Children with asthma miss more school: fact or fiction?

Chest. 2009 Feb;135(2):303-306. doi: 10.1378/chest.08-1642. Epub 2008 Oct 10.


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 FEV(1) < 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 FEV(1)), 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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absenteeism*
  • Adolescent
  • Age Distribution
  • Asthma / diagnosis*
  • Asthma / epidemiology*
  • Chi-Square Distribution
  • Child
  • Female
  • Health Surveys
  • Humans
  • Incidence
  • Male
  • Probability
  • Risk Assessment
  • Schools
  • Severity of Illness Index
  • Sex Distribution
  • Spirometry
  • Students / statistics & numerical data*
  • Surveys and Questionnaires
  • Texas / epidemiology
  • Urban Population