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School-based asthma, food allergy policies lacking

Tuesday November 8, 2011
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Most states continue to struggle with implementing school-based policies that address student asthma and allergy health, according to an annual report from the Asthma and Allergy Foundation of America.

According to a news release, 7 million school children have asthma and 13 million have allergies. The report encompasses more than 100,000 elementary, middle and high schools in the United States.

Each year, the AAFA's report, "State Honor Roll of Asthma and Allergy School Policies" outlines 18 school-related core policies proven to affect positive healthy school environments, then assesses each state on how many of these policies they have adopted. If a state has enacted at least 15 of the policies, it is listed on the AAFA's Honor Roll.

This year, six states achieved this distinction: Connecticut, Massachusetts, New Jersey, Rhode Island, Vermont and Washington.

"New England has been committed to student health, and public health overall, for decades," Judi McAuliffe, RN, a school nurse in the Pembroke, Mass., school district, said in the news release. "I'm not really surprised that we continue to lead the rest of the country on asthma and allergy health. I just wish others would follow."

With so many people affected in the school setting, according to the AAFA, these diseases create a burden on schools and communities, requiring improvements to indoor air quality, emergency procedures and prevention training for food allergies, individual health plans for students, notification to parents of pesticide spraying, student access to medications such as epinephrine auto-injectors or albuterol inhalers, and campus smoking bans and cessation programs, among other measures.

While thousands of local schools and districts may show innovation and leadership in support of students and staff with asthma and allergies, strong state-wide policies are lacking throughout the U.S., according to the AAFA.

"In fact, 12 states failed to achieve even half of the core policy standards," Charlotte Collins, JD, AAFA's vice president of policy and programs, said in the news release.

The AAFA found that overall, most states are at least taking a few steps each to address the needs of students with asthma and allergies in the school setting. For example, most states now protect student access to their own medications, document chronic diseases and prohibit smoking at school and on school buses.

However, about half the states fail to require schools to develop emergency protocols for asthma and anaphylaxis emergencies, and only five recommend schools provide at least one nurse per 750 students.

One major positive finding in the report was that almost every state has a law allowing students to carry and self-administer epinephrine auto-injectors for allergic emergencies. The difference is significant from a decade ago, when many states prohibited such access and few allowed it. Wisconsin and New York have not yet passed the law enabling access and are considering it in their legislatures.

Now that student self-use of epinephrine has near nationwide acceptance, other access issues have emerged. Surprisingly, according to the AAFA, states do not regulate emergency services consistently. In some states, emergency medical technicians might not have access to epinephrine, might not be permitted to administer the medication, or might be permitted only to assist administering a patient's own epinephrine auto-injector device.

"This is a definite area of concern since school personnel rely on 911 services in these types of emergencies," Collins said.

Full results of the study, including detailed state profiles and charts, are available at www.StateHonorRoll.org. The site also has several links to free resources for parents, advocates, schools and policymakers.

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