The school inner-city asthma study: design, methods, and lessons learned.
BACKGROUND
Children spend a significant amount of time in school. Little is known about the role of allergen exposure in school environments and asthma morbidity.


OBJECTIVE
The School Inner-City Asthma Study (SICAS) is a National Institutes of Health (NIH)-funded prospective study evaluating the school/classroom-specific risk factors and asthma morbidity among urban children.


RESULTS
This article describes the design, methods, and important lessons learned from this extensive investigation. A single center is recruiting 500 elementary school-aged children, all of whom attend inner-city metropolitan schools. The primary hypothesis is that exposure to common indoor allergens in the classroom will increase the risk of asthma morbidity in children with asthma, even after controlling for home allergen exposures. The protocol includes screening surveys of entire schools and baseline eligibility assessments obtained in the spring prior to the academic year. Extensive baseline clinical visits are being conducted among eligible children with asthma during the summer prior to the academic school year. Environmental classroom/school assessments including settled dust and air sampling for allergen, mold, air pollution, and inspection data are collected twice during the academic school year and one home dust sample linked to the enrolled student. Clinical outcomes are measured every 3 months during the academic school year.


CONCLUSIONS
The overall goal of SICAS is to complete the first study of its kind to better understand school-specific urban environmental factors on childhood asthma morbidity. We also discuss the unique challenges related to school-based urban research and lessons being learned from recruiting such a cohort.
Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital, Boston, MA 02115, USA. wanda.phipatanakul@childrens.harvard.edu
Wanda
W
Phipatanakul
Anne
A
Bailey
Elaine B
EB
Hoffman
William J
WJ
Sheehan
Jeffrey P
JP
Lane
Sachin
S
Baxi
Devika
D
Rao
Perdita
P
Permaul
Jonathan M
JM
Gaffin
Christine A
CA
Rogers
Michael L
ML
Muilenberg
Diane R
DR
Gold
D000293:Adolescent; D016902:Air Pollution, Indoor / Q000009:adverse effects* / Q000032:analysis; D000485:Allergens / Q000032:analysis; D001249:Asthma / Q000209:etiology*; D001900:Boston; D002648:Child; D002675:Child, Preschool; D004391:Dust / Q000032:analysis; D006296:Health Services / Q000706:statistics & numerical data; D006798:Housing; D006801:Humans; D012574:Schools; D011795:Surveys and Questionnaires; D014504:Urban Health
D000485:Allergens; D004391:Dust