Asthma in classroom as school year begins

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Asthma in classroom as school year begins

63,000 students may be affected by the disease

Los Angeles Daily News - Los Angeles,CA*

BY SUSAN ABRAM, Staff Writer

09/04/2007

http://www.dailynews.com/news/ci_6802752

As Los Angeles Unified School District students flood back to

classes today, dozens - maybe even hundreds - will miss their very

first day of school because of asthma.

The leading cause of absenteeism among LAUSD students with chronic

diseases, asthma afflicts some 63,000 students.

Of those, a majority miss 10 days or more of the school year. The

district also estimates that 1,000 of its students visit emergency

rooms each year because of asthma.

Health officials know that L.A.'s polluted skies, moldy apartments,

proximity of residential areas to freeways and limited parental

knowledge about inhalers all contribute to the high numbers of

asthma cases. But they say they've only recently begun to link the

illness to childhood obesity, poor academic performance, depression

and other problems interfering with success at school.

Now, the school district wants to determine how widespread the

problem is and how to help children manage it better so they can at

least show up for class.

" We live in a relatively high-pollution city and that contributes to

respiratory problems, " said Dr. Uyeda, director of the

LAUSD's Student Medical Services.

" Sometimes the waxing and waning of asthma awareness can cause a

problem. "

More than 600 LAUSD nurses gathered at the Los Angeles Convention

Center on Tuesday to promote an action plan to improve monitoring

students with asthma. They also toured a new " breathmobile " van, one

of several that makes the rounds to schools to test students for

free, and help children monitor their health.

" The major challenge is that many children don't have a regular

health provider and asthma is a disease that needs to be

continuously monitored, " Uyeda said.

The 63,000 known asthma sufferers in the LAUSD represent about 9

percent of the 700,000 student body - many of whom are on year-round

schedules. But district health officials believe the actual figure

is closer to 14 percent of the total, or 98,000 students.

Childhood asthma within the San Valley has decreased

slightly in recent years, from 8.7 percent in 2003 to 7.9 percent in

2005, the last year for which data were available.

Still, about 150 San Valley children miss 10 days of school

or more. Some skip up to 60 days because of illnesses related to the

chronic disease.

" I find that the biggest issue among families of children with

asthma is a lack of confidence in the medication and a lot of fear, "

said a Villanueva, a pediatric nurse practitioner who visits

the homes of children with asthma in the Valley.

She is one of only four who do such work within the entire district.

Since the home-visit program began three years ago, Villanueva said,

she has spotted several patterns among the children affected, such

as a lack of education among parents on how inhalers work and

unhealthy housing conditions.

" Some of the apartment buildings look very nice on the outside, but

inside there are roaches, " she said. " There are carpets that have

never been changed. There is mold from leaking ceilings. There's

fear among residents that they will get in trouble if they report

this to the landlords. "

In some cases, vacuum cleaners, bed covers and roach traps are

provided to help alleviate the problems, she said.

But what is most telling is what asthma can do to a child's psyche,

Villanueva said.

Children who can't participate in physical activities are more

likely to gain weight. Obesity can act as a trigger to asthma. And

among those that Villanueva visits, 90 percent report anxiety,

stress and depression, she said.

The home-visit program, funded by a variety of sources including a

$2 million grant from the Merck Childhood Asthma Network, is proving

to be effective. Of the families she visits, Villanueva said, 65

percent of the children are reporting improved health when she

returns to see them three months later.

Asthma among children began to steadily increase between 1980 and

1998, but has since stabilized, and death rates have decreased,

according to the federal Centers for Disease Control and Prevention.

Still, emergency-room visits continue to rise and African-American

children both nationwide and in Los Angeles County still have the

highest rates of asthma.

What remains problematic in fighting the disease is that there is

little known about the development of asthma, whether it's genetic

or environmental. Symptoms include shortness of breath, coughing,

wheezing, and chest pain or tightness, which can be triggered by

pollen, dust mites and pet dander.

An estimated 6.5 million schoolchildren suffer from the disease

nationwide; it is the third-leading cause of hospitalization among

those 15 and younger. About $16.1 billion is spent on treating

children with asthma.

While California may seem to have the highest prevalence of the

disease because of smog and air pollution, it is Massachusetts,

Hawaii and Oklahoma that rank the highest in asthma prevalence among

children age 17 and younger. California ranks 39th among all states.

Still, the American Lung Association has found that parents

nationwide know very little about their state's or school district's

policy on whether children are allowed to carry their inhalers with

them to class.

A recent survey found that 58.7 percent of parents were uncertain

whether their state has a law allowing students to carry and self-

administer fast-acting " quick relief " inhalers. And 74.4 percent of

parents whose children do have inhalers at school responded that

their child's school does not allow students to keep rescue inhalers

with them.

" What I keep hearing from school officials is that they have a lot

of kids with asthma that don't have the proper medicine, or don't

have good communication with their parents, " said Van Cleave,

coordinator of childhood-asthma programs for the American Lung

Association's Los Angeles Chapter.

" That's why it's important to have an asthma action plan, " she

said. " We're making progress but I feel like we need to make more

strides. "

susan.abram@...

(818) 713-3664