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Hayfever is a common condition which reaches peak prevalence in adolescence. Symptoms occur during periods of high grass pollen exposure (May/June in the UK), at a time when important examinations take place. Despite evidence that allergic rhinitis itself, as well as the medication taken to treat it, can interfere with learning and concentration, symptoms are often trivialised by patients and health professionals. The aim of this study was to investigate the prevalence of self-reported hayfever diagnosis, hayfever symptoms, respiratory health and use of allergy medication in UK secondary school children. All students aged 15/16 (n = 3286) in 14 schools in the West Midlands area of the UK were invited to participate via parental letter and consent. A pre-piloted questionnaire asking about respiratory health, smoking and hayfever treatment was developed (using, where appropriate, validated questions from the ISAAC study) and piloted among a group of 16 year olds to identify ambiguities and errors. The resulting questionnaire was distributed to all year 11 students in April 2004. 3189/3286 (97%) students agreed to participate in the study, and questionnaires were completed and returned by 2282 (72%). 51% (1153) students reported symptoms indicative of hayfever although only 21% (485) reported a diagnosis of hayfever by their nurse or doctor. 25% (570) reported a diagnosis of asthma, whilst 20% (461) smoked cigarettes. 22% (502) reported taking medication for their hayfever. Of responders, 51% of UK 15/16 year olds report symptoms indicative of hayfever, although only 21% reported having had a confirmed diagnosis. Those children without a formal diagnosis may have untreated symptoms which could impact on exam performance and other social and psychological outcomes. The high prevalence of hayfever symptoms in this age group, and their potentially disruptive nature, should prompt health professionals to diagnose and treat hayfever symptoms more appropriately.

Background: Approximately 210 million people are estimated to have chronic obstructive pulmonary disease\ud [COPD] worldwide. The burden of disease is known to be high, though less is known about those of a younger\ud age. The aim of this study was to investigate the wider personal, economic and societal burden of COPD on a\ud cross country working-age cohort.\ud \ud Methods: A cross-country [Brazil, China, Germany, Turkey, US, UK] cross-sectional survey methodology was utilised\ud to answer the research questions. 2426 participants aged 45-67 recruited via a number of recruitment methods\ud specific to each country completed the full survey. Inclusion criteria were a recalled physician diagnosis of COPD, a smoking history of > 10 pack years and the use of COPD medications in the previous 3 months prior to\ud questioning. The survey included items from the validated Work Productivity and Activity Impairment [WPAI] scale\ud and the EuroQoL 5 Dimension [EQ-5D] scale. Disease severity was measured using the 5-point MRC [Medical\ud Research Council] dyspnoea scale as a surrogate measure.\ud Results: 64% had either moderate [n = 1012] or severe [n = 521] COPD, although this varied by country. 75% of\ud the cohort reported at least one comorbid condition. Quality of life declined with severity of illness [mild, mean EQ-5D score = 0.84; moderate 0.58; severe 0.41]. The annual cost of healthcare utilisation [excluding treatment\ud costs and diagnostic tests] per individual was estimated to be $2,364 [£1,500]. For those remaining in active\ud employment [n: 677]: lost time from work cost the individual an average of $880 [£556] per annum and lifetime\ud losses of $7,365 [£4,661] amounting to $596,000 [£377,000] for the cohort. 447 [~40%] of the working population\ud had retired prematurely because of COPD incurring individual estimated lifetime income losses of $316,000\ud [£200,000] or a combined total of $141 m [£89.6 m]. As the mean age of retirees was 58.3 and average time since\ud retirement was 4 years, this suggests the average age of retirement is around 54. This would mean a high societal\ud and economic impact in all study countries, particularly where typical state retirement ages are higher, for example\ud in Brazil, Germany and the UK [65] and the US [65,66,67], compared to Turkey [58 for women, 60 for men] and\ud China [60].\ud \ud Conclusions: Although generalisation across a broader COPD population is limited due to the varied participant\ud recruitment methods, these data nevertheless suggest that COPD has significant personal, economic and societal\ud burden on working age people. Further efforts to improve COPD diagnosis and management are required.