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. Given the paucity of
comprehensive data on school-based environmental interventions and health
outcomes, successful home-based strategies currently serve as the model for
school-based interventions. For example, practical interventions to reduce
environmental exposures at home such as the use of air filtration systems and integrated
pest management can be utilized in schools.
Despite the challenges associated with implementing
environmental interventions in schools, evidence supports the importance of
school and classroom exposures and health outcomes. School-based interventions
have the potential to reduce exposures for many symptomatic children, in
contrast to the individual families impacted by home-based interventions. If
effective, results from school-based interventional studies could inform public
policy change, funding and initiatives. If it can be demonstrated that
reduction of classroom-specific exposures leads to improved asthma outcomes,
then findings can be translated into efficient and cost-effective strategies to
benefit communities of children through improvement of the school environment,
where children in America spend the majority of their day.
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