Hayfever and Exam Performance

This is the first study to investigate the link between hayfever and exam performance and showed that children who have hayfever symptoms while taking their GCSE exams are 40% more likely to drop a grade between their mocks and final exams...

‘Unblock Your Potential’ is the name of a disease awareness campaign launched in 2008, which has been developed by pharmaceutical company Schering-Plough and is independently endorsed by Education for Health. The aim of the campaign is to raise awareness of the impact of hayfever on exam performance.

The campaign is based on a study published last year by Education for Health. The paper was published online in the Journal of Allergy & Clinical Immunology, and is the first study to show that children who have hayfever symptoms while taking their GCSE exams are 40% more likely to drop a grade between their mocks and final exams. This figure rose to 70% if they were taking sedating anti-histamines.

If you are interested to know more about the 'Unblock Your Potential' Campaign, a resource pack has been sent to school nurses and other primary healthcare professionals, including all of Education for Health's current membership.

If you would like to receive additional packs or posters, please email your requirements to: unblockyourpotential@hhealth.com

The remainder of this page has been created by Education for Health to provide information about the original research that underpins the campaign:

Further background to the Study

The study was carried out by Education for Health, in collaboration with the University of Edinburgh and Imperial College London. It found that students who have allergic rhinitis symptoms on an exam day are 40% more likely to drop a grade in their GCSE exams, and that this figure rose to 70% if they were taking sedating anti-histamines.(1) 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)

Hayfever 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 hayfever 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 hayfever symptoms, the findings were expected to prompt discussions on how to better manage hayfever symptoms in children before and during the exam season.

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 s 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 exams
This increased to 70% if they were on a sedating allergy medication at the time of their exams
Teenagers with severe hayfever, and a history of symptoms in previous years, were twice as likely to drop a grade(1)
28% of those on hayfever medication in the study were on a sedating anti-histamine
This is despite the wide availability of non-sedating treatments and current treatment guidelines advocating their use over sedating medication.(2)

It was hoped that the results of the study would 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 prescription-only non-sedating medications that can effectively control symptoms, there should no longer be any excuse for hayfever impacting on school, work or other activities.

Symptoms of hayfever, which include nasal congestion, 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)

References

Walker S, Khan-Wasti S, Fletcher M, Cullinan P, Harris J, Sheikh A. J Allergy Clin Immunol. 2007
Bousquet J. ARIA in collaboration with the World Health Organisation. Allergy 2002:57:841-855
Sheikh A, Panesar SS, Dhami S, Salvilla S. BMJ Clinical Evidence. Web publication date: 01 Apr 2007 (based on September 2005 search) http://www.clinicalevidence.com/ceweb/conditions/ent/0509/0509_background.jsp
Shedden A. Treat Respir Med. 2005; 4 (6):438-445
O’Connor & Punekar. J Allergy Clin Immunol. 2006; 117: S322. Abstract 1244
Kay CG, Berman B, Mockoviak SH et al. Arch Intern Med 1997;157(20):2350-2356.