The patient rubbed his swollen eyes with his hands, wishing to dig out his eyeballs. “I can still rub my eyes, but if there is itching deep in my ears, I can’t even pick them out.” There are also patients who feel like there is a ball of cotton stuffed deep in their throats, and they feel like there are ants crawling all over their bodies. Only one of their two nostrils can ventilate. They often wake up at night due to poor breathing and feel suffocated. They cough when the cool breeze blows.
These scenes often occur in allergy (allergy) departments across the country. Doctors often see tearful patients and roughly “ravage” their facial features with their hands, so that the itching on their faces can be slightly relieved.
They receive allergy patients with various symptoms: eczema, rhinitis, asthma, urticaria… After a thunderstorm this fall, many hospitals in Hohhot, Inner Mongolia, were crowded with allergy patients. A pediatrician at one of the hospitals said that 800 people were there that day. Many people come to see asthma.
Many allergists from Beijing, Shanghai, Guangzhou, Wuhan and other places said that in recent years, the number of allergic patients has increased. Liu Guanghui, director of the Allergy Prevention and Treatment Center of Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), conducted a survey at a community hospital in Futian, Shenzhen and found that allergic patients accounted for about 40%. “This proportion is very scary.”
Living with allergies is a required topic in today’s era. As early as 2013, the World Allergy Organization released a white paper: the global prevalence of allergic diseases is estimated to be 10%-40%. Yin Jia, president of the Allergist Branch of the Chinese Medical Doctor Association, said that the prevalence of allergies in Western countries increased rapidly in the early years and has now reached a plateau, while the prevalence of allergies in China is on the rise.
Allergens you may not know about
Imagine that on the bed where you lie every day, every gram of dust can hide up to 18,000 mites, feeding on the skin flakes that fall off your body. Especially in areas with humid and warm climates, up to 2 million mites can live on a bed. The limb fragments and feces produced by these mites are highly allergenic.
This may explain why some people feel the urge to sneeze or have a runny nose when making their bed or shaking out the sheets. Mites may also be mixed into flour and cornmeal. When they are made into pancakes, people who eat the pancakes may suffer from severe allergic reactions or even shock due to ingesting a large amount of mite-allergenic ingredients.
Another allergen that can be found throughout your home is mold. It is mixed in the soil of green plants, fallen leaves, air conditioning vents, leftover food that was not thrown out in time, and in houses soaked by floods. Yin Jia once treated a child with mold allergy. The mold that caused the allergy was hidden in the plastic cracks of the child’s bathtub.
Zhu Rongfei, director of the Allergy Department of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, has continuously tracked the changes in sensitization rates to common allergens in patients with allergic rhinitis for 13 years in Wuhan, Chongqing, and Zhengzhou, and found that the sensitization rate of dust mites has always been at a high level, but The proportion of people allergic to pets, especially cat and dog hair, is rising rapidly, almost tripling in 13 years, and the number of people allergic to multiple allergens is also on the rise.
Guo Yinshi, chief physician of the Allergy Department of Shanghai Renji Hospital, and Lai He, director of the Allergy Department of the Second Affiliated Hospital of Guangzhou Medical University, both said that in East and South China, dust mites, molds, and cockroaches are the most common allergens.
“Some patients said that there are no cockroaches in my house. I have to educate them. They are not allergic to cockroaches when they see them. Cockroaches only active in the middle of the night. Cockroach excrement and body parts left at home are all allergens.” Laihe said.
Guo Yinshi said that in the Yangtze River Basin, the black-breasted cockroach is the dominant indoor cockroach species. They found that this cockroach can significantly induce allergic asthma. “Shanghai has many old residential areas with many cockroaches.”
Even in Beijing, there are many patients with dust mite allergies. Yin Jia found that every winter in Beijing, the doors and windows of most homes are closed and humidifiers are turned on, which inadvertently creates a living environment for dust mites that like warm and humid environments, aggravating the symptoms of allergy patients.
Zhu Rongfei concluded that from the distribution of allergens across the country, there is a trend of “southern mites and northern wormwood”, that is, in the humid and warm south, there are more patients with dust mite allergies; in the dry and cold north, there are more patients with wormwood allergies. In central China, in Henan Province, which is located in the north, the symptoms of pollen allergy patients are generally more severe than those in Hubei.
Guo Yinshi also found that in East China, there are more pollen allergy patients in areas north of the Yangtze River than in areas south of the Yangtze River.
Deng Shan, director of the Allergy (Allergy) Department of the Second Affiliated Hospital of Dalian Medical University, discovered that every year after the beginning of autumn, many Dalian people begin to sneeze unconsciously, have itchy noses, eyes, and palates. In severe cases, they may cough, have chest tightness and shortness of breath. “Although Dalian is a coastal city and relatively humid, the pollen concentration in the air is high. Artemisia is the main allergen, followed by wormwood and ragweed.”
Among them, pollen allergy patients in spring, summer and autumn have different allergens. Deng Shan introduced that in spring, most people are allergic to tree pollen, which affects people’s upper respiratory tract; in autumn, they are allergic to weed pollen, which in addition to causing symptoms of rhinitis and conjunctivitis, can also induce acute attacks of asthma. Relatively speaking, the symptoms of pollen allergy in autumn are more severe. Heavy.
In my country, trees that are allergic to pollen include juniper, orientalis, birch, pine, etc. in spring, and Artemisia plants such as mugwort, large-seeded mugwort, and mugwort in autumn.
Wang Chengcheng, executive deputy director of the Urban Forest Research Center of the National Forestry and Grassland Administration, has long studied plant-derived pollution such as pollen and flying catkins in cities. The survey found that the proportion of patients with pollen allergies reaches 5% in the population, and as high as 10% in northern areas. “In fact, The proportion should be higher than the number we surveyed because many patients with mild allergies do not go to the hospital.”
He explained that pollen is small and spreads easily in the air. In northern my country, there are many wind-pollinated flowers and large amounts of pollen in spring. Coupled with the sunny, dry and breezy weather, pollen allergies are more likely to occur. Generally speaking, pollen concentration is higher in the north than in the south, because the higher the humidity, the closer the pollen travel distance.
Wang Cheng did an observation survey in Beijing and found that the pollen concentration in the city is usually the highest at 2 p.m., but in hardened squares in communities and parks, the pollen concentration has a small peak at 8 p.m. “The air temperature at that time It has dropped, but the temperature on the cement or asphalt surface is still relatively high, and the micro-airflow can blow the pollen up, even five or six stories high.”
Thunderstorm asthma has attracted much attention this autumn. The principle is that after a thunderstorm, allergens such as pollen and mold are broken into smaller particles by lightning, which are more easily inhaled by the human body and cause allergies.
Nowadays, pollen allergies have a tendency to develop among younger people. Xiang Li, director of the Department of Allergy at Beijing Children’s Hospital, found that in the past, babies would develop pollen allergies only a few years after birth, but now clinically, she sees many children under the age of two with pollen allergies.
Some pollen and plants have similar allergenic proteins, which can easily cause food cross-allergy after pollen allergy. For example, patients with birch pollen allergies may experience allergic symptoms after eating apples, peaches, pears, etc.; Artemisia plants have similar allergenic proteins to celery and mustard; the allergenic components of natural latex are highly similar to those of bananas, avocados, and kiwis. homogeneous.
Guo Yinshi also found that in recent years, there has been a significant increase in patients with food allergies. Allergens include fruits such as dragon fruit, kiwi, strawberry, and pear, as well as seafood such as shrimp and crab. Liu Guanghui introduced that in Chinese food, crayfish and Chinese mitten crab are also allergens. Eggs and milk are common food allergens.
Catch the “criminal”
In many people’s minds, allergies are a “slow” disease that neither kills nor threatens to cause serious illness. At most, it can only be scratched or scratched, and it will be fine if you can tolerate it.
In fact, if allergies are delayed for too long, new and more serious symptoms may easily appear, and even serious consequences such as shock and death may occur. A research paper pointed out that 46% of allergic rhinitis patients will develop into asthma within 9 years. Zhu Rongfei said that if asthma is not well controlled with medication, it can easily turn into chronic obstructive pulmonary disease.
Laihe once treated a patient who initially had urticaria and went to a dermatologist; then the allergy worsened and turned into allergic rhinitis, so he went to an otolaryngology department; and finally it turned into asthma and he went to a respiratory department. After going back and forth for seven or eight years, I finally saw the allergist.
“Children’s allergies are like a march.” said Gao Xiang, director of the Allergy (Allergy) Department of Qingdao University Affiliated Hospital. “A new chapter will open at different ages. In infancy, it is mainly manifested by eczema, as well as food such as milk and eggs. Allergy. As we age, it gradually manifests itself as asthma and allergic rhinitis. Early diagnosis and early treatment are needed to stop this march.”
Xiang Li met a school-age girl who was allergic to molds and also suffered from allergic rhinitis, sinusitis, and asthma. At the height of her sinusitis attack, the girl banged her head against the wall in an attempt to relieve her headache. Xiang Li also observed that it only takes a short time for some children to develop from allergic rhinitis to asthma.
“It is not difficult to diagnose allergies clinically, but it is sometimes difficult to identify the allergens.” Li Lun, an allergist at Peking Union Medical College Hospital, likened the process of clinical consultation to catching “criminals.”
Suspects could be pollen, dust mites, mold, pets, food, medications, insects, etc. Doctors need to determine who is the “culprit” based on the relationship between the appearance time of these “suspects” and the patient, combined with laboratory tests.
To find the “criminal”, Li Lun needs to start by asking about the patient’s living environment and habits: what he eats, what he drinks, what plants there are in his area, what skin care products he uses…
Wheat is one of the most common food allergens in China. Some patients must eat wheat before exercising before they will suffer from severe allergic reactions and anaphylactic shock. “Just like bad guys don’t necessarily do bad things every time they go out, but they wait for opportunities to commit crimes under special circumstances such as exercise, excitement, drinking, etc.” Li Lun said.
An old man in his 70s from the north refused to eat wheat for 9 years because of allergies. When he was about to reach the end of his life due to other diseases, he suddenly became greedy and went to the allergology clinic to ask if he could have a bite of dumplings. Another patient would lie in bed every time he finished eating dumplings. He could not take a bath, get excited, or walk, otherwise he would go into shock at any time.
If you want to catch the “criminal”, you may have to accurately locate multiple “suspects”. A patient with allergic rhinitis from Qingdao came to Gao Xiang’s clinic and said that he had encountered strange things in the past three years. During the annual family seafood dinner, he would go into shock for no apparent reason during the meal.
Gao Xiang asked him to list various seafood dishes on the table, including shrimps, crabs, fish, clams, etc., and then took these suspected allergens to the laboratory, extracted the proteins to make crude extracts, and tested the patients for allergens. After testing, it was finally discovered that the patient had a severe allergic reaction induced by conch.
“We discovered a new type of conch allergen, which was reported for the first time in the world and was included in the international allergen database.” Later, Gao Xiang successively received four patients who were also allergic to conch.
Sometimes, “criminals” appear in unexpected places. An old man walked into Deng Shan’s clinic with a “sausage mouth” on his head. It turned out that he had switched to a toothpaste with special functions six months ago. Deng Shan did not prescribe him any medicine, but suggested that he stop using the toothpaste he was currently using and rinse his mouth with light salt water. In less than half a month, the old man’s “sausage mouth” was swollen.
Meng Juan, deputy director of the Allergy Center of West China Hospital of Sichuan University, found that patients from southern Sichuan, such as Xichang and Panzhihua, looked very likely to be allergic to pollen based on their medical history, but when tested for common allergens, the results were Negative, no allergens were found.
Meng Juan said: “The allergen detection reagents used today can detect very limited types of allergens, especially pollen allergens. Due to different climates, soil conditions, and vegetation distribution in different regions, different types of pollen are likely to cause allergies to people in different regions. The difference is huge, so even if foreign reagents are introduced, they cannot fully meet the needs of local patients.”
Meng Juan believes that my country’s research on airborne allergens should further develop local allergen detection reagents and desensitization treatment drugs, which are very necessary to meet the needs of clinical diagnosis and treatment.
She saw a child over 6 years old who had rhinitis and asthma since he was 3 years old. After doing allergy testing in other hospitals, he was told that he had many food intolerances and could not eat eggs, milk, wheat, rice, tomatoes, potatoes, and beef. , chicken, pork… It has seriously affected the children’s diet, growth and development, and physical and mental health. It has also caused great trouble to family life and caused serious mental burden.
Later, the child and his parents went to many hospitals. It was not until an allergen test was performed at the Allergy Department of West China Hospital of Sichuan University that they discovered that the child did not have a food allergy at all and that the real cause was dust mites. The test the child had previously done was a so-called food intolerance test and had nothing to do with allergies.
“Many patients hold physical examination reports of food intolerance as allergen test reports.” Meng Juan had to explain to the patients one by one that food intolerance reports are of no value in clarifying allergens. “Food intolerance has long been known abroad. No one has done it. This has long been proven to be a normal physiological indicator of the human body after contact with food and has no clinical value.”
There are over 100 million allergic patients, but there are only about 300 allergy doctors
According to the “People’s Daily” report in 2022, a survey by the Allergy Branch of the Chinese Medical Association estimated that there are as many as 150 million adult allergic rhinitis patients, but there are less than 300 allergy (allergy) specialists in the country, and there are not enough doctors who can diagnose and treat allergies. More than 3,000 people.
Zhu Rongfei said that there are few allergists in various places, and there are also few hospitals with allergy departments. In addition to seeing patients from Wuhan and other cities in Hubei, he often sees patients from Hunan, Henan, and Jiangxi. Outpatient registration often has to wait until two weeks later, and the supply exceeds demand.
Since there are few allergists, many allergy patients seek treatment in other specialties, such as otolaryngology for allergic rhinitis, pediatrics for infants and young children, dermatology for atopic dermatitis, and respiratory medicine for asthma.
Many of the allergy patients Laihe sees have already been seen by other specialties. She said that the allergy department can solve allergic diseases in multiple systems of the body in one stop. “In my clinic, there are few patients in Guangzhou and many patients from other places. Many people have been allergic for a long time.”
Guo Yinshi said that it is very common for a patient to suffer from two or three allergic diseases. When patients are scattered to two or three departments for treatment, doctors in traditional departments are often unable to predict the medication for other diseases. For example, dermatologists often cannot predict the medication for other diseases. The medication for asthma is accurate, but the respiratory doctor is also unsure about the medication for dermatitis.
Recruiting doctors specializing in allergology is a problem. Yin Jia said that in China, except for Peking Union Medical College, no other medical school can grant a doctorate or master’s degree in allergy. Because of the scarcity of talents, allergology doctoral graduates from Union Medical College are in high demand every year.
Zhu Rongfei said that currently, there are about 50-60 people with master’s degrees in allergy and more than 20 people with doctorates across the country. In recent years, some medical schools have offered “Clinical Allergy” as an elective or required course for undergraduates. Many medical students who are interested in allergies have allergies themselves or their family members.
Liu Guanghui, 72, is the oldest allergy doctor currently working in China and has been working in allergy clinics for 43 years. He said that there is a lack of popularization of allergy knowledge among Chinese medical students during their training. Doctors in other specialties have a misunderstanding that there are so many allergens and it doesn’t matter whether they check them or not. “Unless they are medical students who have returned from studying abroad and have been exposed to allergies abroad, Take the course.”
Another reason for the shortage of doctors is that there is no specialist assessment system in allergology.
Yin Jia introduced that Peking Union Medical College was the first to offer allergy courses for undergraduate medical students. Before 2012, graduate students in the Department of Allergy at Peking Union Medical College were awarded a master’s or doctoral degree in internal medicine. In 2012, allergy became an independent secondary discipline at Peking Union Medical College. Peking Union Medical College is still the only medical school in China that can grant a master’s or doctoral degree in allergy. However, there is no institution in the country that can examine or certify allergists.
She explained that allergist doctors in various places need to be affiliated with other specialties before they can be evaluated for professional titles. Laihe also said that many young doctors are unwilling to work in the allergology department because there is no specialist sequence in the department, which affects their promotion.
Yin Jia said that internationally, allergology is a secondary discipline alongside internal medicine, but in China, even in cities like Yulin, Shaanxi, which have a high incidence of allergies, the allergy specialty still does not have an independent department and is affiliated with the respiratory department. of subspecialties. She suggested expanding the allergy talent team and strengthening the construction of allergy specialists.
This cold bench has begun to become hotter in recent years. Yin Jia found that in recent years, among the eight-year medical graduates from Peking Union Medical College, the first and second-ranked students are willing to choose the allergy department. This shows that the new medical students have also discovered that there is a great demand for allergy patients. There is also a lot of room for exploration in the subject, which is a good trend.
Xiang Li said that training a pediatric allergist is not easy and requires cross-learning in other specialties such as children’s growth and development, ear, nose, and throat, and dermatology. “There is an imbalance and inadequacy in the development of the discipline and the needs of patients.”
Liu Guanghui said that many hospitals are currently eager to set up allergy departments, but they cannot recruit allergy specialists. They have to use multidisciplinary consultation (MDT), inviting doctors from otolaryngology, dermatology, pediatrics and other disciplines to sit together to solve the problem. Problems for allergy sufferers.
He insists that the fundamental way to solve the problems of allergy patients in one stop is to train more allergists.
There are too few usable “weapons”
To combat multiple allergens in the environment, many allergy doctors say there are too few “weapons” at our disposal. Currently, there are only two imported subcutaneous injection preparations for dust mite desensitization that can be circulated in allergology departments across the country, a domestic sublingual preparation for dust mite desensitization and a domestic desensitization preparation for Artemisia annua.
Desensitization treatment is equivalent to a “vaccine”. After the desensitization preparation is injected or taken sublingually, the patient’s body will produce protective antibodies against the allergen, and the immune system will develop tolerance to the allergen. This is the only treatment recognized worldwide for curing allergies.
However, in clinical practice, desensitization treatment is not widely used. Guo Yinshi found in clinical practice that less than 20% of allergy patients are willing to undergo desensitization treatment, and those who can finally undergo desensitization treatment only account for less than 10% of the overall number of suitable patients. However, in Europe, about 10% – 30% of patients will undergo desensitization treatment.
Zhu Rongfei made preliminary estimates based on domestic epidemiological data on allergic diseases and publicly disclosed market data on desensitization drugs, and found that less than 1% of allergy patients who meet the conditions for desensitization treatment actually receive desensitization treatment.
Many doctors have concluded that Chinese allergy patients are reluctant to undergo desensitization treatment mainly because the entire course of treatment takes 3-5 years and cannot be reimbursed by medical insurance. Using imported dust mite desensitizing preparations for subcutaneous injection for 3 years, the patient had to pay 15,000 yuan in medication. In addition, the success rate of desensitization treatment is less than 90%. The younger the patient, the better the treatment effect. However, school-age children are busy with studies and do not have time to come to the hospital regularly for treatment.
Moreover, there are few desensitizing preparations in China. “For patients with multiple allergies, just desensitizing dust mites is not enough,” Meng Juan said.
Yin Jia introduced that the Union Preparation developed by Peking Union Medical College Hospital can provide desensitization treatment for dozens of allergens. However, Xiehe preparations can only be used in this hospital. Although they are allowed to be transferred to hospitals outside the province, the transfer procedures are complicated and lengthy, and there are only 9 types of desensitization preparations that can be transferred to hospitals outside the province.
Some doctors who have not been successful in dispensing Xiehe preparations said that sometimes the dispensing process takes a year, but the validity period is only half a year.
Zhu Rongfei found that pharmaceutical companies lacked motivation to develop desensitizing preparations. For pharmaceutical companies, the initial investment in developing desensitizing preparations is high and there is a risk of R&D failure. Except for common allergens such as dust mites and mugwort pollen, the market capacity of other allergen desensitization preparations is not large.
In comparison, foreign desensitization preparations have more choices. More than 10 years ago, there were more than 500 desensitizing preparations available on the German market. Later, after the drug regulatory department adopted a new registration management policy for allergen preparations, the number of desensitizing preparations decreased, but there are still more than 100 desensitizing preparations available. clinical application. In France and the UK, allergic diseases are covered by medical insurance, and patients receiving desensitization treatment do not require additional medical expenses.
Since there are few preparations to choose from, more Chinese doctors choose to provide symptomatic treatment to patients with allergic diseases in clinical practice. Zhu Rongfei, for example, uses nasal spray hormones and anti-allergic drugs for patients with allergic rhinitis. These drugs can relieve the symptoms of allergic rhinitis in most cases, but cannot prevent the recurrence of rhinitis symptoms.
If you encounter patients with severe symptoms, Guo Yinshi recommends giving symptomatic control drugs first, including new biological agents. The main difference between biologically targeted drugs and desensitizing preparations is that biological drugs are mostly made-up antibodies that are directly injected into the body to exert curative effect and have few side effects. However, the maintenance time of curative effect is relatively short, usually a few weeks, and the current price is relatively expensive. , which generally requires tens of thousands of yuan per year.
The Second Affiliated Hospital of Guangzhou Medical University is the first hospital in China to establish an allergy department. Lai He said that since 1979, the department has been based on allergens unique to South China, including bayberry trees, fir trees and paper mulberry trees that are common in South China. There are now 60 kinds of homemade in-hospital preparations.
She once asked a pharmaceutical company to help make in-hospital preparations, but the price was very high and they had to apply for a batch number. She was unwilling to spend tens of millions to make a preparation. Therefore, the Allergy Department of the Second Affiliated Hospital of Guangzhou Medical University has specially opened a preparation room and hired a pharmacist to be responsible for dispensing medicines in the department.
Living with allergies
Avoiding allergens is an important way that doctors often teach allergy patients. For patients with pollen allergies, they spend at least two months every year in a state of “feeling unwell”. Yin Jia has seen many patients. Every pollen season, they prepare their own pollen protection equipment: plug their ears and nostrils with cotton, wear goggles or large transparent eye masks, and then wear a mask with a fan filter.
Allergy patients in Yulin, Shaanxi Province leave Yulin in autumn to live in the south. When choosing a college, students with pollen allergies in the north tend to choose colleges in the south. A group of mothers in Qingdao set up an online group to advise each other in order to provide complementary foods for infants and young children with allergies. There was a mother in Beijing who quit her job to take care of her baby full-time in order to control her egg-allergic child from eating egg-fried rice.
As the number of patients increased, doctors discovered that allergies mainly occur in urban areas, among those with high levels of education, international students, and those with mysophobia. This is similar to the characteristics of allergic patients abroad.
Yin Jia said that to a certain extent, allergies are a “disease of wealth”. Most patients who come to see a doctor are concerned about the quality of life, so their economic conditions are relatively good. “The higher the level of modern life, the greater the possibility of allergies.”
“The more primitive the living conditions, the better.” Yin Jia suggested that when choosing laundry products, give priority to soap, then washing powder and laundry detergent.
Laihe often tells patients to get more sun and take their children to play on farms where there are chickens, ducks and geese. “The diversity of skin bacteria in patients with atopic dermatitis is significantly reduced, and bacteria harmful to humans are dominant.”
“People’s awareness of allergies is not as fast as the rate of increase in the incidence of allergies.” Liu Guanghui visited a female teacher from Wuhan University. After returning from studying abroad, she had continuous attacks of asthma, conjunctivitis, and rhinitis due to allergies. Sometimes she would have unintentional bleeding while teaching students. Rhinorrhoea, asthma.
When he reached the marriageable age, the teacher had a psychological burden. He was worried that he would pass the allergy to his children after getting married, so he secluded himself at home and refused to go to class. Liu Guanghui wanted to provide her with psychological counseling, but he never waited until she came to the department again. “In fact, most patients who come to the allergy department for treatment will improve a lot with intervention.”
Xiang Li also discovered that some children with allergies worry about being a trouble to others at school because of coughs, runny noses and facial discomfort. “Sometimes, physical symptoms also need psychological analysis.”
She treated an asthmatic boy who was hospitalized because of bronchial asthma. The boy was originally told that he would be discharged from the hospital tomorrow and he should be very happy, but he had another asthma attack that night. Later communication revealed that the boy had experienced the pain of dying from asthma and was very scared. He was also worried about a family history of asthma at home, so he had negative emotions about being discharged from the hospital, which triggered an asthma attack.
Sometimes allergies are hard to avoid. A girl who was allergic to cat hair suddenly developed allergic symptoms again in the office after giving her cat away. It turns out that among the more than 50 colleagues in the office, fifteen or sixteen are raising cats.
The problem of pollen allergies is also becoming more and more prominent in cities. Wang Cheng believes that urban vegetation management is getting better and better, and plants have more opportunities to grow to the reproductive stage and bloom, and pollen in the air naturally increases. However, the main reason is that green space management is too “clean”, causing trees and plants to fall. Pollen is not absorbed by the ground surface, but is repeatedly dispersed and accumulated.
At the same time, global warming and the urban heat island effect have also caused plants to bloom earlier, more in number, and longer.
He suggested reducing the use of allergenic tree species in squares, game areas, living areas, sidewalks, and upwind vents. There should be no bare land in cities and no bare soil in green spaces, otherwise it will aggravate the secondary spread of pollen.
Now, the Beijing Meteorological Bureau and the gardening department have also begun to cooperate to make regular pollen forecasts every day. However, Wang Cheng said that the equipment and instruments for measuring pollen concentration are not perfect, and professionals need to collect pollen first to know the amount of pollen on that day. “The current pollen forecast is an after-the-fact forecast, not an advance forecast, and there is a lag.”
The accurate pollen forecast he hopes for can pinpoint the plants that have bloomed recently and what areas of the city the plants are concentrated in, making it easier for residents to travel. Moreover, currently only a few cities across the country conduct pollen forecasts.
Guo Yinshi said that some developed countries have relatively complete monitoring of pollen and other allergens. During the pollen season, pollen forecasts are generally made every few hours, including pollen concentration, varieties, etc., which is also related to the vegetation distribution in the area.
Many allergy doctors believe that health-related departments pay insufficient attention to allergic diseases and pay more attention to diseases with high mortality. For example, the amount of scientific research devoted to allergy is less than one-tenth that of other specialties, there is also little drug research and development for allergy, and the health department rarely issues documents for the training of allergist talents.
Moreover, the health authorities have not yet established a nationally recognized allergy specialist training, assessment and admission system similar to that of gastroenterology and rheumatology and immunology. This is also a bottleneck restricting the training and construction of allergy specialists in my country.
However, the economic burden that allergies place on society and individual patients is no less than other diseases. A study conducted in the United States found that people with severe asthma spent $12,813 per year on drugs, hospitalization, and reduced workload or absence from work. Atopic dermatitis costs the UK a total of £465 million each year, including £297 million in treatment costs for patients, £125 million in public health prevention and treatment, and £43 million in lost working days or reduced employment opportunities for patients.
“Although in recent years, with the rapid growth of the number of allergy patients in my country, the development of allergy disciplines has gradually received attention, but there is still a gap of at least more than 10 years compared with foreign countries.” Meng Juan said.
The French government will hire technicians with medical backgrounds as home environment consultants to regularly go to the homes of allergy patients to collect allergens, specifically detect the concentration of mold on the walls and dust mites on the bed, and guide patients to live a healthy life. Europe, North America, and Oceania have also carried out allergen epidemiological surveys of varying scales.
Yin Jia said that from 2010 to 2015, the Department of Allergy at Peking Union Medical College Hospital led an epidemiological survey of eight allergic diseases in more than a dozen cities, and 140,000 people filled out paper questionnaires. It is difficult and delays statistics. Fortunately, all statistics and article writing have been completed recently, and the results of my country’s first epidemiological survey of eight allergic diseases among the general population across the country will be published soon.
“There is no popular survey data, and the government has no idea.” Yin Jia said that as an important town for pollen allergy, the government of Yulin, Shaanxi Province particularly hopes to understand the seriousness of urban allergies through the survey, so as to facilitate subsequent public health investment. To this end, the Yulin government and Yin Jia’s team from Peking Union Medical College Hospital signed a strategic cooperation agreement to mainly complete the local epidemiological investigation of allergic rhinitis.
“China’s disease spectrum is changing too fast,” Guo Yinshi concluded. In the past, during the agricultural period, there were many infectious diseases, with pneumonia and hepatitis being the diseases of major concern; now that we are moving towards industrialization, tumors have become a major concern. “But in developed areas at home and abroad, the incidence of tumors has entered a plateau, while immune system diseases are on the rise, including autoimmune diseases and allergic diseases.”
The rapidly changing disease spectrum puts pressure on the already heavy medical system. Guo Yinshi said that the original doctor training model has not yet turned a corner. If we look back in 10 years, it may be too late to deal with the high incidence of allergic diseases.