Severely-affected allergy sufferers experience many symptoms despite treatment with symptom-relieving medication. This has substantial socio-economic consequences.

Allergy is a widespread disease, which is becoming increasingly common worldwide and has a tendency to get worse with time. Currently, more than 20% of the world’s population suffer from respiratory allergies.

Socio-economic impact
For most people with respiratory allergies, their condition significantly reduces their quality of life, affecting both work and leisure time. They can relieve their symptoms by trying to avoid allergen exposure, but restricting their lives in this way can have psychological and social consequences as well as a socio-economic impact.

According to a European survey of diagnosed allergy sufferers, around 80% of the respondents said that their condition considerably affects their daily activities.

The increasing prevalence of allergy also has major economic consequences for society through reduced working capacity and more sick leave.

Unmet medical need
A small proportion of people with respiratory allergy still have symptoms despite treatment with symptom-relieving medication. As a result, their quality of life is affected along with their effectiveness at work and elsewhere.

The burden can be relieved
There are several ways to ease the burden of respiratory allergies:

• A significant number of people with allergy are undiagnosed, and the condition is often trivialised both by patients and doctors
• Although effective treatments exist, the disease is often not correctly managed
• An integrated management approach for patients with allergic rhinitis and asthma may both reduce medical treatment costs and improve symptom control

It’s common to ignore allergy symptoms, especially if you do not know enough about the available treatment options. But, for many, pollen allergy can be more than just a minor inconvenience.

If left untreated, it can significantly affect quality of life and is a major risk factor in the development of asthma.

Depending on the severity of the symptoms, pollen allergy can cause poor sleep quality and daytime fatigue which can make it difficult for adults function at work,  or for children to perform well at school.

Particles in the air
Respiratory allergens are in the very air we breathe and house dust mite and grass pollen affect people all over the world.

But there are specific regional allergens too, including pollen from birch and related trees, ragweed pollen and Japanese cedar pollen.

Is it necessary to see a doctor?
If you have not been diagnosed with pollen allergy yet and you have symptoms that significantly impact your life, it is advised that you consult your doctor.

The doctor will probably ask about the history of your symptoms and arrange tests that can show if you have pollen allergy.

There are two ways of treating allergic rhinitis. Both have been shown to provide relief and put an end to discomfort and feeling ill.

Symptomatic treatment
Symptomatic treatments are typically used to relieve the symptoms of allergic rhinitis but only work while the medicine is being taken. They have no long-term effect on the allergy itself.   This is because, while they reduce the symptoms of allergy, unlike immunotherapy, they do not induce allergen tolerance. 

Most symptomatic treatments are available over-the-counter (OTC), for example, in supermarkets or pharmacies, and include pharmaceutical medicines such as antihistamines, nasal steroids and decongestants.

Immunotherapy treatment
Immunotherapy treatment has a long-term effect which offers a sustained improvement in the patient’s condition, sometimes for several years following treatment. 

The main difference between symptomatic and immunotherapy treatment is that immunotherapy induces tolerance and so alters the natural course of the disease. There are immunotherapy treatments available for each of the most common respiratory allergens. 

Seeking medical attention is especially important for children as a single initial allergy can deteriorate into multiple allergies, and because allergic rhinitis can lead to asthma. An early diagnosis is therefore important  so preventative treatment can begin and the impact of the allergy minimised.

The diagnosis is typically made based on symptoms, a physical examination and a series of questions. In some cases, an allergy specialist can identify what is causing the allergy just from your medical history and symptoms, and supported by a confirmatory test.

Testing by skin prick test or blood test
A skin prick test ‘provokes’ an allergic reaction by introducing a tiny amount of allergen – the substance which doctors think you may be allergic to – into the skin using a lancet. If you are allergic, the skin will react and something similar to a mosquito bite will appear where the allergen was applied.

A blood test can be used on its own, or to support the results of the skin prick test. The blood is tested for immunoglobulin E (IgE) antibodies, which are substances produced by the body when there is an allergic reaction.   If high levels of IgE antibodies are found in the blood and related symptoms are also present, then this will help to confirm the diagnosis.

Just like allergic rhinitis, allergic asthma is a condition that can be triggered by exposure to particular allergens, such as grass pollen, tree pollen, or house dust mites.

Whereas allergic rhinitis causes inflammation and irritation in the eyes, nose and the upper airway, allergic asthma primarily affects the lower airways. Symptoms of allergic asthma include wheezing, chest tightness, shortness of breath and persistent coughing.

Asthma development more likely among allergy sufferers
Studies show that allergic rhinitis and allergic asthma are closely linked, with nearly half of respiratory allergy sufferers experiencing both.

Indeed, many people with allergic rhinitis go on to develop allergic asthma.

Treating allergy and asthma together
As a result, evidence increasingly suggests that, rather than being two separate conditions, allergic rhinitis and allergic asthma are caused by the same allergy and that treating – the allergy – can be beneficial for both conditions.

Common triggers of respiratory allergic disease include pollens, house dust mites, moulds and animal dander. Exposure can lead to a range of symptoms, including allergic rhinitis (inflammation of the upper airways), conjunctivitis (itchy, watery eyes), and allergic asthma (inflammation of the lower airways). 

These symptoms can worsen over time if not treated appropriately, and allergic rhinitis is considered to be one of the major risk factors in the development of asthma.

Nearly half of all allergy sufferers are children
The prevalence of respiratory allergic disease has increased over recent decades  and is rising in both developed and developing countries.  Globally, an estimated 400-500 million people are affected by allergic rhinitis and 40% of these are children.

It is estimated that 10-20% of allergic rhinitis sufferers have symptoms which are not well controlled despite the use of symptom-relieving medication and that less than one in ten of these receives allergy immunotherapy treatment.

Millions of work days lost
For many people, respiratory allergic disease has a significant impact on their quality of life, causing sleepless nights, shortness of breath and resulting in millions of lost school and work days.

However, there are several treatment options, including symptom suppressing medicines and allergy immunotherapy. Immunotherapy treats the underlying cause of allergy and allergic asthma and can offer long-lasting improvement by reprogramming the immune system to better cope with exposure to specific allergens.