Why are so many of us suddenly being hit by hay fever in middle age



00:30 GMT, 7 August 2012

Middle-aged and never experienced the misery of hay fever

Do not congratulate yourself just yet.

A growing number of middle-aged people who have never before suffered from an allergic reaction to pollen are discovering for the first time this summer that age offers no protection against the curse of a constantly runny nose, itchy, streaming eyes and a prickly throat that just won’t clear.

Man blowing his nose

Sick woman wiping her nose

A new species of plants which have spread from the U.S. are producing pollen that causes hay fever symptoms

Experts believe our washed-out summer has created a ‘perfect storm’ for hay fever, with the result that more adults are suffering for the first time.

They also say new species of plants which have spread from the U.S. are producing pollen that causes symptoms because we have not been exposed to them before.

‘Each year my colleagues and I see more middle-aged and older patients coming to our clinics for the very first time,’ says Dr Suranjith Seneviratne, a consultant in clinical immunology and allergy at The Royal Free Hospital in London.

‘The idea that allergies affect only young people is, I’m afraid, a bit of a myth.’

Around 26 per cent of the adult population — 12 million people — suffer from allergic rhinitis, a term which covers all kinds of reactions to allergens, including hay fever.

But at least a third of those — more than
four million — are between the ages of 45 to 65, according to the
research company Datamonitor Healthcare.

‘An allergy occurs when the immune system starts to react to an innocuous agent such as pollen as if it were an enemy to the body,’ explains Dr Seneviratne.

In response to the perceived danger, the immune system produces antibodies that trigger the release of a chemical called histamine — this is what causes the symptoms of hay fever.

The symptoms can vary: some will have swollen eyes without a runny nose, others may suffer from just a sore throat or a combination of all three.

‘We don’t know why this response happens, although there is a much higher likelihood if you have a family history of allergies, or other allergic conditions such as eczema,’ says Dr Seneviratne.

But we know it can happen at any time of life. The question we’re asking is: why is it happening to higher numbers of older people than before’

Man blowing his nose

Senior woman blowing nose

We have become so clean and healthy, and free of infection and disease, that our immune system is not being kept occupied

One hypothesis is that our immune system starts to show signs of wear and tear and begins to malfunction as we get older.

The problem may lie with regulatory T-cells, which work to dampen down reactions from the immune system.

He says: ‘As you get older and your immune system becomes compromised, maybe through illness, long-term stress or simply through ageing, these T-cells may become disrupted and don’t work as well as they did.’

Lindsey McManus, deputy chief executive of the charity Allergy UK, says: ‘A weak immune system doesn’t mean you will get hay fever, but it could mean that you are more susceptible to it.

‘We hear from people for whom hay fever becomes a problem after a severe illness or a run of nasty viruses or bugs.

'They may have had it mildly in the past, in fact so mildly they didn’t even know that they had it, but as soon as their immune system becomes compromised — which does happen more as we grow older — then they react more violently to allergens.

‘Pollens are by far the most common allergen, so it is most likely that they will develop hay fever, although they can develop allergies to other substances such as foods.’

Another possibility is that we have become so clean and healthy, and free of infection and disease, that our immune system is not being kept occupied.

Without enemies to fight, it starts overreacting to compounds that don’t pose a threat, such as pollen.

‘This group of middle-aged people are the first of the baby boomers to come through a system where there was mass inoculation, an NHS which kept them alive and well, antibiotics to beat infection and a sustained campaign to keep homes hygienic and sanitised,’ says Dr Seneviratne.

‘It is a possibility that although our health has improved considerably overall, perhaps there has been a price to pay in other ways which we are only just beginning to see — a delayed response to a hygienic life.

‘On top of this people are living longer: the baby boomers are reaching middle age and beyond, providing a larger group of people to develop certain illnesses.’

CLEVER WHEEZES TO BEAT SNEEZES Wash your hair before going to bed as pollen sticks to the hair and can be easily transferred to the pillow, resulting in uncomfortable nights.Pollen count is highest first thing and late afternoon/early evening, so don’t sit outside then.Don’t hang your clothes to dry outside during these times either — pollen will cling to them.Apply a barrier around the edge of each nostril to trap or block pollen. You can buy balms or nasal spray, or try petroleum jelly. And wear wraparound sunglasses to avoid pollen affecting your eyes.Try Sterimar Nasal Spray (from pharmacies) to flush out the nasal passages.Speak to your GP or pharmacist for advice on whether eye drops, nasal sprays or antihistamines (or a combination of all three) is best for you.If taking antihistamines, use two to three weeks prior to your normal onset time of symptoms.

As well as physiological reasons, there may be other causes for the upsurge in hay fever.

Grass pollen, which is thought to cause 90 per cent of all hay fever, has had a bumper season (other major culprits include tree pollens and mould spores from fungus).

‘The heavy rain has created a particularly lush crop of grasses this year,’ explains Patrick Suchon, health business manager of the Meteorological Office.

‘While the rain dampens down the pollen count, when it stops and the sun comes out, as it did last week, the pollen count goes very high very quickly as the plants make the most of the sunshine.’

This year we have seen much higher pollen counts than in previous years where the dry weather meant a more sparse grass growth.

‘Another issue is that because of the wet damp weather, mould spores, which come from fungi such as mushrooms and decaying vegetation — which usually don’t appear until very late summer and early autumn — are being released early.

'Some people are just allergic to mould and some to just grass, but those who are allergic to both will be suffering twice as much.’

And what many may have dismissed as a cold in previous years where there was a low pollen count, could have actually been the start of hay fever, he explains.

‘It could well be that people had hay fever in past years but so mildly they thought it was a cold.

'The conditions this year have made symptoms much worse, so they believe they’re getting it for the first time.’

But Professor Roy Kennedy, of The National Pollen and Aerobiology Research Unit, believes late onset sufferers may also be falling prey to new allergens.

‘There are a lot of new species of plant being introduced to the UK,’ he says.

‘For example ragweed, which came from America and is now spreading throughout Europe, is a highly allergenic plant, producing very high rates of grains of pollen over a season.

'It also produces more pollen in wet years. Oil seed rape pollen is also more commonplace.’

Despite the lack of green spaces, hay fever can be worse in towns and cities, warns Professor Kennedy.

‘People think that because they live in an urban area they’ll be spared the worst exposure, but pollen binds to pollution and is carried into the city that way.’

Pollution itself is also a low level irritant to the immune system, making symptoms even worse, adds Dr Seneviratne.

Hay fever should not be dismissed as simply the sniffles, warns Lindsey McManus.

‘Untreated, it increases the risk of asthma.

‘Unfortunately, once you have been sensitised to an allergen you are pretty much stuck with it, but there are certain things you can do to help.

'Work out what time of year you are affected which will give you an idea of what you are allergic to.

'Then next year, start taking your anti-histamines and eye drops a few weeks before the pollen season starts. It really does help.’

But Dr Seneviratne says there’s hope for middle-aged sufferers: ‘There are so many variables.

'Maybe next year the weather will create a different growth pattern for grass and trees; perhaps your immune system will be stronger.

‘The body is not a computer that always behaves in the expected way.

'Just because you had a bad year, it doesn’t you’ll suffer next year.’

allergyuk.org, 01322 619898