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T. Haahtela, L. Hertzen, M. Mäkelä, M. Hannuksela (2008)
Finnish Allergy Programme 2008–2018 – time to act and change the courseAllergy, 63
L. Hertzen, J. Savolainen, Matti Hannuksela, Timo Klaukka, Antti Lauerma, Mika Mäkelä, J. Pekkanen, A. Pietinalho, O. Vaarala, E. Valovirta, Erkki Vartiainen, T. Haahtela (2009)
Scientific rationale for the Finnish Allergy Programme 2008–2018: emphasis on prevention and endorsing toleranceAllergy, 64
The Finnish National Allergy Programme 2008–2018 is re‐evaluating many of the older dogmas in allergology ( 1, 2 ). There is a growing body of evidence suggesting that excessive avoidance of natural exposure to allergens without justification can lead to impaired immunologic tolerance and a poorer quality of life of children and their families. The focus of the Allergy Programme is to draw a clear distinction between those who have mild disease and those who are at risk of suffering severe consequences from these diseases. Strategies and recommendations for the prevention of allergies have typically been exaggerated and restrictive based on relatively poor scientific evidence. New data imply that most children do not benefit from avoidance diets or by taking extra precautions to avoid environmental allergen exposure. Therefore, the health of children is best served by giving similar recommendations to every child, i.e., a balanced diet, physical activity, and a close connection with the natural environment, whether he/she is allergic or not. This does not mean that the environment should not be still improved in many ways. For example, anti‐smoking advice and legislation discouraging smoking should be implemented because exposure of children to environmental tobacco smoke is still a problem. Food allergies and asthma have been on the increase from a global perspective until recently, although in countries such as Finland, the incidence of many allergic diseases seems to have reached a plateau. The numbers are so vast that not all children with allergies can receive specialist medical care. Medicalization should be avoided; it is in neither the society’s nor the patients’ interests to provide specialist treatment to large numbers of people with mild symptoms that can hardly be diagnosed as a disease. Both GP’s and nurses at well‐baby clinics, health care centers, and schools need to be provided with straightforward instructions about how to take care of the children with mild symptoms or disease. An important aspect is also relaying the correct public health messages. Overall, the population should be encouraged to adopt sensible behaviors, including avoidance of unnecessary diets, but instead diets that promote general health and immune balance. As part of the Allergy Programme, specific written recommendations for nurses and GP’s at well‐baby clinics, schools, and health care centers have been developed, which strive to provide answers and instructions about the most frequently asked questions in allergic diseases (published in this issue of PAI). These simple practical recommendations and instructions for treatment are based on the scientific literature and best practices, but they are not graded according to their scientific quality. You will not find references for each instruction, and many of the statements are commonly debated at every allergy conference! For example, the question of avoiding animals in the first months or years of a child’s life still generates vigorous debate and many reviews and even more scientific papers. We are trying to make common sense of this controversy by saying: pets are ok for anyone as long as they don’t cause symptoms. These instructions are not guidelines that could and should be adopted at specialized care centers. We recognize the still widely held beliefs and there are some aspects of handling these diseases that can certainly be debated. However, the general goal of the Allergy Programme and these instructions is to promote the health of all children, whether allergic or not!
Pediatric Allergy and Immunology – Wiley
Published: Mar 1, 2012
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