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Original Research: ASTHMA |

Children With Asthma Miss More School: Fact or Fiction?

Mark W. Millard, MD, FCCP; Pauline T. Johnson, PhD, RN; Anna Hilton, MSN, RN; Mary Hart, RRT, RCP
Author and Funding Information

*From the Baylor University Medical Center–Baylor Martha Foster Lung Center (Dr. Millard and Ms. Hart), Dallas, TX; Baylor University Louise Herrington School of Nursing (Dr. Johnson), Dallas, TX; and Veterans Administration (Ms. Hilton), Memphis, TN.

Correspondence to: Mark W. Millard, MD, FCCP, Baylor University Medical Center, 3500 Gaston Ave, Dallas, TX 75246


The study was supported by funds from the Dallas Asthma Consortium and the Summerfield Roberts Foundation.

The authors have no conflicts of interest regarding the subject matter of this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2009;135(2):303-306. doi:10.1378/chest.08-1642
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Background:  It is widely believed that children with asthma miss considerably more school than children without asthma. Previous surveys have indicated that 49% of children with asthma miss school (Asthma in America, 1998), but only a few studies have attempted to quantify the amount of school missed. Understanding the role of asthma in school attendance will help direct limited health-care resources to the children who need them most.

Methods:  We investigated school absence rates in fourth- through sixth-grade students in 19 inner-city schools in the Dallas Independent School District (DISD). The sample consisted of 353 students who were identified as possibly having asthma based on responses to a modified Brief Pediatric Screen instrument and who underwent spirometry and/or exercise challenge (EC) testing to confirm the diagnosis of asthma: 25 students were excluded for FEV1 < 70% and without bronchodilator response, while 157 students had EC-positive test results, and 171 students had EC-negative test results. We compared yearly absences for these students with each other, with all fourth- through sixth-grade students in the 19 study schools, and with all fourth- through sixth-grade students in the district. We also tabulated data from a separate database that included asthma patients identified by the school registered nurse (RN). Absence data by school and by grade level were provided by the school district for the 2002–2003 school year.

Results:  Absence rates were as follows: 2.54% (EC positive), 2.12% (EC negative), 2.59% (abnormal FEV1), 2.86% (RN identified), 2.85% (all fourth- through sixth-grade students in study schools), and 2.95% (all fourth- through sixth-grade students in the DISD).

Conclusion:  Students with asthma in the DISD miss no more school their classmates without asthma.


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