Jackson, Fountain and Perry counties have been targeted for high rates of asthma among school-aged children and emergency room visits related to the respiratory condition.

Asthma is a condition in which a person’s airways narrow and swell and produce extra mucus, which can make breathing difficult and trigger coughing, wheezing and shortness of breath.

Nursing supervisor Joyce McKinney said in 2016-17, Brownstown Central Community School Corp. had 159 students in kindergarten through 12th grade with asthma.

In that same school year, school nurse coordinator Sherry Reinhart said 167 Seymour Community School Corp. K-12 students had asthma.

The Jackson County Health Department reported 16 Crothersville Elementary School students and 10 Medora Community School Corp. K-12 students had asthma last school year.

According to the Centers for Disease Control and Prevention, asthma is a leading chronic illness among children and adolescents in the United States and also is one of the leading causes of school absenteeism.

The CDC also said, on average, about three children in a classroom of 30 are likely to have asthma; nearly 1 in 2 children with asthma miss at least one day of school each year because of their asthma; and each year, asthma causes more than 10 million missed days of school.

In an effort to decrease absenteeism related to asthma in Jackson County, the CDC, Indiana State Department of Health, Indiana Department of Education, Schneck Medical Center and the local school corporations are working with the American Lung Association to roll out the asthma-friendly school program.

Asthma-friendly schools make an effort to create safe and supportive learning environments for students with asthma. They have policies and procedures that allow students to manage their asthma.

The goals are to get more clean air in the schools for those with sensitive airways, teach and provide resources to the schools and improve the health of children with asthma and management of their airways.

“We’re going to try to reduce absenteeism and try to educate the staff a little bit more,” McKinney said. “They have a basic knowledge, but the American Lung Association has some programs that they have shared with the schools to help us with that.”

The CDC’s National Asthma Control Program plays a pivotal role in promoting asthma-friendly schools.

Throughout the 2000s, the program worked with the CDC’s Division of Adolescent and School Health to fund various asthma control strategies across several urban school districts and created tools to assist them with program planning and monitoring.

While DASH no longer includes a focus on asthma, the 36 state and territorial state asthma programs funded by the NACP actively are involved in asthma activities with students and schools.

The major activities include school-based asthma management, self-management education for students, indoor air quality and asthma trigger reduction, educational training for school personnel and administering asthma medication self-carry laws.

State asthma programs utilize the data from their CDC-funded asthma surveillance systems to focus activities in areas with the most hospitalizations and emergency department visits for asthma. They work with their state asthma partnerships to identify areas with high health risk students and to identify evidence-based interventions they can implement statewide.

In May 2018, local schools will be awarded either a bronze, silver, gold or platinum designation of being asthma-friendly. That will be based on the steps they take this school year to bring awareness to asthma and provide a better learning environment for those with the condition.

Susan Wynn, director of respiratory care and sleep services at Schneck, said meetings have been conducted throughout the summer to discuss the asthma-friendly school program with school nurse leaders.

She recently attended open house events at all three Brownstown schools to hand out consent forms for parents to fill out and also have their child’s asthma care provider fill out.

The signed form is returned to the school nurse, who will keep it on file and use it to track data. The form will have to be filled out every year.

“The physician has to say whether or not the child is educated well enough to carry (asthma medication) or if they need assistance,” McKinney said.

She said she has never tracked asthma-related absenteeism, but she’s now having the schools’ administrative assistants ask parents calling in to report their child’s absence if it’s respiratory-related.

“Then I’m going to have to look back at data and track it,” she said. “I don’t think it has been a real issue in the past because parents are real good about communicating with me for the most part, but maybe it’s more of an issue than we realize.”

Schneck is helping ensure tools to treat students with asthma are accessible. That includes putting spirometers in doctor’s offices to test air capacity of the lungs. Schools also have to have albuterol and nebulizer treatments on hand.

“If you’re a child and you’re in kindergarten and your mom didn’t bring it, now, we’ll have that so we can go ahead and administer that,” McKinney said. “We keep nebulizers here, but we ask everybody bring in their own medicine.”

Reinhart said many students need to carry inhalers and may need nebulizer treatments at school, which require assistance of the school nurse.

“Asthma is the most common health problem at Seymour Community School Corp. and can lead to very serious consequences if not treated appropriately,” she said.

McKinney said environmental factors also come into play, including compliant heating, ventilation and air conditioning units, no fragrant scents in classrooms and being careful when spraying for insects.

The American Lung Association also is asking schools to consider air quality when students go outdoors. McKinney said there are different colored flags that represent the air quality, and everyone should be aware of what color is in effect every day.

“We’ve already thought about going out to recess when they are harvesting the crops,” McKinney said of fields near the elementary school. “Sometimes, it’s too dusty, so we have thought like that, but now, it’s going to be more at the forefront of everybody’s mind. That’s the goal.”

Wynn said educating staff members and coaches who interact with kids with asthma is key, too.

“We want them to live normal lives and be able to be active,” she said. “We want to teach the coaches not to push them when they can’t (do certain activities); however, we want them to get treated so that they can and know when to let them keep their inhalers. We want them to be able to be active and not be afraid because their coach doesn’t understand.”