The World Environment Day, a United Nations event, focuses this year on air pollution, an environmental problem that kills some 7 million people every year worldwide.
In addition to its impact on global health, air pollution also contributes to climate change. It is believed that exposure to pollution is partly responsible for the increased prevalence and severity of allergic diseases. Air pollution and exposure prevention will once again be at the forefront of this year's annual congress of the European Academy of Allergy and Clinical Immunology (EAACI) in Lisbon.
Allergies affect almost a quarter of the population in industrialized countries and are increasing in all age groups. Currently, more than 150 million Europeans suffer from chronic allergic diseases and it is predicted that by 2025 half of the total EU population will be affected. This epidemic continues to have an increasing impact on global health budgets, with total expenditure on asthma in Europe alone estimated at EUR 72.2 billion per year. The avoidable indirect costs of inadequate treatment of allergies in the EU are estimated to be between €55 to €151 billion per year.
The first increase in pollen-related respiratory allergies occurred after the industrial revolution, which was accompanied by a deterioration in air quality. Some pollutants such as CO2 promote plant growth and increase pollination. In addition, CO2 contributes to the rise in global temperature, which also affects allergic patients. "Depending on where you live, higher temperatures can lead to more plant growth. A shift in exposure to pollen is to be expected, and the new allergen shift will vary depending on where you live," says Jeroen Buters, a toxicologist at TUM and former chairman of the EAACI working group on aerobiology and pollution.
More and more digital aids and state-of-the-art technology are being used to provide better care for patients in the future.
The field of allergology is influenced by the advent of mobile health technology, which provides unprecedented communication channels for allergists and their patients and represents a real revolution in epidemiology, care, and research, paving the way for personalized and accurate medicine.
Patient diaries and digital questionnaires enable monitoring of the severity of the disease and its impact on the quality of life over time, enable patients to control the disease themselves, and provide physicians with valuable longitudinal data on the course of the disease and the impact of treatment. These tools can also include playful information for children, management recommendations, videos, and patient stories.
The possibilities for all allergic diseases are huge and only a few clicks away: Apps such as the Mobile Airways Sentinel Network, which uses a visual analog scale for nose, eye and asthma symptoms to associate allergies with work impairments; pollen diaries that compare different seasons and aerobiological particles to detect a possible pollen allergy or predict a worsening of pollen allergy symptoms; telemonitoring; integrated care pathways and clinical support systems that serve as potential decision making tools for allergen immunotherapy; and apps for those who measure the impact of allergic diseases on sleep quality, provide medication reminders, or help patients choose allergen-free foods.
EAACI has recognized the potential of mobile technologies and is actively contributing to their development by setting up a Health and Allergy Task Force as part of a two-year action plan (2018-2020). "It will be very important to regulate this area and quickly distinguish between good and bad services. Not everything that is new will automatically be efficient and reliable. EAACI will play a role in helping public health systems and allergy sufferers guide and manage this process," says Paolo Matricardi, Charité Universitätsmedizin Berlin and Chairman of the EAACI mHealth Task Force.
Particularly innovative are pollen monitors, which are mainly used in Bavaria, Germany. Since this year's pollen season, every citizen has been able to find out the current pollen load for specific locations and pollen types online via the Bavarian State Office for Health and Food Safety (German acronym: LGL). The data is updated every three hours. This preventive measure is particularly valuable for people who suffer from hay fever or asthma. But only those who know which pollen fly when and where can take important precautionary measures and take their medication in a precise manner. For this reason, in the future, allergy sufferers and asthmatics will be provided with more up-to-date and accurate real-time data on pollen flight patterns in Bavaria.
The costs for the regular operation of the 'ePIN' project are estimated at €600,000 per year. The total annual costs of pollen allergy are beyond the six-figure-range range in Bavaria alone, which LGL calculated to be €609 million in 2013. This figure includes, for example, the costs of medical treatment or lost working hours. Therefore, this preventive measure appears to be an extremely sensible investment. These expenses are now to be reduced by better information and real-time data on the pollen flight in Bavaria.
The Charité Berlin Research Institute is also interested in the Bavarian flagship project and has recently set up a Bavarian pollen monitor for research purposes. The hope is to measure pollen values in the German capital and made available to patients in the future. Currently, this monitoring is financed by the institute itself. Whether and when other states will follow suit is still to be seen. As is so often the case, the costs of treatment are out of all proportion to the costs of meaningful prevention, but the Federal Government and the German federal states still need to be convinced by the good data to be made available from Bavaria.
The "ePIN" project is part of Bavaria's climate adaptation strategy and was adopted by the Bavarian Council of Ministers on September 13th, 2016. It is conducted under the direction of the LGL in cooperation with the State Office for the Environment (German acronym: LfU). Consultants and project partners are the Centre for Allergy and Environment (ZAUM) of the Munich Technical University and Helmholtz Zentrum München, the Leibniz Computer Centre (German acronym: LRZ), the Environmental Research Station Schneefernerhaus Zugspitze (German acronym: UFS) and other national and international research institutions.
1. EAACI White Paper. Selroos O, et al. (2015, September), National and regional asthma programs in Europe, European Respiratory Review 2015, 24(137):474-483., retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26324809.
2. Press release: Bavarian State Ministry of Health and Care, 27 April 2018. Modern pollen measurements to help allergy sufferers - Bavaria's Health Minister Huml launches the first automatic pollen monitor as part of the new electronic pollen information network in Garmisch-Partenkirchen. (Original German title: Moderne Pollenmessungen sollen Allergikern helfen – Bayerns Gesundheitsministerin Huml startet in Garmisch-Partenkirchen den ersten automatischen Pollenmonitor im Rahmen des neuen elektronischen Polleninformationsnetzwerkes).
3. Press Release: Annual Congress 2019 of the European Academy of Allergy and Clinical Immunology. June 1, 2019. Policing pollution. EAACI supports World Environment Day.
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