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Few studies have comprehensively examined the role the school environment plays in asthma and how effectively changing the environment may reduce morbidity, when adjusting for exposures in the home. In their review, Huffaker and Phipatanakul summarize the importance and common challenges of school-based environmental assessment and intervention studies linked to health effects ( J Allergy Clin Immunol 2014; 134: 1232-1237 ). They discuss the challenges and potential benefits of comprehensive environmental assessment and health outcomes in inner-city schools. The school environment has been shown to be a significant reservoir for allergens and pollutants. Indoor allergens known to be important in urban home environments may also be important in schools, including cockroach, cat, dog, mouse, dust-mite, and molds. Studies have identified children with asthma in inner-cities have markedly higher levels of mouse allergen in their schools compared to levels in their individual bedrooms. Give...

Approximately 36,000 children miss school each day due to asthma which ultimately affects a child’s ability to learn. In fact, according to a U.S National Interview Survey, children with asthma missed three times more school and had a 1.7 times greater risk of having a learning disability compared to well children. Moreover, students attending schools with the highest proportions of low income students are more likely to miss school because of asthma. In their review article, Cicutto et al discuss how asthma and associated causal pathways can have interactive and synergistic effects that result in a complex situation that must be addressed collectively through a coordinated and partnered approach ( J Allergy Clin Immunol 2014; 134: 1223-1230 ). School-centered interventions are thus directed at improving asthma control and reducing asthma-related absenteeism. Asthma management at schools is important for pediatric pulmonologists and allergists, primary care providers and the whole int...