The Science Journal of the American Association for Respiratory Care

1999 OPEN FORUM Abstracts

VALUE OF SCREENING FOR PEDIATRIC ASTHMA RISK IN SCHOOLS.

R.R. Baker, PhD, RRT, RCPT; V.H. Kemp, PhD, FNP; J.A. Lucas, BS, RRT; C.R. Hall, BS, RRT, RPFT; C.B. Arant, BS, RRT; and N.T. Rupp, MD, Medical College of Georgia, Augusta, GA

BACKGROUND: Exercise-induced bronchospasm (EIB) has been associated with the development of symptomatic asthma and chronic impairment of lung function. Parental or child self-report may not adequately identify children at risk for asthma. Our goal was to examine the prevalence of exercise related asthma in an inner city elementary school attended only by African-American children.

Methods: We attempted computerized spirometry and a standardized, outdoor free running test in 190 children in grades K through 5 during physical education (PE) classes following parental consent. The children were also screened with an 8 question survey prior to testing. Chronic airway obstruction (CAO) was suspected if baseline FEV1 was < 80% of predicted and the FEV1/FVC ratio was < 0.80 or FEV1 increased > 10% post-bronchodilator. EIB was identified by a post-exercise fall in FEV1 of³ 10%. Ninety-three percent (176) of the children were able to complete both the pulmonary function and exercise tests.

Results: The percent of students with EIB and/or CAO are presented by grade in the following table. Thirty-one percent (54 of 176) of the students had either EIB, CAO or both.

Grade (n) EIB% (n) CAO% (n) EIB + CAO% (n) Total% (n)
K (26) 7 (2) 7 (2) 4 (1) 19 (5)
1 (25) 16 (4) 4 (1) 4 (1) 24 (6)
2 (28) 21 (6) 7 (2) 7 (2) 36 (10)
3 (35) 17 (6) 14 (5) 9 (3) 40 (14)
4 (32) 22 (7) 13 (4) 6 (2) 41 (13)
5 (30) 3 (1) 13 (4) 3 (1) 20 (6)

School records did not identify breathing problems in 80% of students with EIB or CAO. Two questions related to ?having asthma? and ?wheezing? were significantly correlated (r= 0.75 and 0.90, respectively; p<0.05) with CAO or EIB. CONCLUSION: Adequate treatment of asthma requires recognition and diagnosis. This screening procedure identified a significant number of children with respiratory abnormalities and potential breathing problems related to exercise which were not adequately recognized, evaluated, or treated

OF-99-201

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