ASTHMA IN CLASSROOM AS SCHOOL YEAR BEGINS 63,000 STUDENTS MAY BE AFFECTED BY THE DISEASE.

Byline: SUSAN ABRAM

Staff Writer

As Los Angeles Unified School District students flood back to classes today, dozens -- maybe even hundreds -- will miss their very first day of school because of asthma.

The leading cause of absenteeism among LAUSD students with chronic diseases, asthma afflicts some 63,000 students.

Of those, a majority miss 10 days or more of the school year. The district also estimates that 1,000 of its students visit emergency rooms each year because of asthma.

Health officials know that L.A.'s polluted skies, moldy apartments, proximity of residential areas to freeways and limited parental knowledge about inhalers all contribute to the high numbers of asthma cases. But they say they've only recently begun to link the illness to childhood obesity, poor academic performance, depression and other problems interfering with success at school.

Now, the school district wants to determine how widespread the problem is and how to help children manage it better so they can at least show up for class.

"We live in a relatively high-pollution city and that contributes to respiratory problems," said Dr. Kimberly Uyeda, director of the LAUSD's Student Medical Services.

"Sometimes the waxing and waning of asthma awareness can cause a problem."

More than 600 LAUSD nurses gathered at the Los Angeles Convention Center on Tuesday to promote an action plan to improve monitoring students with asthma. They also toured a new "breathmobile" van, one of several that makes the rounds to schools to test students for free, and help children monitor their health.

"The major challenge is that many children don't have a regular health provider and asthma is a disease that needs to be continuously monitored," Uyeda said.

The 63,000 known asthma sufferers in the LAUSD represent about 9 percent of the 700,000 student body -- many of whom are on year-round schedules. But district health officials believe the actual figure is closer to 14 percent of the total, or 98,000 students.

Childhood asthma within the San Fernando Valley has decreased slightly in recent years, from 8.7 percent in 2003 to 7.9 percent in 2005, the last year for which data were available.

Still, about 150 San Fernando Valley children miss 10 days of school or more. Some skip up to 60 days because of illnesses related to the chronic disease.

"I find that the biggest issue among families of children with asthma is a lack of confidence in the medication and a lot of fear," said Roberta Villanueva, a pediatric nurse practitioner who visits the homes of children with asthma in the Valley.

She is one of only four who do such work within the entire district.

Since the home-visit program began three years ago, Villanueva said, she has spotted several patterns among the children affected, such as a lack of education among parents on how inhalers work and unhealthy housing conditions.

"Some of the apartment buildings look very nice on the outside, but inside there are roaches," she said. "There are carpets that have never been changed. There is mold from leaking ceilings. There's fear among residents that they will get in trouble if they report this to the landlords."

In some cases, vacuum cleaners, bed covers and roach traps are provided to help alleviate the problems, she said.

But what is most telling is what asthma can do to a child's psyche, Villanueva said.

Children who can't participate in physical activities are more likely to gain weight. Obesity can act as a trigger to asthma. And among those that Villanueva visits, 90 percent report anxiety, stress and depression, she said.

The home-visit program, funded by a variety of sources including a $2 million grant from the Merck Childhood Asthma Network, is proving to be effective. Of the families she visits, Villanueva said, 65 percent of the children are reporting improved health when she returns to see them three months later.

Asthma among children began to steadily increase between 1980 and 1998, but has since stabilized, and death rates have decreased, according to the federal Centers for Disease Control and Prevention. Still, emergency-room visits continue to rise and African-American children both nationwide and in Los Angeles County still have the highest rates of asthma.

What remains problematic in fighting the disease is that there is little known about the development of asthma, whether it's genetic or environmental. Symptoms include shortness of breath, coughing, wheezing, and chest pain or tightness, which can be triggered by pollen, dust mites and pet dander.

An estimated 6.5 million schoolchildren suffer from the disease nationwide; it is the third-leading cause of hospitalization among those 15 and younger. About $16.1 billion is spent on treating children with asthma.

While California may seem to have the highest prevalence of the disease because of smog and air pollution, it is Massachusetts, Hawaii and Oklahoma that rank the highest in asthma prevalence among children age 17 and younger. California ranks 39th among all states.

Still, the American Lung Association has found that parents nationwide know very little about their state's or school district's policy on whether children are allowed to carry their inhalers with them to class.

A recent survey found that 58.7 percent of parents were uncertain whether their state has a law allowing students to carry and self-administer fast-acting "quick relief" inhalers. And 74.4 percent of parents whose children do have inhalers at school responded that their child's school does not allow students to keep rescue inhalers with them.

"What I keep hearing from school officials is that they have a lot of kids with asthma that don't have the proper medicine, or don't have good communication with their parents," said Katie Van Cleave, coordinator of childhood-asthma programs for the American Lung Association's Los Angeles Chapter.

"That's why it's important to have an asthma action plan," she said. "We're making progress but I feel like we need to make more strides."

susan.abram(at)dailynews.com

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SOURCE: Los Angeles Unified School District

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