Allergic, a fascinating book by author Theresa MacPhail, provides a minute-by-minute account of a man experiencing an allergic reaction to a bee sting while in his car. MacPhail, who is a medical anthropologist, takes a cool and scientific approach as she describes the progression of anaphylaxis throughout his body. The reader feels the rising panic of his helpless girlfriend and the frustrating resignation of the pharmacist who couldn’t administer adrenaline due to legal restrictions. Sadly, MacPhail’s father, the man in the car, passed away on that fateful day.
The book delves into the science, politics, and personal experiences surrounding allergies in the same matter-of-fact tone, steadily building towards a grimly inevitable conclusion. MacPhail portrays allergic individuals as the “canaries in the environmental change coal mine,” suggesting that our way of life is contributing to the worsening of allergies.
MacPhail’s extensive research on allergies reveals the challenges in understanding and addressing them. There is a lack of standardization in various aspects, such as allergen levels in skin-prick tests and immunotherapy treatments. Even experts struggle to agree on a universal definition of allergies. Surprisingly, one study showed that depending on the definition used, up to 39% of children shifted from having asthma to no longer having it. Although there is a consensus that allergies are becoming more prevalent and severe, there is no consensus on how to measure them accurately.
While allergies have always existed to some extent, their prevalence has significantly increased in our modern, industrialized world. Hay fever rates rose initially, followed by a spike in asthma cases during the 1960s and 70s, and later the emergence of eczema and food allergies in the 1980s and 90s.
MacPhail attributes this escalation to a complex combination of genetic, environmental, and human-made factors. She highlights how the interaction between pollen and diesel particulates increases the likelihood of allergic conditions. Climate change also plays a role by lengthening pollen seasons and introducing new allergens. Every aspect of our increasingly developed world, from the crops we grow to the fuels we burn and the chemicals we use, impacts our health. While some factors, like changing bed linens less frequently, can be addressed, others are more challenging, such as the concerning link between early-life exposure to high levels of air pollution and an increased risk of developing asthma by age seven.
Allergy medicine has become a significant market, raising ethical questions about providing care for those who are affected by our current way of life and determining who should bear the financial burden. Experts predict that by 2030, 50% of the global population will have allergies. Surprisingly, MacPhail discovered that 52% of adults in the US with life-threatening allergies don’t carry the prescribed EpiPens due to cost issues.
Despite some promising developments like Dupilumab, an antibody treatment for eczema, MacPhail maintains a largely pessimistic view. While changing sheets can make a difference, fully preventing allergies from ruining lives will require a complete overhaul of our lifestyles.
In conclusion, Allergic: How Our Immune System Reacts to a Changing World presents a thought-provoking exploration of allergies. With MacPhail’s expertise and thorough research, readers gain valuable insights into the causes, effects, and potential solutions for this growing issue. To support the Guardian and Observer and get your copy of the book, visit guardianbookshop.com (delivery charges may apply).
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