Back to School With Allergies and Asthma

By Barry Jacobs, MD, FACS

As a new school year is about to begin, it is important to remember that children with allergies and asthma face challenges in the classroom. These can include difficulty concentrating on school work, to symptoms that reduce their ability to participate in sports, to serious reactions to food or insect stings.

It is reported that more than 9 million children under the age of 18 suffer from allergies and asthma. This can account for more than 14 million missed school days and cost millions of dollars in medical bills and lost work days for parents.

Before school begins

Given the amount of time children are away from home when attending school and the incidence of allergies and asthma, it is important that children and their families work together with teachers, coaches and school nurses to avoid asthma and allergy triggers and to deal with symptoms. Use this helpful checklist to find out what can be done before the school year starts to reduce potential allergens that may affect your child.

• Schedule a meeting with teachers, coaches and the school nurse to discuss your child’s condition. 
• Work together with your child’s allergist to ensure that their medications are helping.
• Talk to your child and review what triggers allergy or asthma symptoms. Encourage them to ask their teacher for help when symptoms worsen.
• Inform school cafeteria staff and teachers of what foods to avoid and suggest safe alternatives. If possible, have your child bring a bag lunch to school, and remind them not to share food with their friends.
• Inform physical education teachers and coaches about asthma and warning signs of an asthma attack.
• Make sure your child has his or her medications and peak flow meter with them at school.

In the classroom

Common allergens in the classroom that can trigger an allergic or asthmatic reaction in children are:

• Dust Mites - microscopic creatures that thrive in high humidity and in areas where there is dust. The droppings of these mites are the most common trigger of perennial allergy and asthma symptoms. Check if your child’s school is air conditioned, this may help reduce dust mites.
• Chalk Dust - an irritant that can trigger an asthma attack. Students with allergies or asthma should try to stay away from the chalk board and erasers, and wash hands after writing on the board.
• Animal Dander - proteins found in the saliva, dander or urine of furry animals can trigger allergy symptoms such as sneezing, itchy and runny nose and itchy, swollen eyes. Itchy skin or hives can also come from touching animals, so children should try to avoid contact if they are allergic. Make sure the teacher knows that your child has an allergy to animal dander.
• Mold - found in dark, warm, humid places. Mold spores can trigger an allergy or asthma attack. Fortunately, indoor molds and mildew can be easily eliminated with a detergent cleaning solution once discovered. Make sure your child’s school repairs and seals any leaking roofs or pipes.

In the cafeteria

Lunch is a time to take a break from the school books and a time to socialize with new friends, but precautions must be taken to ensure your child’s safety when it comes to allergies. 

• Food allergies - have your child bring their own food to school and remind them not to share or trade food with others. Also, your child, the nurse or teacher should have injectable epinephrine and know how to use it.

Recess/Gym class

Going back to school for the year also means recess, physical education and sports. These fun activities can take a turn for the worse if the following triggers aren’t avoided.

• Pollen - With the start of ragweed season (fall and spring), it is important to remember that allergy and asthma symptoms may be on the increase. Ask the teacher to close the windows in the classroom to keep the pollen from blowing into the classroom.
• Stinging Insects - severe allergic reactions can occur after insect stings, especially from yellow jackets, wasps and hornets. Symptoms may include itching and hives over large areas of the body, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps nausea or diarrhea. Carry injectable epinephrine with you to help control allergic symptoms if you have a history of such reactions.
• Exercise-Induced Asthma (EIA) - for children with asthma it is common to experience symptoms after about six to eight minutes of physical activity. People with EIA can experience coughing, wheezing, chest tightness, and prolonged and unexpected shortness of breath.

Basic EIA Treatment Checklist:

• Use a short-acting inhaler, 15 minutes prior to exercise. This will help ease asthma exacerbations and lasts between four to six hours.
• Warm-up for six to ten minutes before beginning a full exercise program.
• Drink plenty of fluids. 
• Stop exercising if symptoms arise.
• Cool down at the end of your exercise.

Many school children and young adults suffer from food allergies, asthma and allergic rhinitis. But if the appropriate measures are taken, they may not be endangered or slowed down by these diseases. It is important to have good communication with your child and school personnel about their allergies and asthma.

Ear, Nose and Throat Surgeons of Western New England, with Barry Jacobs, MD, FACS; Theodore Mason, MD; Grant Moore, MD, FACS; Daniel Plosky, MD; Jacquelyn Reilly, MD; Carl Reiner, MD; Jerry Schreibstein, MD, FACS; Kimberly Byrne, PA-C and Adam Sprague, PA-C, is, in addition to allergy drops, again starting an allergy shot program.  Please ask anyone at Ear, Nose and Throat Surgeons of Western New England for more information.