WAITING TO INHALE TOO MANY CHILDREN ARE MISSING TOO MUCH SCHOOL - AND TOO MUCH OF LIFE - BECAUSE OF ASTHMA.

Byline: Evan Henerson Staff Writer

Seated inside the aptly named Breathmobile where her on-campus treatment for asthma began several years ago, 10-year-old Ashley Brown twirls a piece of plastic equipment like a top and arranges boxes of medication. The Breathmobile - which services more than 3,000 students at 95 schools throughout the Los Angeles Unified School District - is positively bustling with children, none of whom look especially sick.

``That boy in there, he's in my class, and he has asthma, too,'' says Ashley, a fifth-grader at Figueroa Elementary School. ``So I don't feel lonely.''

Nor should she. In another room, Ashley's classmate, 11-year-old Rickey Palmer, has battled the chronic lung disease since early childhood. Ditto Rickey's 5-year-old sister, who is also named Ashley. Health officials in LAUSD say at least 20,000 students have the condition, but estimate many more among the 800,000-student population are undiagnosed asthmatics.

``We're trying to get a count. We know it's a lot,'' says Susan LaCombe, a school nurse and the director of LAUSD's Asthma Project. ``There are a lot more, according to the national statistics.''

An epidemic

Five million American children have asthma, which is the No. 1 cause of school absence in the nation. Parents do their share of gasping and wheezing as well. The number of Americans with asthma has more than doubled over the past 20 years and is expected to double again by 2020, bringing the nation's asthmatic total to 29 million, according to the U.S. Centers for Disease Control and Prevention and the Pew Environmental Health Commission.

People with asthma have sensitive airways in their lungs. Triggers such as mold, dust mites or tobacco smoke can cause the airways to swell or cause the muscles around the airway to constrict, making breathing difficult. Coughing, wheezing and tightness of the chest are the usual results.

With the National Institute of Health-sponsored World Asthma Day taking place Tuesday, research advocates would like nothing more than to see every asthmatic child receiving proper treatment for the disease. The sooner you get that treatment, advocates say, the more likely you'll be able to get it under control. Children can outgrow their asthma, and the condition, for all its prevalence, is highly treatable, though there is no cure.

``There should never be one death from asthma,'' says Dr. Jean Hanley- Lopez, clinical director of the Pediatric Asthma Disease Program. ``It's not like having cardiac disease. If they use preventive medication and continue with programs, kids get better.''

It's an elusive ailment

Getting a diagnosis can be the difficult part, says Dr. William Berger, president-elect of the American College of Allergy, Asthma and Immunology. During the World Asthma Day campaign, Berger and Pittsburgh Steelers running back Jerome Bettis - himself an asthmatic - will be on Capitol Hill lobbying for funding, research programs and general disease awareness.

Locally on Tuesday, the California Endowment, the UCLA Center for Health Policy Research and the California Department of Health Services will unveil the California Health Interview Survey data pertaining to the prevalence and control of asthma among Californians and how this incidence varies statewide - geographically, ethnically and socioeconomically.

The California Endowment will also announce the launch of a new $12 million statewide program aimed at improving the quality of life of school-age children with asthma. A dozen organizations throughout the state, including St. John's Well Child Center in Los Angeles, will be given $450,000 grants over three years to instigate asthma-combating programs.

While LAUSD's Asthma Project and Breathmobile - a mobile full-service unit administered by Los Angeles County-USC Medical Center - are models for school districts throughout the nation, educational facilities in other states aren't nearly as progressive. The right of children to have their asthma medication at school - in the face of strict campus zero-tolerance drug policies - is another battle for asthma advocates.

The right to breathe

``At one point, there was a misconception that asthma was an emotional disorder, which is so ridiculous now,'' says Berger, who also wrote ``Asthma for Dummies.'' ``We know now it's a physiological disease, comparable to hypertension, diabetes and heart disease. I think the stigma is gone, and the disease is well-publicized. There are professional athletes and people who are very successful who have been able to overcome asthma.''

Not that asthmatic children necessarily need role models. Being able to run and play without restriction overwhelmingly beats any embarrassment over having to use an inhaler at strategic times during the a day, say teachers and parents.

``We try to make the medication regimens in the morning before school and in the evening,'' says Hanley-Lopez who spent three years as the Breathmobile's first physician. ``At most, some who have exercise-induced asthma may have to use the medicine before they exercise.''

Dr. Cesar Chavarria, a pediatric pulmonologist at Encino Tarzana Regional Medical Center, says the schoolchildren he sees are not self- conscious about being treated for asthma, especially since the condition is so common.

``So many children are on inhalers now, many schools consider it cool,'' says Chavarria. ``People telling me, 'I don't want to take this' because they think they're going to feel different or be teased is very rarely a concern of my patients.''

A part of their lives

Nonetheless, awareness campaigns might help erase whatever stigma remains. Two years ago, the producers of the award-winning PBS children's show ``Arthur'' decided to create an episode explaining the ``back story'' of Buster, Arthur's best friend, who has asthma. The character had referred to his asthma and occasionally used an inhaler, but the condition was never the focal point of any episode.

Producers fielded occasional letters from parents praising the on-screen depiction of Buster's asthma and since ``Arthur'' often tackles issues that are of concern to school-age children and their families, the producers decided to bring childhood asthma front and center.

``My own son had childhood asthma, although he outgrew it,'' said series executive producer Carol Greenwald. ``We knew how broad-based asthma was for kids.''

The episode, titled ``Buster's Breathless,'' had the character explaining to Arthur's sister, D.W., how he found out he had asthma. Buster goes from feeling self-conscious about his asthma to presenting a report on the condition.

``Buster's Breathless,'' which will be rebroadcast Tuesday, and its accompanying educational campaign won the National Environmental Asthma Educator Award from the U.S. Environmental Protection Agency. The award, says Greenwald, is just as meaningful as winning an Emmy, if not more so.

``If you can see someone who you admire dealing with the same kind of thing, it helps smooth the way,'' said Greenwald. ``We want to smooth the way for kids and make them not feel alone.''

Why can't Johnny breathe?

The first step in battling asthma is knowing what it is - and isn't

What is asthma?: It's a chronic disease that results in the tightening of the muscles around the airway, causing it to narrow (broncho-constriction); or swelling, irritation and increased mucus in the airway (inflammation), also causing the airway to narrow.

Frequency: More than 14 million people in the United States have asthma; 5 million are children.

What triggers an attack?: The presence of dust, mold, pet dander, tobacco smoke, cockroaches, strong odors or fumes.

Symptoms: Coughing, wheezing, chest tightening, shortness of breath.

How is asthma treated?: Daily controller medication can prevent asthma attacks. Quick-relief medicine is often used to combat asthma attacks as they happen.

Is asthma the same as an allergy?: No, although the two often occur together.

Can asthma be cured?: No, although some people report ``outgrowing'' childhood asthma when they reach adulthood.

- E.H.

CAPTION(S):

2 photos, box

Photo:

(1 -- cover -- color) Absent with asthma

What can be done to prevent the No. 1 cause of missed school days

(2) During a visit from the Breathmobile, asthma patient Ashley Brown, 10, gets a checkup from Dr. Jean Hanley-Lopez, clinical director of the Pediatric Asthma Disease Program. ``There should never be one death from asthma,'' says Hanley-Lopez.

Gus Ruelas/Staff Photographer

Box:

Why can't Johnny breathe? (see text)

Source: National Heart Lung and Blood Institute