Deaths from food allergies have declined in the UK over the past 20 years, despite a rise in hospital admissions, according to analysis published today.
Scientists from Imperial College London examined NHS data and found that while admissions tripled between 1998 and 2018, the number of deaths halved.
Cow’s milk was found to be the most common single cause of fatal food-induced allergic reaction in school-age children.
About two million people are thought to live with a food allergy in the UK, although deaths are rare, estimated at fewer than 10 per year.
Lead study author Dr Paul Turner from Imperial’s National Lung and Heart Institute said: “This study raises two important points. The first is that despite hospital admissions increasing, the number of deaths from food-induced anaphylaxis has fallen.
“However, the second, more worrying point, is that cow’s milk is now the single most common cause of fatal allergic reactions in children. There is now a lot of awareness of allergies to peanut and tree nut, but many people think milk allergy is mild, perhaps because most children outgrow it. However, for those who don’t, it remains a big problem because milk is so common in our diet, and people don’t realise how dangerous it can be.”
The study, which is published in today’s edition of The BMJ, analysed UK hospital admissions for food-induced anaphylaxis between 1998 and 2018, comparing them to fatal anaphylaxis events.
They found hospital admissions for food-induced anaphylaxis increased by 5.7% per year from 1.23 to 4.04 admissions per 100,000 population per year, while over the same period, the case fatality rate more than halved, from 0.7% in 1998 to 0.3% in 2018.
Sushma Acharya, head of policy and strategy for food hypersensitivity at the Food Standard Agency, which funded the research with the Medical Research Council, said the research is part of a wider study it has commissioned to support its ambition for the UK to be the best place in the world to be a food hypersensitive consumer.
“These important findings help us understand the trends of severe food induced allergic reactions, like who is most at risk and which foods are responsible,” she said.
“We want to improve the quality of life for people living with food hypersensitivity and support them to make safe informed food choices.
“We note that young adults are most at risk from severe and fatal allergic reactions to foods. Our upcoming promotion to encourage young people to ask for allergen information when ordering food is one example of how this valuable data will be used to inform our campaigns and policy making.”
The study also assessed food-related anaphylaxis fatalities, which have been recorded since 1992, and found 187 deaths where the cause of death was likely to be food-induced anaphylaxis. At least 86 (46%) of these were due to peanuts or tree nuts, such as almonds, cashews and walnuts.
There were 66 children’s deaths reported, 14% of which were caused by peanuts and 9% by tree nuts. In 12% of cases the nut could not be identified. However, cows’ milk was responsible for 26% of cases.
A four-fold increase in prescriptions for adrenaline auto-injectors was also recorded, although the researchers say they are unclear as to what effect this has had on the number of deaths from severe reactions.
The Imperial team is now investigating why some people may be more susceptible to severe allergic reactions, and if factors, such as genetics, play a role.
Bassegio Conrado A, Ierodiakonou D, Gowland MH et al. Food anaphylaxis in the United Kingdom: analysis of national data, 1998-2018. BMJ 18 February 2021; doi: BMJ 2021;372:n251
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