Back to School with Allergies and Asthma Back to School with Allergies and Asthma
American Academy of Allergy, Asthma and Immunology

What is the prevalenceof allergies and asthma in children?

How can you prepare before school begins?

What are common allergies and triggers to avoid during the school year?

In the classroom
In the cafeteria
At recess or in gym class
How can an allergist/immunologist help?

Back-to-school season can be a fun and exciting time for children and parents. However, it is also an important time to remember that children with allergies and asthma face challenges in the classroom. These challenges can range from discomfort that makes it hard to concentrate on school work, to symptoms that reduce a child’s ability to participate in recess or physical education class, to life-threatening reactions from food allergies or insect stings.

What is the prevalence of allergies and asthma in children?
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, millions of dollars in medical bills and even lost work days for parents of children who suffer from allergic disease.

Therefore, it is important for children and their families to prepare for back-to-school season by learning about ways to prevent allergies and asthma in the classroom. Having a plan of action for avoiding triggers will keep students focused on their school work and not on their symptoms.

How can you prepare before school begins?
Given the amount of time children are away from home during the school year, it is important that children and their families work together with teachers, coaches and school nurses. Together, you can help your child avoid allergy and asthma triggers, and also teach them ways to properly deal with their 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.

Before school starts, tour the school to identify potential allergy/asthma triggers in the classrooms.
Schedule a meeting with teachers and the school nurse to discuss your child’s allergic condition.
Encourage your child to take his or her medications as prescribed.
Review your child’s triggers with them and encourage them to ask their teacher for help when symptoms worsen.
If your child is allergic to certain foods, inform school cafeteria staff and teachers to avoid those and suggest safe alternatives.
Have your food sensitive child bring a bag lunch to school each day.
Make sure a dose of auto-injectable epinephrine is with your child for emergency situations, and make sure that teachers and the school nurse know how to use it properly.
All children with a severe allergy that may require the use of auto-injectable epinephrine should have a written action plan similar to this anaphylaxis action plan.
Inform physical education teachers and coaches about asthma and warning signs of exacerbation which could trigger exercise-induced asthma.

What are common allergens and triggers to avoid during the school year?
Below you will find a list of the most common allergens and triggers found in the classroom, in the cafeteria and during gym class or at recess:

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

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.
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 to prevent mold and mildew from forming.
Animal dander – proteins found in saliva, dander (dead skin flakes) or urine in furry animals can trigger allergy symptoms, such as sneezing, an itchy, runny nose and itchy, swollen eyes. Itchy skin or a raised, red rash called hives can also come from touching animals, so children should try to avoid contact with classroom pets if they are allergic. Make sure the teacher knows that your child has an allergy to animal dander.

In the cafeteria
Lunch is a time to take a break from school books and studying, and instead is a time to socialize with friends over food. However, precautions must be taken to ensure your child’s safety in the lunchroom if he or she is allergic to certain foods. If your child has food sensitivities, encourage them to bring their own food to school in a bag lunch and remind them not to share or trade food with friends. Six foods to avoid that account for 90% of food allergy in children include:

Milk
Egg
Peanuts
Wheat
Soy
Tree nuts

At recess or in gym class
Going back to school also presents opportunities for recess, physical education class and after-school sports. These fun activities can unfortunately take a turn for the worse if the following triggers are not avoided:

Pollen – microscopic, powdery granules necessary for plant fertilization. The average pollen particle is less than the width of an average human hair. With the start of ragweed season, which began in August, it is important to remember to have your child take his or her allergy medication 30 minutes before going outside. Also, ask the teacher to close the windows in the classroom or gym to keep pollen from blowing in.
Stinging insects – severe allergic reactions to insect stings can involve many body organs and may develop rapidly. This reaction is called anaphylaxis. 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. Make sure a dose of auto-injectable epinephrine is with your child during recess, gym class or during after-school sports activities for emergency situations.
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 experience coughing, wheezing, prolonged and unexpected shortness of breath and a tight chest. As many as one out of every 10 young athletes has asthma. It should not stop them from enjoying exercise or even high level of competition, but athletes of all levels need to remember to take proper precautions if they have EIA.

Children with EIA should use a short-acting inhaler 15 minutes prior to exercise. This will help ease asthma exacerbations for four to six hours. Children with EIA should also warm-up for six to ten minutes before beginning a full exercise program, drink plenty of fluids, stop exercising if symptoms arise, and cool down at the end of exercising.

How can an allergist/immunologist help?
Having good communication with school personnel about your child’s allergic condition is vital; but it is also important for your child to see an allergist/immunologist for an evaluation before the school year begins. Allergist/immunologists see children with food allergies, asthma and allergic rhinitis every day and are ideal physicians to consult with about these diseases. They will discuss medications and a treatment plan to help your child have a successful school year. Furthermore, studies have shown that those under the care of an allergist/immunologist make fewer visits to the emergency room and are better able to manage their allergies and asthma.

Consulting with an allergist/immunologist before your symptoms begin, or before they worsen, is an important first step in maintaining proper allergy and asthma control. An allergist/immunologist is the best qualified medical professional trained to manage the prevention, diagnosis and treatment of allergic disease. To find an allergist/immunologist in your area, please visit www.aaaai.org/physref.