A generation ago, children with asthma bore a stigma much the same as children with epilepsy, diabetes, or polio. Today, through education, awareness, and medication, children with asthma are no longer singled out as having a condition that sets them apart from the general population. But asthma still remains the most prevalent chronic disease among children, making it the third ranked cause of hospitalization among children under the age of fifteen.
According to the National Health Interview Survey, over 6 million children in the United States suffer from asthma; in California alone, 2.3 million adults and children suffer from this often debilitating disease. As a matter of fact, asthma has risen 75% worldwide in the past 10 years.
The San Joaquin Valley has the highest level of childhood asthma in California. Because of our geographic location, pollen, dust, vehicle emissions, and smoke from agricultural burns are literally trapped in our valley, making it especially difficult for asthmatics to breathe. A survey by the University of California, Los Angeles, found that 16.4% of children in Fresno County had asthma, nearly twice the state average.
According to Dr. Al Aminian, M.D. of the Allergy Institute, we are currently in a “crisis situation for people with respiratory problems.” Although there is a mandate to improve the air by 2013, it is not yet federally funded. According to Dr. Aminian, there has been some improvement in the air, but not enough to impact the currents of asthma. Clearly, we, as residents and voters, have to do more to help improve air quality.
WHAT IS ASTHMA?
Asthma is a chronic disease that affects the airways. The inside walls of the airways are inflamed and thus more sensitive to irritants or allergens. In children, most asthma is classified as allergic asthma. When a child is allergic to certain types of pollen, cigarette smoke, or mold, the airways tend to become more inflamed and breathing becomes labored and often seriously restricted.
When this happens it is called an asthma “attack.” Children whose families have a history of asthma are more likely to have the disease, which usually starts in childhood. Non-allergic asthma is less prevalent in children, but can occur with weather changes, anxiety, and viruses.
Asthma attacks are often “triggered” by certain allergens and/or irritants. Some of the most common irritants include:
- Cold air
- Tobacco and wood smoke
- Perfume, paint, hair spray or other
- Strong Odors
- Dust mites and cockroaches
- Pollen
- Molds
- Air pollution
- Animal dander
- Common cold
Children need to identify what triggers their attacks and learn to avoid them whenever possible.
ASTHMA GOES TO SCHOOL
Asthma is the leading cause of school absenteeism, accounting for 10 million lost school days, 12 million bed rest days, and 24 million restricted activity days per year. In Fresno County’s Central Unified School District, for example, the absences per child, per day results in an annual decrease of 74,250 hours of instruction and $416,000 in State revenue.
Time lost from school due to asthma may negatively impact academic achievement, self-esteem, and future life successes.With back-to-school season upon us, it is important for both parents and teachers to be made aware of the triggers that may irritate children with asthma. According to Dr. Aminian, “Parents should tour the school their child will attend, discuss their child’s allergies with the teacher and the school nurse, pack their child’s lunch at home, and review with their child the triggers that induce an asthmatic reaction.”Teachers should be aware of a child’s needs and must be able to spot the symptoms of an impending asthma attack.
Coughing, wheezing, shortness of breath, tightness in the chest, unusual fatigue, complaining and withdrawing from physical or social activities are early indicators of an asthma attack. Teachers need to know what medications the child takes and how they are used, and need to be able to tell whether or not to contact a doctor or an emergency room. Most attacks can be quelled by early intervention, helping the child avoid serious effects.
HELP AND HOPE WITH TREATMENT
Childhood asthma, however, need not be debilitating. Children who are properly screened and treated can lead normal, active lives if they continue with their prescribed regimens. In the past, children with asthma were usually excused from Physical Education; they were the kids who sat on the bench during basketball practice and rarely participated. Today, with the introduction of inhaled bronchodilator medications, which have few side effects if used properly, and anti-inflammatory drugs, children may participate in many sports. “No child should be taken off PE because of asthma. To do so would be a disservice to that child,” stated Dr. Aminian.
Most children with asthma learn quickly which sports are better suited to them. For example, soccer may not a good choice for a child with severe asthma symptoms, but softball, with its frequent breaks, may be fine. If the inhaler is used 10 to 15 minutes before the activity begins, most children are able to compete with their classmates.Dr. Reddi Sudhakar, pediatric lung specialist at Children’s Hospital Central California, says that children can participate in any sport in school, as long as their lung function allows them to.
Children who want to participate in sports should work out a prescribed plan with their doctor. They should, of course, have a complete physical, followed by annual check-ups to make sure they are living within the guidelines set up for them. There is no reason why “athlete” and “asthma” can not be used in the same sentence. Olympians Jackie Joyner-Kersee and Greg Louganis have asthma as does football star Jerome Bettis. All have successfully competed despite their condition.
All asthmatics should have an asthma plan. It’s especially important for a child whose asthma is aggravated by exercise to have a management plan on file at his or her school. Through teamwork with school personnel, families and healthcare providers, it is possible for a child with asthma to have normal endurance and even excel in athletics.
Although childhood asthma is not curable, it is treatable and controllable. Many children, as long as they follow their prescribed regimen and take their medication, rarely have any symptoms or attacks. According to Dr. Sudhakar, “If children take their medications on a regular basis, asthma is 100% controllable.”
Controlled asthma means that children do not miss school, they do not visit the emergency room, and they achieve normal lung function. Dr. Sudhakar also states that once children stop growing (age 18 for girls and 21 for boys), their asthma improves. Conversely, after age 45, as lung function naturally diminishes, asthma symptoms may return.
Despite the available medications that can control childhood asthma, the children of the San Joaquin Valley need a commitment from both State and Federal government to improve the quality of the air. The people of the San Joaquin Valley need to help by reducing auto emissions, burning wood in fireplaces, smoking in public places, and following the guidelines set up by the San Joaquin Valley Air Control District and their “Spare the Air” days.
There is no magic bullet. Awareness and education are our best defenses against the growing problem of asthma and its far-reaching effects on the children of California.For the most current information on asthma, please visit the National Institute of Health’s New Guidelines for Asthma at www.nih.gov/guidelines/asthma.