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Topic of the Month: August 2005:
Preparing for School with Allergies and Asthma

In this Topic of the Month,
you will learn:

Beginning a new school year is always an exciting time for children and parents. It is also an important time to remember that children with allergies and asthma face challenges in the classroom. These challenges can range from discomfort that makes it hard to concentrate on school work, to symptoms that reduce their ability to participate in recess or physical education class, to life-threatening reactions to food or insect stings.

It is reported that more than 9 million children under the age of 18 suffer from allergies and asthma. This can account for more than 14 million missed school days and cost millions of dollars in medical bills and lost work days for parents.

Anaphylaxis: Killer Allergy

Before school begins
Given the amount of time children are away from home when attending school and the incidence of allergies and asthma, it is important that children and their families work together with teachers, coaches and school nurses to avoid asthma and allergy triggers and to deal with symptoms. Use this helpful checklist to find out what can be done before the school year starts to reduce potential allergens that may affect your child.

Schedule a meeting with teachers, coaches and the school nurse to discuss your child's condition.
Make sure a "School Management Plan" is on file for your child at school. Here is a sample copy of an asthma management plan (Part 1 and Part 2) for your use.
Inform the school nurse about the free "Allergy and Asthma Tool Kit for School Nurses."
Work together with your child's allergist/immunologist to ensure that their medications are helping. If you don't have an allergist/immunologist, visit www.aaaai.org/physref/ to find one in your area.
Talk to your child and review what triggers allergy or asthma symptoms. Encourage them to ask their teacher for help when symptoms worsen.
Ask your child's allergist/immunologist to complete a "Food Allergy Action Plan" if your child has a food allergy.
Inform school cafeteria staff and teachers of what foods to avoid and suggest safe alternatives. If possible, have your child bring a bag lunch to school, and remind them not to share food with their friends.
Inform physical education teachers and coaches about asthma and warning signs of an asthma attack.
Encourage your child's physician to be an informational resource for the school.
Make sure your child has his or her medications and peak flow meter with them at school.

In the classroom
Teach your child about allergies in the classroom by using the Classroom Corner as a learning tool. Common allergens in the classroom that can trigger an allergic or asthmatic reaction in children are:

  • Dust Mites - microscopic creatures that thrive in high humidity and in areas where there is dust. The droppings of these mites are the most common trigger of perennial allergy and asthma symptoms. Check if your child's school is air conditioned, this may help reduce dust mites.
  • Chalk Dust - an irritant that can trigger an asthma attack. Students with allergies or asthma should try to stay away from the chalk board and erasers, and wash hands after writing on the board.
  • Animal Dander - proteins found in the saliva, dander (dead skin flakes) or urine of furry animals can trigger allergy symptoms such as sneezing, an itchy, runny nose and itchy, swollen eyes. Itchy skin or raised, red rash called hives can also come from touching animals, so children should try to avoid contact, if they are allergic. Make sure the teacher knows that your child has an allergy to animal dander.
  • Mold - found in dark, warm, humid places. Mold spores can trigger an allergy or asthma attack. Fortunately, indoor molds and mildew can be easily eliminated with a detergent cleaning solution once discovered. Make sure your child's school repairs and seals any leaking roofs or pipes.

In the cafeteria
Lunch is a time to take a break from the school books and a time to socialize with new friends, but precautions must be taken to ensure your child's safety when it comes to allergies.

  • Food allergies - have your child bring their own food to school and remind them not to share or trade food with others. Also, your child, the nurse or teacher should have injectable epinephrine and know how to use it. Check out Tips to Remember: Food Allergy.

Recess/Gym class
Going back to school for the year also means recess, physical education and sports. These fun activities can take a turn for the worse if the following triggers aren't avoided.

  • Pollen - microscopic, powdery granules necessary for plant fertilization. The average pollen particle is less than the width of an average human hair. With the start of ragweed season just around the corner, it is important to remember to take your medications 30 minutes before going outside. Also, ask the teacher to close the windows in the classroom to keep the pollen from blowing into the classroom. Review Tips to Remember: Outdoor Allergies for more ideas to protect your child.
  • Stinging Insects - severe allergic reactions to insect stings can involve many body organs and may develop rapidly. This reaction is called anaphylaxis. Symptoms of anaphylaxis may include itching and hives over large areas of the body, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps nausea or diarrhea. Carry injectable epinephrine with you to help control allergic symptoms. Go to Tips to Remember: Stinging Insect Allergy for more information.
  • Exercise-Induced Asthma (EIA) - for children with asthma it is common to experience symptoms after about six to eight minutes of physical activity. People with EIA experience coughing, wheezing, tight chest, prolonged and unexpected shortness of breath.

    As many as one out of every 10 young athletes has asthma. It should not stop them from enjoying exercise or even high level of competition, but athletes of all levels need to remember to take proper precautions if they have EIA.

    Patients with EIA have airways that are overly sensitive to sudden changes in temperature and humidity, especially when breathing colder, drier air. During strenuous activity, people tend to breathe through their mouths, allowing the cold, dry air to reach the lower airways without passing through the warming, humidifying effect of the nose.

Basic EIA Treatment Checklist:
Use a short-acting inhaler, 15 minutes prior to exercise. This will help ease asthma exacerbations and lasts between four to six hours.
Warm-up for six to ten minutes before beginning a full exercise program.
Drink plenty of fluids.
Stop exercising if symptoms arise.
Cool down at the end of your exercise.
Check out Tips to Remember: Exercise-Induced Asthma for more on prevention.

What an allergist/immunologist can do for you
It is also important to review these diseases on a regular basis with an allergist/immunologist to update the medications and the treatment plan. Allergist/immunologists see children with food allergies, asthma and allergic rhinitis every day and are ideal physicians to consult with about these diseases. Studies have shown that those under the care of an allergist/immunologist make fewer visits to emergency rooms and are better able to manage their allergies and asthma.

Many school children and young adults suffer from food allergies, asthma and allergic rhinitis. But if the appropriate measures are taken, they may not be endangered or slowed down by these diseases. It is important to have good communication with your child and school personnel about the allergies and asthma.

To find an allergist/immunologist in your area, call the AAAAI Physician Referral and Information Line at (800) 822-2762 or visit www.aaaai.org/physref/.

Additional Resources

Back to School Interactive Game

All About Asthma Storybook

All About Allergies Storybook

Dr. Al Coloring Book Pages



This topic was reviewed on 8/1/2005 by Stuart Friedman, MD, FAAAAI,
Patients & Consumers Web Editor.

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