TAKE A DEEP BREATH?
I watched the second of two programmes on Channel 4 last night which described an experiment carried out with a small number of families where a child was severely affected by asthma. The idea was to see whether the symptoms could be affected by management of the home environment thus reducing the reliance on inhalers. The programme started with a comprehensive allergen test for each child and a programme of managing the environment to reduce the triggers of attacks by allergens shown up by the sensitivity test. In every case where the programme was adhered to there was an improvement in quality of life and reduction of the use of drugs. On the face of it, a very good result and I’m sure it was helpful for parents willing to put the effort into improving their child’s quality of life. Asthma UK have issued the following statement in response to the programme:
“Asthma UK believes that all people with asthma should be on the lowest dose of medication which satisfactorily controls their condition. If their asthma is well controlled they should very rarely, if ever, experience an asthma attack or need to rely on their blue inhaler for relief. Reducing or stopping their regular asthma medicine could worsen their asthma symptoms and put their health at risk.At Asthma UK we know that people are keen to learn about non-drug approaches to managing their asthma and we have funded and continue to fund research into this area. There has been a lot of research into allergen avoidance, some suggesting benefit and some not, but the evidence currently available is still conflicting.Allergen avoidance is not a cure; it simply helps to reduce symptoms. It may work for some, but often people with asthma have multiple triggers, making it very difficult to achieve a sufficient reduction in allergen exposure. People with asthma should therefore speak to their doctor or asthma nurse before undertaking any allergen avoidance programme and should continue to take their prescribed medication as advised.”
I went on Tinternet to look for some statistics. “5.2m people in the UK are currently receiving treatment for asthma. 1.1m children in the UK are currently receiving treatment for asthma. There is a person with asthma in one in five households in the UK.”
“The UK has one of the highest prevalence rates for asthma in the world, along with New Zealand, Australia and Ireland. The 2001 Asthma Audit by the National Asthma Campaign provided a higher estimate of the number of people suffering with asthma in the UK then ever before. The Audit estimated that 5.1 million people - 1 in 13 adults and 1 in 8 children - are currently being treated for asthma. The Campaign's previous audit in 1999 estimated the figure at 3.4 million. Nobody knows for sure why asthma is becoming more common, but it is thought to be due to a complex combination of genetic and environmental factors. Serious or life-threatening asthma results in 74,000 emergency hospital admissions each year. Currently, 1,500 people die from asthma each year, over a third of which are people under the age of 65.”
I knew that there was a body of research which suggested that these figures could be an under-estimate so I went looking for ‘wheezing after exercise’. Here’s what I found: “Dr Mohammad Shamssain of the University of Sunderland and his research team recently completed phase two of a major study into the prevalence and severity of asthma in children in the North-East of England. In phase two, Dr Shamssain investigated the frequency of self-reported symptoms of asthma among 3000 13-14-year-olds. He found that one in four children had lifetime asthma. One in three reported lifetime wheezing and one in four complained of wheezing after exercise. Dr Shamssain found similar results while looking at the conditions rhinitis and eczema.”
It’s always complicated isn’t it, but I made what I think is a reasonable assumption and boiled this lot down. Asthma UK find that 5.1 million people - 1 in 13 adults and 1 in 8 children are being treated for asthma and Dr Shamssain found that 1 in 3 children are affected in one way or another. Both studies agree that the incidence is rising and they suspect the root cause is a complex combination of genetic and environmental factors. I don’t think these findings are in conflict. Asthma UK are looking at cases under treatment and Dr Shamssain was searching for children affected but not necessarily recognised as being sufferers.
Taken together, I think anyone would agree that it’s a shocking picture. It is estimated that the NHS spends £850million annually on treatment. Non-NHS spending must add to this. Apart from the cost there is the distress suffered by the sufferers. It gets worse if you add in rhinitis, eczema and other related conditions. I was surprised to learn that children make most physical growth when they are asleep and the damage caused to sleep patterns by difficulty in breathing has an effect on physical development. Recognise the consequent restrictions in participation in play and socialising and we can add in another set of handicaps.
The thing that worries me about all this is that what I’ve described above must be the result of something. What has changed in the last 50 years to produce the complex combination of genetic and environmental factors I flagged up above?
I sat there in front of the TV watching the magnified images of dust mites busily scavenging to eat bits of human skin etc. and reflected that in the programme’s terms my house was a nightmare! I’m sure it has some sort of an effect on me and I made a resolution to try to improve. However, I don’t have asthma and to the best of my knowledge I have never suffered from it. I think of the young mother who said to me the other day that my generation and possibly the one after were the last healthy ones. So I go back to my question; What has changed in the last 50 years?
If you want ‘complex’ you couldn’t do much better than this. If you skim the research you become aware that there is a growing body of opinion that the cause of much of the deterioration we see in health nowadays is a consequence of many factors ranging from less natural diet to pollution of the environment by everything from increased radiation to rogue chemicals ranging from deadly poisons to oestrogen excreted by women on the contraceptive pill.
I haven’t a conclusion, it would be arrogant to even entertain the thought that I might have. However, I have suspicions and until someone tells me any different I shall work on the assumption that I am being sensible. I shall avoid all processed foods and stick to a simple diet, it’s much cheaper anyway! As far as possible I shall avoid introducing complex chemicals into my life such as highly scented or coloured products, air fresheners and solvents. I shall not attempt to make my environment sterile or stop cuddling Jack the Lurcher. I shall recognise that throughout my childhood and working life I have been exposed to more dust, pollutants and bacteria than anyone experiences today and have survived, probably because of the exposure. Above all, I shall save my worry and concern for the children who are suffering because they didn’t have the advantage that I had of being reared in a dirty but relatively benign environment. True we had Hitler, but looking back, given the choice between being brought up under bombardment and having chronic asthma, I’d take the bombs!
SCG/11 April 2006