It may affect your neighbor's child, your niece or nephew, or perhaps your own son or daughter. Asthma rates have been increasing since the early 1980s among boys and girls of different ages and racial groups. Parents, teachers, and caregivers of young children have lots of reasons to be concerned about asthma and children.

What Is Asthma?

Asthma is defined as a "chronic inflammation of the lungs" [8]. Asthma attacks vary in duration. They may last for several days or only a few minutes. Signs of an asthmatic attack include breathing difficulties such as coughing, wheezing, shortness of breath, and chest tightness. Children who regularly cough after running or crying, who experience recurrent night coughing, or who have frequent respiratory infections such as pneumonia or bronchitis should be evaluated for asthma. In young children, chest tightness associated with asthma may explain irritability that is otherwise unexplained [1; 7].

Children of color, who are likely to live in inner cities, and all children living in poor urban areas are disproportionately affected by asthma. These children are likely to have insufficient access to adequate medical care to help control the disease; live in substandard housing and attend school buildings that are overcrowded and more apt to contain harmful pollutants; have stressful life circumstances that accompany poverty; and live in areas with high ozone levels [4; 7].

Here are some other facts about asthma:

The highest frequency of new asthma cases occurs in very young children. Asthma is the most common chronic childhood disease and afflicts 4.8 million children under 18 nationwide. Between 1980 and 1994, the prevalence of asthma increased 160% for children up to 4 years of age and increased 74% for children 5-14 years of age, rates higher than for any other age group [6; 8].

Asthma is the number one cause of hospitalization among children under the age of 15. Several factors may trigger an asthmatic attack. Triggers can include any of the following: respiratory infections, physical overexertion, exposure to allergens (such as pollen, mold, particular foods, and animal dander), exposure to irritants (such as cigarette smoke, air pollution, aerosol sprays, paint fumes, pesticides, and chalk dust), and certain weather conditions such as very cold air. Emotional factors do not cause asthma, but in some cases emotional stress may trigger asthma.

There were nearly 658,000 visits to pediatric emergency rooms in 1999 due to asthma, with the highest visit rate occurring among children under age 5. Three in 10 parents report that their children were hospitalized in the past year due to asthma, including 17% whose children were hospitalized two or more times. The estimated annual cost of treating asthma in children under 18 is $3.2 billion, with hospitalizations accounting for the single largest portion of the costs [1; 8].

Asthma is the primary chronic condition associated with school absenteeism. On average, a child with asthma will miss the equivalent of one full week of school annually because of the disease. Children miss a total of 10.1 million school days annually as a result of asthma [2; 8].

What Can Parents Do if They Have a Child with Asthma?

Learn to recognize what triggers the attacks (such as pet dander, pollen, molds, dust mites, cockroaches and mice) and try to avoid exposure to those substances.

Check your local weather report to keep track of outdoor air pollution and pollen levels. Children with asthma are especially affected by air pollution. Studies by the American Lung Association and the American Medical Association found that children with asthma were 40% more likely to have asthma attacks when playing outside on high-pollution summer days than when playing outside on days with average air pollution levels [4; 5].

Provide a "lung-healthy" indoor environment, one that is smoke-free and cleaned regularly to minimize dust mites and cockroach antigen. Inexpensive humidity gauges are available at most hardware or department stores. Repair indoor leaks or moisture problems that lead to mold growth. Inside humidity should be maintained at 50% or less. Furry pets such as dogs and cats should be kept out of the house. Household pests such as mice and cockroaches may contribute to asthma [3].

Work with your child care setting to be sure child care staff are prepared to support children with asthma and that the child care environment promotes children's health. "How Asthma-Friendly Is Your Child Care Setting?" Checklist (available in English and Spanish).

Work with your child's school setting to ensure that school staff are prepared to support children with asthma and that the school environment promotes children's health. "How Asthma-Friendly is Your School?" Checklist (available in English and Spanish).

Work with your child's coaches and camp staff. Be sure they are aware of the impact of air pollution and other allergen triggers on children with asthma and have policies in place to protect children when air quality is unhealthy.

For more information

National Asthma Education and Prevention Program
National Heart, Lung, and Blood Institute Information Center
http://www.nhlbi.nih.gov

Allergy and Asthma Network/Mothers of Asthmatics
http://www.aanma.org

American Academy of Allergy, Asthma, and Immunology
http://www.aaaai.org

American Academy of Pediatrics
http://www.aap.org

American Lung Association
http://www.lungusa.org

Asthma and Allergy Foundation of America
http://www.aafa.org

Indoor Air Quality: Tools for Schools
http://www.epa.gov/iaq/schools/

References

[1] American Lung Association. (2002). Childhood asthma: An overview [Online]. Available: http://www.lungusa.org/asthma/ascchildhoo.html.

[2] American Lung Association. (2002). Asthma in children fact sheet [Online]. Available: http://www.lungusa.org/asthma/ascpedfac99.html.

[3] Associated Press. (2000, December 12). House mice may contribute to asthma attacks [Online]. Available: http://www.mindfully.org/Health/House-Mice-Asthma.htm.

[4] Ford, Linda. (1999, June/July). Childhood asthma and air pollution. National Voter, 16-19.

[5] Friedman, Michael S.; Powell, Kenneth E.; Hutwagner, Lori; Graham, LeRoy M.; & Teague, W. Gerald. (2001). Impact of changes in transportation and commuting behaviors during the 1996 Summer Olympic Games in Atlanta on air quality and childhood asthma. Journal of the American Medical Association, 285(7), 897-905.

[6] National Institutes of Health. (1999). Data fact sheet: Asthma statistics [Online]. Available: http://www.nhlbi.nih.gov/health/prof/lung/asthma/asthstat.pdf.

[7] Schwartz, Wendy. (1999). Supporting students with asthma. ERIC Digest [Online]. Available: http://eric-web.tc.columbia.edu/digests/dig151.html.

[8] Tuscano, Antoinette. (2000). Waiting to inhale: What parents need to know about asthma. Our Children, 25(8), 11-12. (ERIC Journal No. EJ607394).