Children who experience hay fever symptoms while taking their GCSE exams are 40% more likely to drop a grade between their mocks and final exams, according to the findings of a new study conducted by the charity Education for Health, in collaboration with the University of Edinburgh and Imperial College London.1 This figure rises to 70% if they are taking a sedating anti-histamine treatment (which can cause drowsiness).1,2 Despite current guidelines advocating the use of widely-available non-sedating medication,2 28% of the students taking medication for their symptoms were on a sedating anti-histamine.1 The study is the first to look at the impact of hay fever on actual exam performance (as opposed to simulated conditions) and is available on-line from the Journal of Allergy and Clinical Immunology.

(GCSE - General Certificate of Secondary Education. Taken, usually, when a child is 16. UK equivalent of Junior High School Certificate in USA)

Hay fever has a peak age of onset in adolescence.3 Unfortunately, GCSE exams, which run from mid-May to the end of June, coincide with when the grass pollen season is at its height, and hay fever prevalence is at its greatest. Given the large numbers of young people affected, with as many as 63% of students in this study alone reporting hay fever symptoms1, the findings are expected to prompt discussions on how to better manage hay fever symptoms in children before and during the exam season, and even whether to change the timings of key exams such as GCSEs and A Levels altogether so as not to disadvantage pupils with hay fever in the future.

"Parents and health professionals need to understand that having hay fever could cause their children to perform less well in their exams and that effective treatments are widely available from their GP, practice nurse or pharmacist" commented the lead investigator Dr Samantha Walker, study lead and Director of Education, Research and Development for Education for Health.

1834 students aged 15-17 years participated in the study, and exam performances in mocks and final GCSE exams for the core subjects of Maths, English or Science were compared with responses to questionnaires on hayfever symptoms on the day of the exam. The normal expectation is that most children will either achieve their predicted grades or, with increased effort, improve on them when sitting the final exam. Any drop in grade is therefore unexpected.

The study found:

-- Young people who had hayfever symptoms on an exam day were 40% more likely to drop a grade between their mock and their final exam
-- This increased to 70% if they were on a sedating allergy medication at the time of their exam
-- Teenagers with severe hayfever, and a history of symptoms in previous years, were twice as likely to drop a grade1
-- 28% of those on hayfever medication in the study were on a sedating anti-histamine
-- This is despite the wide availability of effective non-sedating treatments and current treatment guidelines advocating their use over sedating medication2

It is hoped that the results of this study will highlight that hayfever is not a trivial condition, and that the symptoms of it should be taken seriously by both sufferers and healthcare professionals. With the wide availability of both over-the-counter and prescribed non-sedating medications that can effectively control symptoms, there should no longer be any excuse for hayfever impacting on school, work or other activities.

"The impact of hayfever on school, and in particular, exam performance has been a concern for Allergy UK for a long time," commented Muriel Simmons, Chief Executive of Allergy UK. "The findings of this study will hopefully prompt students to ensure that their symptoms are under control, and that they are not on a sedating medication, which clearly worsens the impact on exam performance. If any students are concerned they should contact their pharmacist or GP, or call the Allergy UK helpline number."

Symptoms of hayfever, which include blocked nose, sneezing, runny nose, itchy eyes and poor smell can affect people 24 hours a day. The most troublesome symptom is nasal congestion, with 85% of people with hayfever suffering from it.4 This symptom in particular can have a major impact on the patient's quality of life, notably, emotional function, productivity and the ability to perform daily activities. 40% of patients with hayfever report it has a moderate or severe impact on their sleep, correlating to an estimated 6 million people with hayfever in the UK experiencing sleep disturbance due to their symptoms.5

As well as the symptoms themselves, this high prevalence of sleep disturbance can also have a knock-on effect the following day, with daytime drowsiness affecting performance at work and in children, at school.5 Old-generation sedating anti-histamines can also lead to drowsiness, and have been found to have adverse effects on attention span, working memory, vigilance and speed, as well as higher levels of fatigue, lower levels of motivation, and lower levels of activity compared to placebo.6

Students who are concerned about whether they are on a sedating hayfever medication, or who do not feel their hayfever symptoms are under control, should speak to their pharmacist, GP or practice nurse regarding alternative medication. Queries can also be directed to Allergy UK who run The Allergy Helpline on 01322 619898. The Helpline operates from 9am to 5pm Monday to Friday.

About the study

The study was carried out by Education for Health, in collaboration with the University of Edinburgh and Imperial College London, and was funded by a restricted grant from Schering-Plough UK. The funders of the study had no role in study design, data collection, data synthesis, data interpretation, writing of the report, or the decision to submit it for publication.

About Education for Health

Education for Health is the UK's leading education charity for health professionals working with patients with long term conditions. It aims to provide a consistent, comprehensive and innovative approach to professional health training across the fields of cardiovascular, respiratory and allergic diseases, with the ultimate objective of transforming lives worldwide. Educational programmes are run nationally and internationally and are accredited by the Open University.

About Schering-Plough

Schering-Plough is a global science-based healthcare company with leading prescription, consumer and animal health products. Through internal research and collaborations with partners, Schering-Plough discovers, develops, manufactures and markets advanced drug therapies to meet important medical needs. Schering-Plough's vision is to earn the trust of the physicians, patients and customers served by its workforce of more than 33,500 people around the world. Schering-Plough UK is a country operation of Schering-Plough. http://www.schering.co.uk

References

1. Walker S, Khan-Wasti S, Fletcher M, Cullinan P, Harris J, Sheikh A. J Allergy Clin Immunol. 2007
2. Bousquet J. ARIA in collaboration with the World Health Organisation. Allergy 2002:57:841-855
3. Sheikh A, Panesar SS, Dhami S, Salvilla S. BMJ Clinical Evidence. Web publication date: 01 Apr 2007 (based on September 2005 search) Please click here
4. Shedden A. Treat Respir Med. 2005; 4 (6):438-445
5. O'Connor & Punekar. J Allergy Clin Immunol. 2006; 117: S322. Abstract 1244
6. Kay CG, Berman B, Mockoviak SH et al. Arch Intern Med 1997;157(20):2350-2356