Containing the allergy epidemic in the UK
Summary and recommendations of a new report from the Royal College of Physicians.
There has been a dramatic increase in allergy in recent years, including severe life-threatening and multi-system allergies. There is, however, a growing gulf between the need for effective advice and treatment and the availability of professional services. In particular, there is an urgent need (a) for specialist-led allergy centres where the more complex cases can be treated and which can provide the necessary training for other specialties dealing with allergy patients (many of whom are children), and (b) for GPs to acquire the necessary knowledge and training so that they can provide an effective primary care led allergy service in which patients can have confidence.
The recommendations of the report have been designed to form the basis for the development of a coordinated service.
Why is allergy an increasing problem?
-- INCREASED INCIDENCE The incidence of allergy has increased dramatically in the UK in recent years and is still rising. Recent studies put the rise as approximately three-fold in the last 20 years, giving the UK one of the highest rates of allergic disease in the world.
-- INCREASED SEVERITY The nature of allergic disease has also changed, so a number of severe and potentially life-threatening disorders, which were previously rare, are now common. As part of the increase in incidence, more children are now affected, particularly by previously little-known food allergies, such as peanut allergy. These are also among the most serious allergies, so accurate diagnosis, advice and treatment are vital.
-- INCREASED COMPLEXITY Patients now usually have disorders affecting several systems. For example, a child with peanut allergy often also has eczema, rhinitis and asthma - so-called 'multi-system allergic disease'. Poorly controlled asthma in a patient with nut allergy is a risk factor for life-threatening or fatal reactions.
ROYAL COLLEGE OF PHYSICIANS
What is the scale of the allergy problem?
-- The latest estimates suggest that one-third of the total UK population - approximately 18 million people - will develop allergy at some time in their lives.
-- Asthma, rhinitis and eczema have increased in incidence two- to three-fold in the last 20 years.
-- Anaphylaxis, a severe and potentially life-threatening reaction, occurs in over one in 3,500 of the population each year as a result of exposure to substances to which the sufferer is allergic. Hospital admissions due to anaphylaxis have increased seven-fold over the last decade and doubled over four years.
-- Food allergy is increasingly widespread and is the most common cause of anaphylaxis in children. Peanut allergy, the most common food allergy to cause fatal or near-fatal reactions, has trebled in incidence over four years and now affects one in 70 children in the UK. Yet only 10 years ago this was a rare disorder.
-- Drug allergy is also increasingly common. Adverse drug reactions account for 5% of all hospital admissions in the UK. Up to 15% of inpatients have a hospital stay prolonged as a result of drug allergy. These figures do not include the majority of drug allergies, which occur in primary care and remain undiagnosed and unrecorded.
-- Some 8% of healthcare workers now have an allergy to latex rubber, which in some cases can lead to anaphylaxis. Yet until 1979 only two cases of latex allergy had been reported.
-- Allergic disease currently accounts for 6% of general practice consultations, 0.6% of hospital admissions, and 10% of the GP prescribing budget. The cost (in primary care, excluding hospital services) to the NHS is £900 million per annum.
Why are current services now inadequate to meet the need?
-- Across the whole country, only six major centres staffed by consultant allergists offer a full-time service with expertise in all types of allergic problems. A further nine centres staffed by allergists offer a part-time service.
Continue reading this article from the ROYAL COLLEGE OF SURGEONS, UK. PDF FILE
Contine de alergie epidemie în Regatul Unit - Containing the allergy epidemic in the UK - articole medicale engleza - startsanatate