Dáil Éireann Debate, Wednesday - 3 March 2004
93 Mr. Gormley asked the Minister for Health and Children if his attention has been drawn to recent studies which show that Ireland has a very high rate of allergies; if his Department has undertaken studies to find the reasons for such a high rate; and if he will make a statement on the matter. [7126/04]
Amharc ar fhreagraMy Department has been aware in recent years of a number of references both in the general media and in the medical literature to an increase in the prevalence of conditions which may be related to allergies. These conditions affect a number of systems such as food allergies resulting in gastrointestinal symptoms, allergies to substances in the environment which may lead to a variety of skin conditions, and the one which has been most widely researched and reported, that of an apparent increase in the prevalence of asthma in both children and adults.
Some of these phenomena may be explained by more sophisticated diagnostic and investigative techniques which allow for the more frequent identification of conditions whose pathology and causation were previously unknown. However, it is generally accepted, not only in Ireland but in the Western world in general, that there appears to have been a real increase in the incidence of asthma which is not solely explained by reference to diagnostic techniques. This was confirmed in a study which was carried out on asthma in Ireland by Allen & Hanburys in conjunction with the Asthma Society of Ireland in 2001. This research extended a previous study which was carried out in seven countries in Europe in 1999 which confirmed that, among the European Union countries, there are also variations in asthma prevalence.
It is accepted that some of the factors which may influence this situation include environmental factors, not only smoking and workplace exposure to respiratory irritants, but also a more general level of exposure to environmental substances which cause allergies to occur. The Deputy may wish to note that the EU is developing an action plan on environment and health which is expected to be adopted later this year. The plan is intended to reduce the disease burden caused by environmental factors in the EU, with special emphasis on children and other vulnerable groups in society, to identify and to prevent new health threats caused by environmental factors and to strengthen EU capacity for policy-making in this area. Officials of my Department and of the Department of the Environment, Heritage and Local Government are involved in the preparation of this action plan.
Additionally, an expert workshop on childhood asthma organised by the Joint Research Centre of the European Commission will be held in Cork on 22 and 23 April 2004. This will examine approaches to research on childhood asthma from a genetic and environmental perspective, which is part of a major research initiative ongoing at EU level. It is hoped to agree Council conclusions on this issue at the June meeting of the Employment, Social Protection, Health and Consumer Affairs Council.
The Deputy may wish to note that, at the meeting of the Competitiveness (Internal Market, Industry and Research) Council on 22 September 2003, a directive was approved regarding the labelling of the ingredients present in foodstuffs. The new labelling rules in particular aim to ensure that consumers suffering from food allergies or who wish to avoid eating certain ingredients for any other reason are informed. They foresee that all ingredients in foodstuffs will have to be included on the label and abolish the 25% rule which up to now meant that it is was not obligatory to label the components of compound ingredients that make up less than 25% of the final food product. The new directive also establishes a list of ingredients liable to cause allergies or intolerances. It will also be obligatory to mention allergens on the labels on alcoholic beverages.
Additional information not given on the floor of the House.
At the forthcoming meeting of the European Union chief medical officers, the chief medical officer of my Department has placed the issues of food and asthma on the agenda so that we can share experiences, information and knowledge with our EU partners on this issue. In addition, my Department has contacted the Health Research Board to discuss the issue of research into the incidence of asthma in the Irish population, and the establishment of an asthma register is under discussion between professionals dealing with asthma and the Eastern Regional Health Authority. These initiatives should help to elucidate more clearly some of the causative factors relating to these conditions and, more specifically, to identify factors which contribute to the allergic component of this and other conditions. Thus, preventative and treatment strategies can be more effectively developed and implemented.
I thank the Minister for his comprehensive reply. I take it from the reply that he accepts that this is a serious problem in Ireland. The latest statistics available to me show the percentage of teenagers aged 13 to 14 years in Europe reported to be wheezing in a 12 month period. It was 30% for Irish children. In terms of the league table, does the Minister accept that the United Kingdom and Ireland come off worst? Can he explain why we come out so badly in the asthma league table? In 1983 only 4% of children suffered from asthma, so there has been a dramatic increase in the rates of asthma. There is evidence of this in my constituency. Schools in Ringsend, Sandymount and Rathgar have a box full of inhalers. Can the Minister identify or does he hope to identify why Ireland has such a poor record in this regard? Does he accept the hypothesis that the rise in allergies could be directly linked to the way we live now, in bacteria-free homes, eating semi-sterile food, and that all the evidence shows that children exposed to more infections in early life are less prone to allergies? Will research in this area focus on that?
I have a number of specific questions. There is no dedicated provision for the identification and treatment of allergies in the public health system in Ireland. When does the Minister intend to make provision to address the allergy epidemic and direct his Department or the Central Statistics Office to begin collecting data that will inform his decision-making on adequate service provision in this area? What guidelines are being issued to general practitioners and accident and emergency units where they are confronted with someone with an allergy? There are those who believe —and they are well-informed individuals —that people are not properly informed and that we could have fatalities as a consequence. Is the Department issuing guidelines to people at the coalface dealing with this and to people in schools? Many children have allergies to various foodstuffs and teachers do not know how to deal with them.
Having spoken to those involved in the area and to consultants, clinicians and researchers, I am aware that there are still a number of theories regarding the prevalence of asthma in developed countries such as Ireland. It is argued by some that it is a condition of the developed world and not one that affects those in the developing world. Many clinicians have articulated that explanation but it is yet not definitive in terms of evidence and some people question it.
I recently met the head of the European Union joint research centre and discussed his plans for a major European research study of which the workshop in Cork will be a part. This study will provide an opportunity for Irish researchers to tap into information from across the Continent. The individual who heads the centre happens to be Irish and he was anxious to involve the country in this medium-term project.
To whom is the Minister referring?
I do not want to name the individual involved. He is head of the joint research centre of the European Union. The project will be a substantial, multi-partner research initiative and we hope to put it forward at the June meeting in Budapest which will deal with children and environmental factors. The idea is to carry out genuine research on the linkage between environment exposure and genetic make-up. There could be an interplay between both factors and some may be more exposed and run higher risks in respect of certain environmental considerations than others.
In respect of the specific case of Ireland, I have been involved in discussions with certain professionals. My chief medical officer and his team are currently in discussions about the establishment of a specific asthmatic register so that we can obtain data about the prevalence of asthma in this country. The United Kingdom and other countries in Europe have rates similar to those which obtain here. I take the point that we have lacked infrastructure for development.
When will the register be ready?
It will take time to get it up and running. I hope that the discussions to which I refer will soon reach a conclusion. Dr. Manning has been a tireless advocate for the establishment of such a register. I hope I will be in a position to put in place the machinery to facilitate this.
