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Maintenance needed to prevent asthma attacks
Thursday, August 30, 2007
Late August is to asthma what winter is to flu. Heat and humidity amplify the effects of air pollution, and the blooming ragweed fills that bad air with allergy-sparking pollen.
"We see more asthmatics in the emergency room, and more admitted to the hospital," said Dr. Robert Fink, who directs pulmonary medicine at Children's Medical Center.
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Grade school children make more than six times as many ER visits for asthma this time of year as in the summer, and kids of all ages have the highest rate of life-threatening attacks in August through October, research shows.
In updated asthma guidelines Wednesday, the National Institutes of Health stressed the need to control it instead of just responding to attacks. People need better maintenance plans if they repeatedly wake up coughing at night or stop exercising to avoid attacks, the NIH said.
"Some people say if you're using your rescue inhaler once or twice a week, you need a maintenance medication, too," said Dr. Susan Barde of Dayton Arthritis and Allergy Center in Kettering and Springboro.
Doctors should give patients "action plans" for daily treatment, attacks and how to recognize when asthma is worsening, the NIH said.
About two-thirds of children with asthma will have an attack this year — or one in every 20-student classroom. No chronic condition causes as many school absences. But neither parents nor schools do enough to limit children's asthma attacks, lung experts say.
Schools often have nobody trained in preventing or responding to attacks. More than half of urban schools don't even take the basic precaution of letting kids carry the rescue inhalers that reopen their airways in an attack, a study showed in the September 2006 issue of Pediatrics.
Most local schools allow students to carry inhalers, Fink said. But Ohio law requires it of all schools with doctor and parent notes.
Nor do rescue inhalers pose much threat as illicit stimulant drugs. "About the same as half a can of Coke," he said. "The abuse potential is negligible."
Parents also aren't taking some basic steps. In an American Lung Association poll last year, fewer than half either talked to the teacher about the asthma or made sure the schools had their medication.
That could lead to "an unmanageable medical crisis," said the lung association's Dr. Norman Edelman.
School days also aggravate asthma when kids share respiratory bugs in closed rooms or do more running in fall sports. Running can cause exercise-induced asthma attacks, Fink said, even in kids with mild asthma before adolescence.
