The burden of atopic diseases is quickly rising.[1] The focus in most published research is on medical outcomes, rather than a holistic approach, focusing on the wider impact of atopy on social outcomes.

Data are conflicting regarding atopic diseases and educational attainment. No study has assessed the effect of the three major atopic diseases simultaneously. Although these diseases frequently co-occur, understanding the most predictive phenotypes is important to tailoring interventions. Previous studies have demonstrated that children with rhinitis were 40% more likely to drop a grade between winter and final GCSE examinations, and 70% more likely to drop a grade if they were taking sedating antihistamines during examinations.[3] There are no studies of the effect of childhood eczema on educational attainment. There are contrasting study findings in asthma, with some studies of asthma reporting no effect, adverse effects, and some describing a benefit in terms of exam results. A recent study reported that social adversity and ethnicity was associated with poor exam performance, while asthma was associated with 1.1% increase in exam scores.[4]
Multiple factors may lead to worsened educational attainment. These include absenteeism from school due to ill health. Atopic diseases can also lead to “presenteeism” and poor concentration at school. Depression and anxiety, sleeplessness and ADHD have been associated with eczema and may lead to impaired educational attainment. Medication use including antihistamines and oral corticosteroid use could impact educational outcomes and thus hinder later occupational attainment.

Existing birth cohort data have the potential to answer many critical questions in relation to educational and occupational attainment. We will utilize ALSPAC data to test the hypothesis that atopic diseases are associated with worse education and occupational attainment.