Background
1.1
Allergic disease is on the rise and creating a social and economic burden on Australian society. It is estimated that around one third of people will develop allergies in their lifetime. In Australia, food allergy affects 10 per cent of children and two per cent of adults. Over four million Australians live with allergies or allergic diseases and this number is rising.
1.2
An allergy is a person’s immune system reacting to substances in the environment which are harmless for others. Substances which cause allergic reactions are known as allergens. Atopy is a genetic tendency to develop allergic diseases. When people with atopy are exposed to allergens they develop allergic inflammation which results in conditions such as hay fever (allergic rhinitis), eczema (atopic dermatitis), hives (urticaria) or allergic asthma.
1.3
Allergic disease includes several different conditions, the most common of which are food and drug allergy, atopic dermatitis, allergic rhinitis, allergic asthma, insect bite or sting allergies and latex allergy. Less common allergic conditions include idiopathic anaphylaxis (anaphylactic reactions with no known cause), eosinophilic oesophagitis (EoE) and food protein-induced enterocolitis syndrome (FPIES).
1.4
In its most severe form, an allergic reaction can result in anaphylaxis which can be life threatening. Anaphylaxis is a generalised allergic reaction which can often involve more than one body system, such as the skin, respiratory, cardiovascular or gastro-intestinal systems. Common triggers for anaphylaxis are food, insect bites or stings, and medications. Less common anaphylactic triggers are latex or exercise.
1.5
Between 1997 and 2013, the Australian Bureau of Statistics recorded 324 deaths from anaphylaxis. However many allergy specialists believe this figure is underestimated due to a lack of understanding of anaphylaxis within the medical profession.
About the inquiry
Objectives and scope
1.6
On 27 August 2019, the Minister for Health, the Hon Greg Hunt MP, referred the Inquiry into Allergies and Anaphylaxis (the inquiry) to the Standing Committee on Health, Aged Care and Sport (the Committee).
1.7
As part of the inquiry the Committee reviewed the prevalence and treatment of allergies and anaphylaxis in Australia. More specifically the Committee examined:
an overview of allergies and anaphylaxis, including food and drug allergy, as well as other allergic diseases such as eczema, allergic rhinitis and others;
the management and treatment of allergies and anaphylaxis, including topics such as food labelling and food service, access to adrenaline auto-injectors and access to medical services for allergy and anaphylaxis sufferers; and
research into possible causes of allergy and emerging treatments and therapies, including research into food based oral immunotherapy.
1.8
The Committee received a number of personal accounts from people who suffer from allergies as well as the parents of children suffering from allergies and anaphylaxis. Members of the Committee appreciate the effort taken by these people to participate in the inquiry. The personal accounts provided the Committee with valuable insights into the impacts of allergies and anaphylaxis.
Inquiry conduct
1.9
On 12 September 2019, the Committee issued a media release announcing the inquiry and calling for submissions. The Committee invited submissions from government agencies, peak industry and professional organisations, community support and patient advocacy groups, health providers specialising in allergy care, research organisations and universities, and the general public.
1.10
The inquiry received 257 submissions and five exhibits, which are listed at Appendix A and B respectively.
1.11
The Committee held seven public hearings as outlined in the table below. A list of witnesses and organisations who attended these public hearings is in Appendix C.
Table 1.1: Public hearings held
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24 October 2019
6 February 2020
13 February 2020
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Canberra, ACT
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18 November 2019
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Melbourne, VIC
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19 November 2019
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Sydney, NSW
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17 February 2020
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Adelaide, SA
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18 February 2020
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Brisbane, QLD
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Report structure
1.12
Chapter 2 provides an overview of allergies and anaphylaxis in Australia. This includes definitions and prevalence levels of various allergies, the impacts and costs of allergies and anaphylaxis, theories on possible causes, and a discussion on the availability of allergy and anaphylaxis data in Australia.
1.13
Chapter 3 discusses the support and management currently available for people suffering from allergies and anaphylaxis in Australia. This includes government partnerships, access to treatment, including long waiting lists to see specialists and limited access to specialists in rural and remote Australia. Drug allergy management including drug de-labelling is discussed as well as sting allergy management.
1.14
Chapter 4 reviews the issues raised in relation to food labelling. It discusses the Food Standards Australia New Zealand Code that regulates requirements for all food labelling in Australia as well as Plain English Allergen Labelling (PEAL) and Precautionary Allergen Labelling (PAL). Education and training needs for allergies and anaphylaxis are discussed for various sectors including the medical sector as well as allergen management in the food service industry.
1.15
Chapter 5 outlines research funding for allergies and current clinical trials for food allergies that are available in Australia. It discusses food based oral immunotherapy (OIT) which is not yet available in Australia but is available in some overseas countries. This chapter discusses new treatments for severe eczema and alternative medicines and therapies being used for allergy treatments in Australia.