Hay fever and other allergies are becoming increasingly common

Runny nose? Itching eyes? Tickling throat that makes you cough till your throat is sore? Blocked sinuses? Waking in the night through a combination of these symptoms?

If you’re answering ‘yes’ to this checklist of symptoms at this time of the year, chances are you’re suffering from hay fever, and you probably don’t need to be told.

This spring and summer, the pollen count has been its highest for years, says allergy specialist Dr Adrian Drake-Lee, consultant ear, nose and throat surgeon at the Queen Elizabeth Hospital.

‘The warmth, the sustained period of dryness -these conditions this year have made the amount of pollen in the air this year higher than it has been recently,’ says Dr Drake-Lee. ‘Last year’s pollen count was so low because we had quite a wet summer, which dampened it all down.’

Hay fever is just one of a handful of allergies that are on the increase, as a new report released by the Royal College of Physicians this week revealed, adding that allergy treatment for patients in the NHS was totally inadequate.

However, there’s not just more hay fever because there’s more pollen, thinks Dr Drake-Lee. And while heightened awareness of allergies has played a role, it’s more than just an apparent increase.

‘I think it’s real as opposed to apparent -people are better at recognising it, and there is some increased awareness, but it does appear that allergies are increasing in the developed world.’

Our problem is we are just too healthy, says Dr Drake-Lee. It’s almost as if our bodies cannot cope with not having to fight off a daily onslaught of fierce bacteria or viruses. ‘It’s partly because the immune system has become redundant, because we are so much fitter than we were,’ says Dr Drake-Lee. ‘We no longer have the life- threatening illnesses that used to kill one in two babies.

‘People believe the allergic response is a misdirected response to parasitic infection, particularly of the digestive tract. Another view is that pollution is causing the problem, while another is that children no longer suffer the other infections they would have done in the past through dirt.’

Because today’s household environments are so clean and sterile, thanks to a proliferation of antibacterial sprays and detergents, the immune system is at a loss for what to do, says Dr Drake-Lee. This causes it to turn on any other foreign bodies that get into the digestive tract or airways, such as pollen, minuscule house dust mite faeces, and tiny proteins from animal hair that also act as allergens.

Pathologically, it’s the proteins in pollen, house mite faeces and animal hairs that allergy sufferers’ immune systems are trying to fight.

The weeping, itching and runny nose are the symptoms of our bodies trying to get rid of those foreign bodies. And the problem is made worse as today’s double-glazed, centrally-heated, overinsulated homes are hot, stuffy and underventilated, says Dr Drake-Lee.

‘There’s little in the way of airchange in the modern house -it should have two-and-a-half air-changes in 24 hours, but most houses only have one air-change a day. They’re warmer and therefore more attractive to creatures such as housemites. You have only to see how furniture deteriorates in modern houses -that nice Georgian chest that was fine until you stuck it into a modern house, for example.

‘The Victorians aired stuff, took out bedding and aired it outside, exposed their mattresses to the elements and bashed out their carpets. Today, along comes Mr Dyson to vacuum it all up.

‘People are more allergic to pollen, to dust mites, cats and dogs which are now living inside. The only thing that’s changed for the better is there is less allergy to horse hairs, as we no longer stuff furniture with horse hair.’

Our bodies haven’t changed, says Dr Drake-Lee -the difference is the environment they have to deal with.

‘Genetics haven’t changed much in the last 100 years -it’s the redirection of the immune system. It sits around waiting to do something after evolving over thousands of years of dealing with a pretty tough world.

‘Parts of England were malarial up to a couple of hundred years ago; there was tapeworm and tuberculosis. Antibiotics have sorted out many childhood infections, so the population as a whole is much more healthy.’

Parents are almost paranoid about their infants being exposed to germs on floors and surfaces, constantly mopping them with detergents and anti-bacterial wipes.

‘We need bacteria -we spend far too much money on detergents and bleach that probably do more long-term harm to the environment than sorting anything out, when you consider the average human body has millions of bacteria on the skin and in the digestive tract,’ says Dr Drake-Lee.

So the immune system, in effect frustrated because it does not have bacteria and viruses to fight, turns its attention to any other foreign body.

‘It’s actually positively quite good to expose children to more germs,’ he says.

While the fact there are more plants in the country than in the city, incidence is higher and more extreme in the city. Experts believe pollution is a considerable factor, theorising that diesel particles make cells more sensitive, activating the receptors on the surface of the cells that recognise antigens Chemicals from detergents and bleaches are also probably partly responsible for over-sensitising the body to allergens, says Dr Drake-Lee. Treatments for allergies include antihistamine drugs and cortisone hormone treatment, but many sufferers find their symptoms too severe for these to be too effective.

Research carried out at the Southampton Chest Hospital and the Royal Brompton have had some success in developing desensitising treatments for allergy sufferers, which are now being trialled on volunteer patients at the QE and Heartlands Hospital.

A modified form of the allergen -whether pollen, bee or wasp sting venom -is injected at an increasing rate once a week over a six-week period, then once a month for three years.

Some people suffer side effects such as swollen lips and itchy arms, although these usually decrease over time.

In the successful patients, there’s a change in the immune system whereby the body produces blocking antibodies for the allergic reaction.

‘The evidence is, in grass pollen allergies, it reduces or turns off the allergic reaction in 40 per cent of cases,’ says Dr Drake- Lee. ‘It’s the sort of service that should be offered as an adjunct to cortisone and antihistamine -I think there should be three centres in Birmingham doing it, although, obviously, it’s a question of budgets.’

However, being less meticulous with household cleaning, while airing bedding and ventilating our homes more effectively may well reduce allergies for future generations, says Dr Drake-Lee. ‘I am quite certain that the amount of detergent in the air and chemicals from detergents sensitises people and is partly responsible for the increase in allergies,’ he adds. ‘I think we have become over- conscientious with our cleaning practices.’

Allergy FactsOne in four people in the UK are affected by an allergy at some stage in their life -and approximately half of these are children.

Each year, the number of sufferers in the UK increases by five per cent.

Most common allergens (substances to which the body is allergic) include tree/grass pollen, faeces from house-dust mites, mould spores, pet hair, insects such as wasps and bees, industrial and household detergents and chemicals, medicines, milk and wheat, nuts, fruit and latex.

Allergies occur because the immune system believes allergens to be damaging, producing antibodies to attack the invading material. Other blood cells release chemicals (including histamine) which together cause the symptoms of an allergic reaction.

Anybody can develop an allergy at any time of life, but allergies develop mostly in childhood and adolescence. You’re unlikely to develop an allergy over the age of 40.

They can disappear as suddenly as they arrive.

Symptoms can include asthma-like tightness of chest, streaming nose or congestion and itching eyes.

Severe allergies to bee or wasp venom can result in circulatory and cardio-vascular collapse (anaphylactic shock).

Treatment for hay fever and allergies has been available for 80 years.

Hay fever is at its worst between May and late August, and not all sufferers are allergic to all types of plant pollen.

Allergies are among the topics under discussion at an international conference taking place in Birmingham next week. Leading medical figures from across the world are attending the 11th British Academic Conference in Otolaryngology (head and neck surgery) and Ear, Nose and Throat Expo at the International Convention Centre from July 2 to July 5.

For more advice or information about allergies, contact charity Allergy UK at www.allergyuk.org.uk or via the helpline on 020 8303 8583.