Much work is being done to educate North Americans about controlling asthma, and hospital admissions are down. But what remains consistently unimproved is the so-called asthma spike – the day on which many parents will show up at the hospital with school-age children in the throes of asthma attacks.
Using data accumulated since 1990, scientists in Hamilton, Canada and London, England have been able to plot the spike on a graph at precisely 17 1/2 days after Labor Day.
“If you look at the magnitude of the peak relative to the rest of the year, by 2004 it’s pretty much the same as it was in 1990,” says epidemiologist Neil Johnston, who along with colleagues at St. Joseph’s Healthcare, McMaster University, and Imperial College, has led this research.
The spread of the cold virus is the biggest driver of the spike in students between the ages of 5 and 15, but a number of factors contribute to it. “Kids get back to school and the guy in the next desk or the child they share a school bus ride with has a cold, and maybe they share a drink,” Johnston says.
“But it’s also a period when aero-allergens are at very high levels – ragweed and house dust mite. Then you’ve got the stress of the return to school, allergens in the classroom, and the likelihood that asthma is not as well controlled because kids have been well and their parents haven’t been giving them their [controller] drugs.
“You’ve got a multiple whammy, and that’s what drives the peak.”
There are two other related asthma “peaks”: one in pre-school children, who appear to catch whatever cold brother or sister brings home, since their spike is plotted at 19 to 20 days after Labor Day. For those 16 to 49 with asthma, their peak shows up one week after the big post-Labor Day surge among schoolchildren.
So how do you keep a child from becoming a statistic on Johnston’s graph? He says it begins with awareness and control and making sure asthma medications are up-to-date. Experts remind that your child’s school needs to have a copy of your child’s asthma action plan. If either the plan or the drugs need changes, see a doctor or specialist (respirologist or allergist) promptly. Experts also advise frequent hand-washing to stem the spread of infection.
With students trooping in and out, spills and occasionally odors, classrooms are difficult venues to allergy-proof. But there are ways to reduce environmental exposures.
Mold Growth: Molds reproduce by sending tiny spores into the air, and these can cause asthma symptoms. Since molds flourish in damp conditions, schools should watch humidity levels, and promptly repair roof or window leaks.
Dust Mites: To keep these microscopic allergens at bay, cleaning staff need to dust and vacuum thoroughly. Carpet should be avoided where possible.
Cleaning Supplies: Look for non-toxic supplies free of formaldehyde, ammonia and other lung-irritating chemicals. Principals should also be mindful of pesticide use.
Pets: You may not keep a cat if your child has asthma, but he or she will be inadvertently exposed to some dander on other pupils’ clothes. A parent can’t control this, but you can ask to stop intentional exposures, such as pets brought in for “show and tell” or rodents kept for a class project. Be sure teachers are aware of pet allergies and of your child’s asthma action plan.
Chalk and Markers: Use low-dusting chalk on blackboards. If using a whiteboard, a school can order low VOC (volatile organic compound) markers.
Crafts and Art: Watch out for materials that irritate or have strong odours, such as glues, solvents, certain paints and varnishes. Also watch for potential food allergens in some crafts (e.g. milk or egg in paint).
Fragrance: With an explosion of asthma, particularly in boys 4 to 11, teachers should be mindful to avoid using strong perfumes and deodorants. High school students can have a heavy hand with the perfume bottle. If it’s an issue, inform the principal.
Ventilation: It needs to be adequate, which isn’t always the case in newer, tightly sealed buildings. The school should routinely check the ventilation system; it should be clean and obstruction-free for free flowing air.
Sources: Environmental Protection Agency; Health Canada; AAFA