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Health: Asthma

I thank the noble Viscount, Lord Simon, for bringing the problems of asthma to our attention again. I have probably never heard a more dramatic introduction to a short debate in my many years in your Lordships’ House. As a sufferer of asthma from a variety of causes—perfume is probably the worst to him—he must be admired for the normality of his life and for his tireless campaigning for fellow asthmatics. I was privileged to sit with the noble Viscount on the Science and Technology Committee when we produced the report on allergy, which was published just over a year ago and debated in this House on 8 May this year. The report was useful and the Government’s response has been encouraging, but the required action needs more time and more money. I shall not repeat too many figures, but they are important. About 20 million children and adults in the UK suffer from a form of allergy. More than 5 million of them have asthma, of which 1.1 million are children. Between April 2006 and March 2007, there were 67,077 emergency hospital admissions for people experiencing an asthma attack, 40 per cent of whom were children under 15. A simple allergy can be an early step on the allergic march towards much more serious allergies. The critical impact of allergy on health and the quality of life and its potential to cause fatalities, usually in older children and adolescents, should not be ignored. The prospects of unexpected allergic catastrophe or anaphylactic death are real for many families and should not be underestimated. Good health and the ability to fight off disease are a function of the immune system. We read references daily to how that can be improved. It has been suggested that pregnant women who lead a sedentary lifestyle increase the risk of asthma for their children. Recent studies have shown that levels of vitamin D, which is found in food such as oily fish and is boosted by natural sunlight, can influence the development of a child’s lungs and immune system while in the womb. There is increasing evidence that an infection with gut parasites may protect against asthma and allergy. A recent study, funded by Asthma UK, showed that children born to mothers who had a low intake of vitamin E during pregnancy were five times more likely to have asthma than children whose mothers had eaten a diet high in vitamin E. There is also a possible link between asthma and obesity. The number of people with both problems has soared in recent decades. There are many more possible links between asthma, diet, rubbish collection and storage, pets, environmental issues, pollution and regional variations; I would need a whole hour to myself to cover them all, but they all carry an increased risk to the respiratory system. In 2007, a person was admitted to hospital every eight minutes because of their asthma. A possibly defective gene has been blamed. Scientists have identified a cold-fighting protein that asthmatics lack. The common cold triggers about 85 per cent of asthma attacks in children and 60 per cent of those in adults. We need accurate data, so I repeat the Science and Technology Committee’s recommendation to the Department of Health, which was that the systemised nomenclature of medicine system, supported by appropriate training, should ensure efficacy as a simple, consistent classification system to record allergic disease, monitor its prevalence and inform the commissioning of allergic services. Patients and the public should be better informed about allergy and allergic asthma. The ability to make an accurate diagnosis should be improved and there should be better, more specialised training for healthcare professionals. Poor knowledge of allergic conditions stems from the lack of an integrated and holistic approach to treatments. People with multiple allergies tend to see multiple specialists for multiple treatments, rather than a single allergy specialist. There is a clear need for more research into the causes of allergy and asthma and into the clinical effectiveness of different forms of treatment. Work is proceeding on the definition of susceptibility genes for asthma and related phenotypes by positioning cloning approaches and recognising that pharmacogenetic approaches may be beneficial in managing patients. More diagnostic testing is needed, and services in both primary and secondary care should be improved. Only then will people with asthma and allergic conditions get the treatment that they need. I hope that the noble Viscount keeps up the good work.