Don't get 'sniffy' with hay fever victims at work

Blog posts

24 Aug 2016

Stephen BevanStephen Bevan, Head of HR Research Development

At this time of year it is all too common for the quiet hum of diligence and industry in your workplace to be interrupted by sniffing and sneezing from colleagues who are struggling on despite their annual bout of hay fever. If, like me, you’re lucky enough not to be affected, you may not realise what an uncomfortable condition it is, nor what impact it has on workplaces up and down the country. In fact a recent survey suggested that up to 18 million people in the UK suffer from hay fever each year and that 75 per cent of those who work claim that the condition affects their productivity. However, a third say that they get no sympathy from their bosses and that 11 per cent of their colleagues who are not affected by the condition are sceptical that hay fever exists at all.

Allergic Rhinitis (AR) – to give it its proper title – is defined as ‘an immunologic response modulated by immunoglobulin E (IgE) and characterised by sneezing, rhinorrhea, nasal congestion and pruritus of the nose’. It can be classified as either seasonal (commonly called hay fever), which most frequently results from sensitivity to pollen allergens, or it can be classified as perennial, most commonly caused by allergy to animal dander or dust mites. The prevalence of AR is estimated to be between 10 to 20 per cent in North America and Europe, (between 20 to 25 per cent in the UK specifically) although there is no standard set of diagnostic criteria which may lead to some under-reporting and under-diagnosis. This may mean that there are as many as 500 million people worldwide with AR, 200 million of whom suffer from co-morbid asthma. Indeed, asthma and rhinitis are frequently comorbid, with asthma co-existing in 10 to 40 per cent of people with AR.

The symptoms of AR vary considerably between individuals, but most people experience physical symptoms, discomfort in the nose and eyes, loss of concentration and comorbid anxiety or even depression. All of these may have an impact on functional capacity and the capacity to enjoy or take part in a range of ‘activities of daily living’ – such as work. It is clear that AR has a considerable impact on several aspects of the quality of life of those living with it:

  • Childhood and Education: several studies have examined the impact of AR on children and their performance in education. This can include impaired sleep, concentration and learning, together with lower attainment in examinations. The cumulative life-course impact of AR – especially if the condition persists into adulthood – has also been the subject of investigation in such studies, together with the clinical and economic consequences. In related work, the impact of childhood AR on the quality of life, work attendance and productivity of parents and carers has also been examined.
  • Work productivity: there is a growing body of research examining the links between AR and work productivity. In general, the primary losses in productivity are attributable to sickness absence from work and ‘presenteeism’ – reduced work effectiveness attributable to ill-health. Research in this field has addressed a number of dimensions of the problem, from the quantification of the lost productivity to the reduced quality of life caused by AR. Some studies have focused on risk factors relating to occupational AR or work-exacerbated AR and others have looked at the effectiveness of interventions to reduce work productivity losses.
  • Comorbidity: aside from the links between AR and asthma, some research has looked at the relationship between AR and mental health, with a focus on mood disorders and anxiety. The relationship between AR, comorbid mental illness and work productivity has not been studied extensively.

Despite its high prevalence and economic and social costs, allergic rhinitis has not been a condition which has received much attention in its work context from clinicians, employers, economists or policy-makers. Nonetheless, its cumulative impact on morbidity and on lost work productivity is likely to rival or even exceed that of non-communicable diseases which are given much higher political and clinical priority. So spare a thought for your colleagues as they try to work through the discomfort and self-consciousness of having AR at work and be reassured that, as the pollen count falls, their productivity will rise again.

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Any views expressed are those of the author and not necessarily those of the Institute as a whole.