Health: Allergy (Science and Technology Committee Report)

My Lords, the noble Lord, Lord Lipsey, should be congratulated. Without being too light-hearted, I must say that if he is on that cocktail of drugs, I am surprised that he managed to stay awake during his own speech today let alone others. I also thank the noble Baroness, Lady Finlay, for her chairmanship, Professor Barry Kay for his specialist advice and Sarah Jones and Cathleen Schulte for their backup on this inquiry. The key theme that has emerged from the report is that allergy in the UK has reached epidemic proportions, with more complex and sometimes life-threatening new allergies emerging almost daily. Advice to sufferers varies: should the hygiene theory, as described by the noble Lord, Lord Rea, be supported or rejected—cats and dogs and dirt—or should we take every opportunity to isolate our children from possible allergens? The noble Baroness, Lady Finlay, and the noble Lords, Lord May and Lord Rea, have already discussed peanut allergy and advice given for very young children as a good example of that. About 20 million children and adults in the UK suffer from a form of allergy, and from April 2006 to March 2007 there were 67,077 emergency hospital admissions for people experiencing just an asthma attack, 40 per cent of whom were children under 15. A simple allergy can be an early step on the allergic march towards more serious allergies, and the critical impact of allergy on health and quality of life and its potential to cause fatalities, usually in older children and adolescents, should not be ignored. Allergic disorders are usually chronic and low-intensity but can have serious effects on quality of life for both patients and their families, and in extreme cases can even lead to death. The prospects of unexpected allergic catastrophe or anaphylactic death are real issues for many families and should not be underestimated. Many common modalities of treatment are outdated and put sufferers at significant risk of side effects, when modern, safe treatments are more effective but not widely available. Allergy treatments are a significant cost to the NHS, and symptoms can have a detrimental impact on lifestyle, the education of children at school or the performance of adults at work. Many lifestyle factors are specifically associated with allergy and must be considered in the context of known or suggested risks for allergic diseases. Good health and the ability to fight off disease are a function of the immune system, and there are daily references in the media about how that can be improved. It has been suggested that pregnant women who lead a sedentary lifestyle may cause an increased risk of asthma in later life. Recent studies have shown that levels of vitamin D, found in food such as oily fish and boosted by natural sunlight, can influence the development of a child’s lungs and immune system while in the womb. There is also a possible link between asthma and obesity; the numbers of people with both problems have soared in recent decades. It has been suggested that handling rubbish that has been left out for two or more weeks before being collected can increase the risk, as the level of bacteria and fungal spores above bins that have not been emptied is more than 10 times higher than in locations where there is a weekly collection. Keeping a cat can allow the onset of allergic symptoms: a study from Imperial College found that increased exposure to cat allergen was associated with greater sensitivity of the respiratory system. Blame has been put on the possibility of a defective gene that plays a key role in the appearance of allergic symptoms that occur when the immune system wrongly identifies allergens such as dust mites, pollen, peanuts or cat hair as being dangerous. Scientists have also identified a cold-fighting protein which asthmatics lack. The common cold triggers about 85 per cent of asthma attacks in children, and 60 per cent of those in adults. A study by US scientists has shown that sufferers of allergic rhinitis appear to be at much greater risk of the degenerative brain condition, Parkinson’s. About 5 million Britons are affected by perennial allergic rhinitis, usually triggered by indoor allergens such as dust mites, pet skin flakes and spores, causing inflammation and irritation to the delicate linings of the nose and eyes. A further 3 million suffer from a mix of perennial and seasonal rhinitis, or hay-fever. We need accurate data, so I commend our recommendation that the Department of Health should ensure that the Systemised Nomenclature of Medicine system, supported by appropriate training, ensures efficacy as a simple, consistent classification system to record allergic disease, monitor its prevalence and inform the commissioning of allergic services. Whatever measures are taken to minimise the risks of allergen contamination, ultimately some responsibility must lie with the allergic consumer. Social difficulties can make sufferers reluctant to take necessary precautions, and many young people take risks with foods carrying a ““may contain”” label, believing that food companies are covering their backs with a generalised warning. Children at school risk contact with allergens such as nut proteins, which are easily transferred between surfaces, and if their understanding of their allergy is poor, they can suffer high levels of anxiety. That sometimes leads to a panic-attack reaction. Although minimal, the possibility of anaphylaxis at schools causes great worry to children and their parents, while placing a burden on the school by requiring members of support staff and teachers to be able to deal with emergencies. In the year to 30 September 2006, about 165,000 prescriptions were dispensed in England for Epipens, at a cost of about £8.2 million. The quick dose of adrenaline which these automatic injectors provide can be life-saving for people suffering an anaphylactic shock to food, insect stings or allergens known to the patient. We had evidence that these auto-injectors were not being used effectively. I agree with my noble friend Lady Perry that it might be a good idea for schools to have their own supply of adrenaline injectors, for use by a trained member of staff or a school nurse, rather than relying on children to carry their own medicine. The prescription of such auto-injectors requires specialist allergy knowledge that is currently lacking among many general practitioners and needs to be coupled with patient training. The establishment of allergy centres and the further education of practitioners in allergy should improve the quality of training provided to patients about administering their treatments. Many patients turn to complementary therapy to diagnose and treat their allergy, usually because they are unable to obtain proper diagnosis from their GP or stand no chance of being referred to a specialist. Many patients are worried about the side effects of conventional drugs. As president of the All-Party Group for Integrated and Complementary Healthcare, I was disappointed by the lack of response from complementary practitioners to this enquiry. Homeopathy, herbalism, acupuncture, cranial osteopathy, applied kinesiology and methods of self-testing, including Vega hair and blood testing, were dismissed as having no scientific evidence or mechanistic base to suggest that those treatments and tests could be remotely effective. Although I know that that is not true and I have sent patients for these treatments with success for many years, there was little evidence to present to the Committee to back up my belief. We heard the argument that complementary practices may delay accurate, valid and pressing diagnosis, leading to medical harm. I regret that the lack of evidence did not enable us to assess the beneficial effects of complementary therapies, which are harmless when compared to those of conventional drugs on the thousands of people who are harmed or die needlessly as a result of idiopathic reaction. I am delighted that the Government accept that research into the effectiveness of complementary treatment should address the outcomes that we have identified, and I hope that the Minister will give serious consideration to the points made today.