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Roberta Bavin, CPNP, who oversees a school-based health center for the Clovis Unified School District in Fresno, says that asthma is a major problem in her school district because of the poor air quality. Here, she listens to the lungs of student Jacob Hart.

Like many children with asthma, Jessica Bryant missed countless days from school because of severe asthma attacks. And on occasion, she didn’t have access to her medication.

“It was really hard for my teachers to understand why I missed so much class, or why after running around at recess, I would have to miss reading and take my medication or go home,” the 15-year-old high school sophomore says.

Unfortunately for Jessica, the public school she attended in Sacramento did not have a school nurse to help educate teachers and administrators about the consequences of asthma. Her mother, Moe, believes Jessica would not have missed so much school if a school nurse had been present.

“The educational component that clinically trained people like nurses bring to educators who don’t have training or personal experience could have saved a tremendous amount of heartache for our family,” she says.

School daze

School nurses face a growing asthma crisis in California. An estimated 800,000 children, or one in seven, are affected by asthma in the Golden State. The prevalence of the respiratory disease has jumped 160% since 1980, and there seems to be no end in sight. It is estimated that asthma accounts for 7 million absences from school each year in California and costs schools $231 million annually.

What is contributing to the significant rise in asthma? There are a number of factors, experts say, ranging from poor indoor and outdoor air quality to environmental and geographical factors to improved diagnosis rates.

“There has been a lot of emphasis on educating pediatricians to recognize asthma sooner,” says certified asthma educator D.J. Kaley, RN, MSN, of Children’s Hospital Oakland. “If you can catch asthma at an earlier stage, then it won’t progress as quickly.”

Asthma attacks may be on the rise because children are spending more time indoors, where they might be exposed to more allergens that trigger inflammatory responses, according to researchers at Duke University. Carpeting and pets are two of the primary sources of indoor irritants that affect children.

Despite statewide efforts by the American Lung Association and other local groups to promote better disease awareness, asthma continues to be one of the biggest health problems facing California schools.

According to a national survey of school nurses in 2003, asthma is more disruptive of school routines than any other chronic condition and has a significant impact on absenteeism. Also, many school staff may lack awareness of the causes of an asthma attack.

“We recognize the damage that can be done to the education process when 14 million school days nationwide are lost annually due to asthma,” says Linda Davis-Alldritt, RN, MA, PHN, a fellow of the National Association of School Nurses and a consultant to the California Department of Education.

Needed: school nurses

Roberta Bavin, CPNP, who oversees a school-based health center for the Clovis Unified School District in Fresno, agrees that asthma is a major problem in her school district because of the poor air quality. Fresno is known for its poor air quality because its bowl-shaped landscape traps polluted air from pesticide use and fumes from nearby oil refineries.

Clovis Unified School District created school-based health centers to provide basic pediatric health care services, like asthma treatment, to underserved kids who often lack health insurance or access to quality medical care.

To improve overall asthma management, Bavin works closely with nurses at the school sites to ensure that children with asthma have immediate access to their medications when needed.