are aware of the dangers that can be faced by these seemingly harmless conditions.
What is an allergy?
Although most of us are likely to use the term on a regular basis, do we know what an ‘allergy’ actually is? An allergy (also known as an ‘allergic disease’) is caused by the overreaction of the immune system to a particular substance in the environment. Substances that produce allergic reactions are called ‘allergens’. When an individual’s immune system is hypersensitive to the substance in question, the body mistakenly responds as though the allergen was posing a threat and produces an inappropriate reaction.
Allergic reactions can be caused by a number of different stimuli and people may be allergic to only one or various substances. The most common offenders include pollen (from trees and/or grass), food (particularly nuts, shellfish and cow’s milk), dust mites, animal hair or skin, insect bites and medication, amongst many others. The reasons for developing allergies are not entirely known, but any person may develop an allergy at any age and it is thought that this is due to a mix of both genetic and environmental factors.
Food allergies are commonly confused with food intolerances but it is important to recognise that the two are separate and have very different causes. To put it simply: an allergy to a specific food will trigger the immune system whereas an intolerance to food will typically involve the digestive system. This distinction is particularly important because an intolerance to food typically requires a large dose of the substance and has much slower symptoms whereas antibodies produced by an allergic reaction only require a minute amount of the allergen to be triggered and will react rapidly.
How prevalent are allergic conditions?
The exact number of people that suffer from an allergic disease is unclear, partly as many reports into prevalence have focussed on a particular manifestation or a population sub-group. Nevertheless, the data available provides a snapshot into how widespread allergies have become.
On a global level, the World Allery Organisation estimate that the allergy prevalence of population by country ranges between 10% – 40%. Allergies are known to be the most common form of chronic disease in Europe and affect over 150 million people. It is expected that by 2025, half of the entire European population will be affected by allergies.
Closer to home, Allergy UK reports that the UK has one of the highest rates prevalence of allergic conditions in the world. A third of the UK population is reported to suffer from one or more allergies. Guys and St Thomas’ Foundation Trust have noted that whilst 21 million adults in the UK have at least one allergy (representing a quarter to a third of the adult population), over half of all children and under 18 year olds are estimated to have one or more allergies. It is recorded that up to 7 million people in the UK have an allergy severe enough to require specialist allergy care.
Are we experiencing an allergy epidemic?
Allergic disease is rising. Data has shown that the incidence of allergic disease has markedly increased over the past 50 years, which some have termed an “allergy epidemic”. Allergies are the most common chronic disorder in children and prevalence has dramatically increased in the last two decades, for example hospital admissions for food allergies among children alone have risen by 500%.
Recent figures from NHS Digital show that there were 29,544 hospital admissions for allergic reactions in 2015/16. This data demonstrates a hike of more than a third over the preceding five years and illustrates a year-on-year increase since 22,206 hospital admissions were recorded in 2011/1.
There is not a clear cause for the increasing rate of allergy disease over recent years and a number of reasons are still under debate. Doctors have argued that rising levels of cleanliness have lowered people’s natural resistance to bacteria and dust which cause common allergies. Other contributory factors have been argued to include: heredity, eating habits, modern medicines, a lack of vitamin D and delayed weaning of solid foods.
What are the effects of an allergic reaction?
Allergic reactions usually develop within a matter of minutes of exposure to an allergen. As anyone with an allergy will know with irritating familiarity, typical symptoms of an allergic reaction include: sneezing, a runny or blocked nose, itchy or watery eyes, wheezing and coughing, rash, sickness and vomiting. Symptoms vary depending on the allergen and how it has been encountered. Although allergic reactions can be a dreadful nuisance, most are very mild.
However, allergies should not all be dismissed as harmless. Extreme allergic reactions (known as anaphylaxis) can occur, which affect the entire body and can have devastating consequences including death. Anaphylaxis has the same symptoms as mild allergic reactions but can also give rise to: a raised skin rash, swelling of the mouth and tongue, throat tightening causing difficulties in breathing, fainting or collapsing, and can result in cardiac arrest and death.
The European Academy of Allergy and Clinical Immunology estimates that 1 in 5 people with allergies struggle with daily fear of an asthma attack, anaphylactic shock or death from an allergic reaction. The Anaphylaxis Campaign and the Resuscitation Council report that anaphylaxis is responsible for approximately 20 deaths per year in the UK. In line with the rise in allergic disease in general, the past five years has seen a 19% increase in the rate of hospitalisation where the primary diagnosis has been anaphylactic shock.
In addition to the drastic health consequences, allergic diseases also have an economic impact. On an individual level there are a high number of allergy-related work absences annually which affect family finances throughout the UK. On a national level, the NHS spends approximately £900m allergies in primary care and £68m on allergy related hospital admissions every year. Allergies also have social costs they can create anxieties concerning what foods can be eaten as well as affecting social interaction and limiting the social and leisure activities.
What is being done to ensure allergens are labelled?
In 2017 alone it is believed that at least three young people have already died as a result of suspected severe allergic reactions to food in the UK. In light of these tragic instances, we must now ask ourselves: what is being done to make consumers aware of allergens in products that they purchase and is it enough?
Due to the potentially disastrous consequences of people eating food that they are allergic to, food labelling is essential as people with allergies need to be extremely careful about what they can eat.
Since December 2014 the EU Food Information for Consumers Regulations (EU FIC) has also imposed changes to food labelling. They help provide allergen ingredients information in a clearer and more consistent way. For example, any of the 14 allergens that are on the regulatory list are to be emphasised on the label of a pre-packaged food if they are used as ingredients.
It’s good news for consumers, as these changes mean that allergen ingredients information is provided in a clearer and more consistent way – making it easier to make safer food choices when buying food or eating out.
Although this new law went live in December 2014, some products (such as tinned or dried food) which have a long shelf-life, will not have changed over yet; which means you could see both types of labelling being used on these types of products for a couple of years more. Which is why it is important to always read the label.
The EU Food Information for Consumers Regulation (EU FIC) changes the way allergen information appears on labels and on food that is prepacked, sold loose or served when you are eating outside of the home. The EU FIC brings general and nutrition labelling together into a single regulation to simplify and consolidate existing labelling legislation.
What are the changes?
The changes are:
- Any of the 14 allergens that are on the regulatory list is to be emphasised on the label, if they are used as ingredients in a pre-packaged food. Businesses can choose what method they want to use to emphasise these allergens, for example, by listing them in bold, italics, highlighted or underlined, to help identify them.
- Information about allergenic ingredients is to be located in a single place, i.e. the ingredients list on prepacked food. This means that the voluntary use of the previous types of allergy boxes (such as: ‘Contains nuts’) that provide a short cut to allergen ingredients information also given in the ingredients list, is no longer allowed. The use of voluntary precautionary allergen labelling such as ‘may contain’, to indicate the risk of unintentional presence of allergens in a food, is still permitted and has not been affected by this regulation.
- Previously, loose foods (that can be bought without packaging) for example in supermarkets, delis, cafes and restaurants; didn’t have to provide information you need about food allergens. However, since 13 December 2014, information on any of the 14 allergens used as ingredients should be provided for these foods.
It is important that we can trust the product that we are buying. Although increasing efforts have been made to ensure allergens are appropriately labelled, non-compliance will still occur and mistakes will be made. In light of the dramatically increasing number of people that are hospitalised as a result of allergy disease we must be alert to the presence of allergens in the products that we use. We must always ensure that we take appropriate steps to protect ourselves where possible, for example through the use of patch-tests with cosmetic products when recommended.
If you suffering from an anaphylactic shock, Allergy UK recommends that you should use an adrenaline pen immediately, call 999 and tell the controller that you are suffering from anaphylaxis. While waiting for the ambulance, it is better if you lie down as this helps to maintain your blood pressure and avoids injury if you faint. You may be more comfortable with your shoulders raised a bit if you feel wheezy or short of breath. Do not wait to see if your symptoms clear up, always call an ambulance.