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Asthma at School is Disruptive to Routine, Underdiagnosed and Often Poorly Understood, Survey Suggests

American Lung Association and National Association of School Nurses Call on Parents, Schools and Health Care Providers to Establish Asthma Action Plans

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(September 10, 2003, Oakland, CA) According to a national sample of members surveyed from the National Association of School Nurses (NASN), asthma is more disruptive of school routines than any other chronic condition, has a significant impact on absenteeism and many school staff may lack awareness of the causes of an asthma attack. The NASN and the American Lung Association are working together to improve communications between parents, school nurses and health care professionals in an effort that may help reduce the number of asthma episodes or attacks children experience each year.

Results from the Asthma in Schools survey suggest that an overwhelming majority (85 percent) of school nurses believe that there are students with undiagnosed asthma in their schools. More than half found asthma more disruptive to the student body routine than any other chronic health condition, with more than a third of nurses having to respond to an acute asthma attack or episode at least 11 times in the last school year.

"We recognize the damage that can be done to the education process when 14 million school days nationwide are lost annually due to asthma," said Linda Davis-Alldritt, RN, MA, PhN, FNASN, school nurse consultant with the California Department of Education. "This survey suggests that when it comes to asthma management as it impacts a child's educational experience, there is definite room for improvement."

Asthma is a serious lung illness, affecting more than 5.2 million school-aged children, according to the American Lung Association. However, with proper treatment and preventative care, it is very controllable, particularly if parents take an active role. Although more than half of school nurses reported that parents routinely update them at regular intervals about children with asthma in their care, still 43 percent said parents rarely provide updates about their children's condition.

"Communication is critical. Your child's school leaders (teacher, physical education coach, nurse, main office) should be aware of asthma, how to manage it and prevent an episode, and what to do in case of an emergency," said Anne Kennedy, RRT, RCP, board member and Asthma Technical Advisory Group Member of the American Lung Association of California "Just as they do at home, parents can take simple steps to help ensure their children with asthma are safe at school."

Effective school asthma management can help prevent an asthma attack, according to Kennedy. This includes:

• Keeping children with asthma away from potential triggers, such as air pollution, smoke, mold, dust, chemicals, strong odors or furry or feather animals;
• Ensuring children take their medication at regular intervals, as prescribed;
• Guaranteeing the child's ready access to his or her medications for routine use and to quickly relieve an asthma episode, and
• Allowing susceptible children to pre-treat with their medications prior to exercise to prevent breathing problems associated with exercise-induced asthma.

One very important issue is access to rescue inhalers; medication that can stop an asthma attack and help save a child's life. Although 70 percent of nurses reported that their schools have policies allowing children to carry rescue inhalers with them at all times, approximately 40 percent say that parents are not aware of the school's policy.

"When an asthma attack occurs, having rescue medication in hand for immediate use, not wasting breath struggling to the school office, can mean the difference between life and death," said Kennedy. "Children have the right to easily accessible quick relief inhalers. We want to encourage students who are responsible and developmentally able to carry their inhalers and self-administer medications so that they become independent in their asthma management."

According to the American Lung Association, asthma among Hispanic, African-American and Asian American students is seen as an increasing problem. More than two-thirds of the school nurses surveyed think that there are insufficient resources in place to address health concerns among these students.

Overall, the survey results suggest a need for more awareness of both asthma triggers and strategies for managing asthma attacks. More than half of the nurses said student and staff awareness of asthma triggers was fair or poor. Likewise, more than half the school nurses rated parent's awareness about managing their child's asthma as fair or poor.

The American Lung Association offers several educational programs to help manage asthma, including "American Lung Association Open Airways for Schools," a student-focused program proven to decrease the number and duration of children's asthma episodes and "Indoor Air Quality Tools for Schools," a program designed to assess indoor air quality and provide recommendations for improvement.

American Lung Associations in California are participating in the Asthma Friendly Schools Initiative and will be holding a related training in Sacramento on September 18. The Initiative is designed to assist schools in developing comprehensive asthma management plans and programs.

For more details, a complete copy of the Asthma in Schools Survey is available online at www.lungusa.org.

In addition, American Lung Association Asthma Walks are being held in many areas throughout California in October. For related details, visit: http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=39073

For 100 years, the American Lung Association has been the lead organization working to prevent lung disease and promote lung health. Lung disease death rates continue to increase while other leading causes of death have declined. The American Lung Association funds vital research on the causes of and treatments for lung disease. With the generous support of the public, the American Lung Association is "Improving life, one breath at a time." For more information about the American Lung Association or to support the work it does, call 1.800.LUNG.USA (1.800.586.4872) or visit www.californialung.org or www.lungusa.org.

The National Association of School Nurses, incorporated in 1979, is a non-profit specialty nursing organization dedicated to the delivery of professional school health services to promote optimal learning in students. With more than 11,000 members nationwide, NASN serves as a resource for school health programs and works as an influential advocate for school nursing. The organization strongly supports outcome-based research that validates school nursing practice.

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