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Finland's National Allergy Program Successfully Reduces Allergic Diseases
In Finland (population 5,5 million), a 10-year national campaign to treat allergic diseases was initiated in 2008. It was carefully planned and based on consensus among experts [1–3] because the long-term strategy of allergen avoidance had not reduced the burden or stopped the “epidemic”. New insights into immune development in modern, urban societies have challenged conventional thinking. A public health programme has now been implemented, and an avoidance strategy was replaced with a tolerance strategy [4]. This course of action was supported by the Ministry of Social Affairs and Health and the National Institute for Health and Welfare.
Reduced connection with natural environments and, for example, the increased use of processed food may have impoverished human microbiota (dysbiosis), caused immune dysfunction (poor tolerance) and led to inappropriate inflammatory responses. Primary prevention Support breastfeeding, with solid foods from 4–6 months onwards Do not avoid exposure to environmental allergens (foods, pets), if not proven necessary Strengthen immunity by increasing contact with natural environments (e.g. by taking regular physical exercise and following a healthy diet such as a traditional Mediterranean or Baltic diet) Antibiotics should only be used in cases of true need (the majority of microbes are useful and build a healthy immune function) Probiotic bacteria in fermented food or other preparations may balance the immune function Do not smoke (parental smoking increases the risk of asthma in children) Secondary and tertiary prevention Regular physical exercise is anti-inflammatory Healthy diets are anti-inflammatory (a traditional Mediterranean or Baltic diet may improve asthma control) Probiotic bacteria in fermented food or other preparations may be anti-inflammatory Respiratory/skin inflammation should be treated early and effectively; maintenance treatment titrated for long-term control To stop symptom exacerbations proactively, instructions for guided self-management are provided for 10 allergic conditions (available in both paper and electronic formats) Allergen-specific immunotherapy is recommended for more severe symptoms, e.g: allergens as such (for foods) sublingual tablets or drops (sublingual immunotherapy, or SLIT) (for pollens) subcutaneous injections (for pollens, pets, mites, insect stings) Smoking should be strictly avoided (the effectiveness of asthma and allergy drugs is reduced in smokers)Education continued also for the personnel of pharmacies, day-care centres, and schools. ↵ Haahtela T, Valovirta E, Hannuksela M, et al. Kansallinen allergiaohjelma puolivälissä – suunnan muutos tuo tuloksia [Finnish nationwide allergy programme at mid-term – Change of direction producing results].
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