Asthma in Children

What's the Problem?

Asthma is a chronic inflammatory disorder of the airway passages in the lungs. Attacks occur when the airways narrow after a viral infection, during exercise or exposure to triggers such as animal dander, dust mites, cockroach particles, pollen, tobacco smoke, air pollution, and chemical irritants. Symptoms of an asthma attack or episode include coughing, wheezing, chest tightness, and difficult breathing.

Who's at Risk?

Asthma, the most common chronic disease among children in the United States, affects about 4.4 million children.

From 1980 through 1993, asthma death rates for children under 19 years of age nearly doubled and are still going up. Among African-American children, the death rate is five times higher than the national average.

Death from asthma is not common, but can be caused by lack of early treatment, poor control of the disease, and repeated exposures to pollution, tobacco smoke, dust, etc.

Can It Be Prevented?

Most attacks can be prevented. Physicians can work with children and parents to develop asthma management plans, including medication. They can help families become aware of the environmental conditions and other factors that trigger asthma attacks and suggest ways to avoid these.

It is sometimes difficult for children and parents to adhere to asthma management plans. In some school districts, regulations prohibit children from carrying medications such as inhalers, which means that although they may have appropriate medication at home or at a school office, they don't have their inhaler if they have an attack traveling to and from school.

Tips for Scripts

EDUCATE viewers that children who suffer from asthma require medication quickly when an attack occurs, careful supervision during high pollution days, and hospitalization for severe attacks.
INFORM viewers that early treatment and reduced exposure to environmental triggers allows many children to live normal lives, sometimes outgrowing their asthma.
REMIND people with asthma to: adhere to their doctor's asthma management plan; never take over-the-counter medications without a doctor's consent; stay away from smoke, perfume, talcum powder or hairspray; minimize exposure to roaches, molds, dust, pets with fur, and strong household chemicals (e.g., cleaners); and stay inside on high- pollution days.

Case Example

High pollution warnings are in effect when seven-year-old David suffers a severe asthma attack on the way home from school. Mrs. Jones, the neighbor who usually watches David in the afternoon asks if he has an inhaler in his backpack. He says he doesn't because his school won't permit kids to carry medication. There's an inhaler in the school nurse's office if he needs one at school, but only empty inhalers in the apartment. The boy admits his mother had no money for refills. As his breathing worsens, Mrs. Jones tries to phone his mom at work, but can't reach her. Mrs. Jones rushes David to the busy emergency room of the local trauma center. They wait for another 30 minutes before he can be seen by a doctor. The frightened mother arrives from work and realizes the delays and lack of medication have created a life-threatening situation. After several hours of intensive treatment and an overnight stay with IV medication, David is released. The next day, a case worker from the hospital visits. She reasserts how important it is to always have enough medication in the house (reminding her that Medicaid pays for inhalers), helps the mother identify environmental exposures in the apartment that can lead to asthma attacks, reminds her to keep her son indoors when air pollution levels are high, and talks to neighbors about stopping secondhand smoke in the hallways would like to thank the Centers for Disease Control and Prevention (CDC) and their contributors for this information in striving to make daycare and childcare a more productive and efficient service.

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