herald

Thursday 23 November 2017

The way we live may be causing the allergies that are ruining our lives

Immunity is weakened by clean living, says allergy expert Dr Paul Carson

The number of people, especially children, troubled with allergy has increased over the last decade. In the UK and Ireland there are approximately 8.5 million sinusitis sufferers, spending a fortune on sinus products.

In the US, health experts estimate 37 million Americans are affected by allergy. Healthcare providers report nearly 32 million cases of chronic sinusitis to the Centres for Disease Control and Prevention annually. Americans spend $5.8bn each year on healthcare costs related to allergy and sinusitis.

This reflects a surge in allergic problems. In Britain, a House of Commons committee found a serious epidemic of allergy -- and the Department of Health agreed. Allergy care in the NHS was totally inadequate at all levels with a postcode lottery of premium care. And in Ireland it's no better.



  • Some 18 million people in Britain have some type of allergy (out of a population of 60 million).


  • Three million will need to see a specialist in allergy because of multi-organ involvement (in other words allergy affecting more than one area: eyes, nose, chest, skin etc) or because of the complexity of the condition.


  • Children are particularly affected. Over 40,000 of the children born each year will develop allergy.


  • One in 50 children have a nut allergy, apart from other food allergies.


  • Allergy has become more complex and severe. At least 10pc of children and young adults with allergy have more than one allergic disorder.


  • This epidemic may be caused by a number of factors, possibly inter-reacting.

HYGIENE HYPOTHESIS

Clean living isn't good for us. By depriving our immune system of key infection by viruses, bacteria and parasites, we fail to develop the necessary tolerance for ordinarily tame foreign particles.

The immune system -- underused and spoiling for a fight -- goes overboard when finally given the opportunity, no matter how slight the opponent. Poor people living in developing countries exhibit markedly lower allergies.

This holds true even for impoverished communities within polluted urban centres. Dirt, in other words, may be good for you. But poor people living in developing countries can become allergic when they move to a more developed area.

ATMOSPHERIC POLLUTION

Persistent exposure to particulate matter due to automobile exhaust in urban settings increases the risks of developing allergies and exacerbates asthma.

Japan is a classic example of industrialisation's downside. In the 1930s, hay fever hadn't yet been recognised. However, by 1970 onwards, 15pc of Japanese schoolchildren were showing signs of hay fever. Perhaps that country's rapid industrialisation and pollution swamped the protective immunity of Japanese children?

OVEREXPOSURE TO ANTIBIOTICS

Over the past 40 years, as widespread antibiotic use climbed, so too did allergy rates.

Abasiofun Radigan is 24. She used to live in Nigeria and moved to Ireland in 2007. In rural Nigeria her lifestyle was simple and her accommodation basic. She shared a concrete brick house under a thatched roof with her four siblings and parents. There were no carpets or curtains and minimal furniture. There were animals in the neighbourhood, cattle and dogs especially, but no domestic pets.

She started working in Ireland in a country house in February 2007. The owners had horses. They had dogs that had the run of the living area and cats that sneaked into any room with an open door. Within one month of working in this environment, Abasiofun developed severe 'head colds' and sneezing attacks. Her employers consoled her that this was just a response to Ireland's cold and damp conditions. Abasiofun grinned and hoped they were right. But she felt miserable. Indeed she'd never felt like this before in her life. Back home she'd been healthy, never requiring medical attention.

Abasiofun's 'head colds' worsened and she had difficulty sleeping at night. She was breathless with exertion. As the weeks went on she became wheezy and her breathing became laboured. Her skin, once smooth and unblemished, was now itchy and irritable. Not wanting to be a nuisance she hid her symptoms.

By week 12 Abasiofun was so unwell she had to visit a doctor. He recognised she had sinusitis and asthma. He also noticed she was developing eczema (itchy skin) in the areas usually seen in children, the creases of the knees and elbows. As part of her check-up, the doctor ordered allergy tests. The results showed that Abasiofun was allergic to horse hair, dust mites and cat hair. Minute particles, a thousand times smaller than a grain of sand, of these allergy-provoking substances had swept inside the girl's nose and sinuses, triggering allergic sinusitis. This in turn kick started asthma and, eventually, eczema.

Abasiofun quit the country house. In fact she quit Ireland too, and returned to her native Nigeria and better health.

Abasiofun was carrying the genetic code for allergy. Her basic living conditions and lifestyle in Nigeria did not challenge her immune system and she stayed well. The move to a damp and colder climate was one shock to her system. An even greater jolt was the amount of allergy-provoking material she became exposed to suddenly. Abasiofun started showing signs of a highly allergic individual. She developed sinusitis, then asthma and finally eczema. In babies, such allergic events are in the reverse order: ie, eczema, followed by nose and sinus allergy and eventually asthma.

When I spoke with Abasiofun I asked her what was the worst feature of her ill-health? "The sinus pains, doctor," she replied, sniffing and snorting, hands full of damp tissues. "Please make my sinuses better."

I did. But she still went back to Nigeria. There's no allergy epidemic in Nigeria.

Allergy World Fair is at the RDS May 27-29

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