The role of corticosteroids in the management of childhood asthma

Preventive treatmen

A national policy on asthma management for schools

Since asthma is the most common chronic illness in childhood, many of the problems associated with this condition will impact on the child's education. Because of widespread concerns regarding the management of asthma in schools, a subcommittee of the Thoracic Society of Australia and New Zealand, Asthma Special Interest Group, was convened to draw up national guidelines for school staff in order to provide optimal management of asthma in the school setting. We used current medical literature and the clinical experience of the authors who have dealt with children and adolescents suffering from asthma in the hospital, community and school environment. A number of issues had been identified, including; the availability of an asthma first aid kit; correct use of bronchodilator aerosols by puffer and spacer devices; and clear instructions as to when to notify parents and when to call an ambulance to the school. To provide optimal care of asthma in the school setting, the committee made the following recommendations: (i) improved guidance and training of school teachers and ancillary staff in appropriate asthma care; (ii) improved recognition by schools of those students with asthma; (iii) schools should encourage a policy of exercise for all students with asthma; (iv) asthma medication should be readily available at all times to those students with asthma; (v) the safety of school excursions and school camps should be improved by having available personnel competent in acute asthma management; a mobile asthma first aid kit; and by ensuring the student continues taking their usual asthma medications throughout the excursion; (vi) the early introduction of a 'lung health' education programme for all students, with particular emphasis on asthma being encouraged. We believe that asthma management in schools would be optimized if this national policy were adopted throughout Australian schools

Asthma knowledge, attitudes, and quality of life in adolescents.

Adolescents with asthma, their peers, and their teachers were studied in order to establish the level of knowledge concerning asthma and its management, their attitudes towards asthma, and the degree quality of life impairment due to asthma. A community survey was conducted among year 8 high school students (n = 4161) and their teachers (n = 1104). There was a good response rate to the questionnaires from students (93%) and teachers (61%). Twenty three per cent of students had asthma and this caused mild to moderate quality of life impairment, particularly with strenuous exercise. Asthma was provoked by passive smoke exposure in 30% of asthmatic students and up to 51% of students avoided situations because of asthma triggers. Asthma knowledge was low in teachers (mean score 14.90 out of a possible 31), students without asthma (11.25) and students with asthma (14.50). Specific knowledge on the prevention and treatment of exercise induced asthma was poor. There was a moderate degree of tolerance towards asthma among all three groups. Most considered internal locus of control as important, although students without asthma also considered chance to be a determinant of outcomes for people with asthma. Asthma is a common cause of quality of life impairment among year 8 high school students. Although specific knowledge on asthma is low, students and teachers hold favourable attitudes towards asthma. There are opportunities to intervene and improve asthma management among adolescents