Asthma is a chronic lung condition with ongoing airway inflammation that results in recurring acute episodes (attacks) of breathing problems such as coughing, wheezing, chest tightness, and shortness of breath. These symptoms occur because the inflammation makes the airways overreact to a variety of stimuli including physical activity, upper respiratory infections, allergens, and irritants. Exposure to these stimuli--often called triggers--creates more swelling and blocking of the airways. Asthma episodes can be mild, moderate, or even life-threatening. Vigorous exercise will cause symptoms for most students with asthma if their asthma is not well-controlled. Some students experience symptoms only when they exercise. However, today's treatments can successfully control asthma so that students can participate fully in physical activities most of the time.
Asthma varies from student to student and often from season to season. This is why physical education teachers and coaches need to understand what asthma is and what the individual needs of their students are. At times, programs for students with asthma may need temporary modification, such as varying the type, length, and/or frequency of activity. At all times, students with asthma should be included in activities as much as possible. Remaining behind in the gym or library or frequently sitting on the bench can set the stage for teasing, loss of self-esteem, unnecessary restriction of activity, and low levels of physical fitness.
Getting control of asthma means recognizing asthma triggers (the factors that make asthma worse or cause an asthma episode), avoiding or controlling these triggers, following an asthma management plan, and having convenient access to asthma medications. It also means modifying physical activities to match the students' current asthma status.
Asthma Triggers
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Exercise--running or playing hard--especially in cold weather
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Upper respiratory infections--colds or flu
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Laughing or crying hard
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Allergens
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Pollens--from trees, plants and grasses, including freshly cut grass
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Animal dander from pets with fur or feathers
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Dust and dust mites--in carpeting, pillows and upholstery
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Cockroach droppings
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Molds
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Irritants
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Cold air
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Strong smells and chemical sprays, including perfumes, paint and cleaning solutions, chalk dust, lawn and turf treatments
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Weather changes
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Cigarette and other tobacco smoke
A student's asthma management plan is developed by the student, parent/guardian, and health care provider. Depending on the student's needs, the plan may be a brief information card or a more extensive individualized health plan (IHP). Table 2 lists what asthma plans typically contain. A copy of the plan should be on file in the school office or health services office, with additional copies for the student's teachers and coaches. The plan--as well as the student's asthma medications--should be easily available for all on- and off-site activities before, during and after school.
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Brief history of the student's asthma
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Asthma symptoms
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Information on how to contact the student's health care provider, parent/guardian
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Physician and parent/guardian signature
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List of factors that make the student's asthma worse
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The student's personal best peak flow reading if the student uses peak flow monitoring.
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List of the student's asthma medications
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A description of the student's treatment plan, based on symptoms or peak flow readings, including recommended actions for school personnel to help handle asthma episodes.
Ensure That Students With Asthma Have Convenient Access to Their Medications
Many students with asthma require two different medications: one for daily control and prevention, the other to treat and relieve symptoms. These medications are usually taken by metered-dose inhaler (see Appendix 2). Preventive asthma medications are taken daily and usually can be scheduled for before and after school hours. However, some students may need to take preventive daily medication during school hours. All students with asthma need to have their medication that relieves symptoms available at school in case of unexpected exposure to asthma triggers, or an asthma episode. In addition, students with asthma often benefit from using their inhaled medication 5-10 minutes before exercise. If accessing the medication is difficult, inconvenient, or embarrassing, the student may be discouraged and fail to use the inhaler as needed. The student's asthma may become unnecessarily worse and his or her activities needlessly limited.
