Children with asthma miss more school: fact or fiction?
BACKGROUND
It is widely believed that children with asthma miss considerably more school than children without asthma. Previous surveys have indicated that 49% of children with asthma miss school (Asthma in America, 1998), but only a few studies have attempted to quantify the amount of school missed. Understanding the role of asthma in school attendance will help direct limited health-care resources to the children who need them most.


METHODS
We investigated school absence rates in fourth- through sixth-grade students in 19 inner-city schools in the Dallas Independent School District (DISD). The sample consisted of 353 students who were identified as possibly having asthma based on responses to a modified Brief Pediatric Screen instrument and who underwent spirometry and/or exercise challenge (EC) testing to confirm the diagnosis of asthma: 25 students were excluded for FEV(1) < 70% and without bronchodilator response, while 157 students had EC-positive test results, and 171 students had EC-negative test results. We compared yearly absences for these students with each other, with all fourth- through sixth-grade students in the 19 study schools, and with all fourth- through sixth-grade students in the district. We also tabulated data from a separate database that included asthma patients identified by the school registered nurse (RN). Absence data by school and by grade level were provided by the school district for the 2002-2003 school year.


RESULTS
Absence rates were as follows: 2.54% (EC positive), 2.12% (EC negative), 2.59% (abnormal FEV(1)), 2.86% (RN identified), 2.85% (all fourth- through sixth-grade students in study schools), and 2.95% (all fourth- through sixth-grade students in the DISD).


CONCLUSIONS
Students with asthma in the DISD miss no more school their classmates without asthma.
Baylor University Medical Center-Baylor Martha Foster Lung Center, Dallas, TX.
Mark W
MW
Millard
Baylor University Louise Herrington School of Nursing, Dallas, TX.
Pauline T
PT
Johnson
Veterans Administration, Memphis, TN.
Anna
A
Hilton
Baylor University Medical Center-Baylor Martha Foster Lung Center, Dallas, TX.
Mary
M
Hart
D000041:Absenteeism; D000293:Adolescent; D017677:Age Distribution; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology*; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D011336:Probability; D018570:Risk Assessment; D012574:Schools; D012720:Severity of Illness Index; D017678:Sex Distribution; D013147:Spirometry; D013334:Students / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology; D014505:Urban Population