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New School of Thought for Asthma Testing

Doctors' group wants nationwide screening program for all kids

SUNDAY, Dec. 9, 2001 (HealthDayNews) -- Screening school children for asthma and allergies may someday become as common as programs that check students for eye and ear problems, says the American College of Allergy, Asthma and Immunology (ACAAI).

There have been several small, local programs around the country that screened school children for asthma and allergies, but the ACAAI wants to establish the first nationwide screening program, says Dr. Robert Miles, chairman of the college's screening program coordinating committee.

"It's really fascinating, and it's very exciting," Miles says of the effort, which is still in the formative stages.

He says this kind of national school screening program could have a significant impact on the health of American children.

"New studies show that the earlier you diagnose asthma and the more aggressive the treatment, the better the outcome," says Miles.

Asthma is the most common chronic illness in childhood, accounting for 10 million missed school days each year in the United States. It's estimated that almost 4.4 million American children under age 18 have asthma, and many others have undiagnosed asthma.

Children are at risk for irreversible lung damage if their asthma isn't diagnosed and treated early, says the ACAAI.

Despite the obvious need, Miles says it will take a long time to establish such a nationwide screening program that will include all students from first grade through the last year of high school.

"That's going to be a mammoth job and it's going to require a lot of personnel. What we'll do is start out small and keep expanding," Miles says.

The eventual success of the program will depend on funding, support from communities and healthcare workers and organizations, and the willingness of schools to participate in the screening effort.

The impetus to develop a national allergy and asthma school screening program was boosted by the results of four ACAAI-funded pilot projects; a review of those projects was presented at the recent ACAAI annual meeting in Orlando, Fla.

The four projects -- in Chicago, Cleveland, Dallas and Rochester, Minn. -- provided useful information and insights on how to get screening programs into schools and effective methods to check children for asthma and allergies.

Miles says information from those pilot projects indicates a national screening effort should include one questionnaire for students and another for their parents or guardians. Children identified as having a potential problem would be referred to a doctor who is an asthma and allergy specialist, Miles says.

"We're not making the diagnosis," he says.

It will probably take more than five years to establish a national school screening program for asthma and allergies, says Dr. Barbara Yawn, director of research at the Olmsted Medical Center in Rochester, Minn. She was program director for the pilot project in that city.

Although such a program would help identify children with problems, parental response would be crucial to success.

Yawn says in her pilot project, only 25 percent of the parents who were told there was some concern about their children took their children for a medical evaluation.

"Many of the children may have mild asthma, and the parents are not ready to focus on a problem they think is not very serious," Yawn says.

Parents need to be better educated about asthma and understand that even mild asthma can seriously affect a child's quality of life because it hampers the ability to play sports or causes kids to miss a lot of school.

"We have a lot of education to do so people can understand that it's not just the children who are hospitalized, it's not just the children who die [from asthma]. It's also the child who can't go out and play soccer or baseball or just run with their friends or swim because they have a problem when they exercise," Yawn says.

What to Do: You can learn more about asthma and allergies at the ACAAI Web site, the Allergy and Asthma Network Mothers of Asthmatics, or the American Lung Association.

SOURCES: Interviews with Robert Miles, M.D., Lynchburg, Va., chairman, American College of Allergy, Asthma and Immunology screening program coordinating committee; Barbara Yawn, M.D., director of research, Olmsted Medical Center, Rochester, Minn.
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