I am an advocate for the growing population of students with asthma and I know that a school that is safe for children with asthma is a safer, more productive, healthier place for everyone.
I urge anyone involved in the design, building, renovation, maintenance, management or inspection of schools to remember that schools are special because they house children. And today, anywhere from 4 to 20% or more of the students in a given school have asthma.
The National Asthma Education and Prevention Program's (NAEPP) questionnaire How Asthma Friendly Is Your School? asks:
- Does the school maintain good indoor air quality?
- Does it reduce or eliminate allergens and irritants that can make asthma worse?
If the answer to any of its questions is no, NAEPP warns that students are facing obstacles to asthma control and their attendance and progress in school will suffer.
Asthma is an inflammatory condition of the airways. Inflammation is the body's response to injury. Having asthma is like having a sunburn in your airways. Preventing and managing asthma requires protecting the airways from the allergens and irritants that cause and aggravate the inflammation.
A sixth grader explains how a school with moldy carpets made him sick in an award winning school essay and exhibit titled, "The Effect of Carpet on Students."
"Allergies make you feel horrible. Sinus and lung congestion, headaches, runny nose, breathing problems, sore throat, coughing and fatigue make it difficult for you to concentrate. You are not happy when you have allergies and are congested. Being sick affects your behavior...Some medicines you take make you sleepy, dopey, irritable, disoriented, or hyper which affects your concentration. If your are absent from school, you get behind in your work and miss the teacher's instruction."
While there are no statistics on children's school-related asthma, one government occupational health survey (1) listed elementary and secondary schools as "industries with a high prevalence of asthma" (12.0%), even higher than automotive repair shops (9.2%).
The MA Department of Public Health's newsletter, Lung Disease Bulletin (2) (December, 1996) highlights teachers who developed asthma as a result of school conditions that included inadequate ventilation, water-damaged moldy carpets, decaying organic debris in the ventilation system, and inappropriate application of pesticides to carpets. The toll from mismanaged renovations in occupied buildings is even higher.
As students and staff at the Pollard School in Needham (MA) learned first hand, going to school amid demolition, construction and renovation presents a variety of serious threats to health and safety and can leave a legacy of disruption, illness and disability that continues for years.
It is obvious that bad air at school sabotages a child's education, making it harder to learn and making it impossible to live well. Students (and teachers) who use bronchodilators to keep their airways open in unhealthy environments are setting themselves up for more serious long term lung damage.
I urge school officials who ignore or minimize complaints of health problems to remember the 1937 Texas School Disaster where students and teachers endured headaches, red teary eyes, nausea, and breathing difficulties for weeks as gas fumes filled the school. Then, on March 18, 1937, just minutes before school was dismissed, a gas explosion killed 319 students, teachers and visitors. (Victims identified as of 2007)
Those lives were a terrible price to pay for the false economies that led to short cuts in design and inadequate ventilation at the expense of health and safety.
It is not hard to see how ignoring air quality concerns at school creates an acute threat and a cumulative disadvantage for students and wastes millions of education and health care dollars. We may never know how many points children lose taking MCAS or SAT tests in rooms with high levels of CO2 (carbon dioxide) or moldy carpets but we know that that these schools are not safe environments for teaching and learning.
The logic is simple. Children are required by law to go to school. Therefore parents assume that schools will be safe for their children. They rely on school officials to anticipate reasonably foreseeable dangers and take steps to prevent harm, for example, from asbestos, solvents or pesticides. Building "experts" that find levels of contaminants below OSHA standards and therefore consider them acceptable for schools ignore the special vulnerabilities of children.
They also ignore the fact that schools have additional responsibilities to children under laws defining special education and disability rights. Schools cannot simply reject or ignore children because they have asthma. Schools must be accessible to all children, including those more vulnerable than typical children to injury or illness because they have health conditions such as asthma, allergies or learning disabilities.
To protect the right of all children to a free and appropriate public education in the least restrictive environment, schools must reduce barriers to attendance including conditions that cause preventable illness. They must work to prevent or change conditions which create a disadvantage or disparate impact on any child or group of children.
Also consider employees with asthma. In 1996, the Massachusetts Commission Against Discrimination awarded $200,000 to a school nurse in Burlington, MA because poor ventilation and contaminants in the school exacerbated her asthma and a school official had repeatedly disregarded her physician's advice to install a window in her office. The judgment concluded that "a reasonable person would have found such conditions intolerable" and that "a reasonable person would not have remained at a job which endangered her health with no hope of improvement." Her case was strong because she had detailed notes of her symptoms, her physician's recommendations, and the school's ventilation and contamination problems. Most significant, she had a copy of every notice she had given to school officials giving them an opportunity to address her concerns.
I guarantee you, if you look at your school through the viewpoint of students and teachers with asthma, you will never set your standards for health and safety too high. You will never betray the trust placed in you by your colleagues and your community and you will save money at the same time.
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