Asthma is unpredictable, so children who have it need special monitoring.
Tragically this week, a teenager died after she had a severe asthma attack at school. The death of Akkriti Bhatia, 17, student of an elite Delhi school, provoked powerful reactions among her schoolmates, their parents, and in society at large. The school authorities find themselves besieged. The news is on TV and all the front pages.
Whose fault Bhatia’s death was, if it was anyone’s, is too contentious to tackle here. Nor is there enough information to deal with the specifics of this tragedy. However, the school nurse is reported to have said that, before visiting the infirmary, the teenager had taken two aspirins and a dose of her inhaler.
There are many triggers for asthma, many of which exist in the environment of a school: exercise, mould and pollen, strong smells including those of colognes or perfumed cleaning products, cold air, ordinary or chalk dust, mice, cockroaches — and aspirin.
Although studies show that regular low doses of aspirin can reduce one’s risk of asthma, paradoxically, nearly 10 per cent of asthma sufferers have aspirin-induced asthma.
A 2001 study in Japan found that such patients can be sensitive to paraben — an additive found in tacholiquine, which in turn is a “mucolytic agent” used in aerosol-based inhalers to open up the bronchial passages in the lungs so the patient can breathe. But given paraben, a person with aspirin-induced asthma may in fact experience the opposite effect: bronchoconstriction, which makes breathing still more difficult.
What can a school do to safeguard its students, now that asthma affects a third or more of all children? Apart from the obvious — reduce asthma triggers — they can follow American school systems in working with parents to ensure that each child has an asthma action plan. Children can be taught to understand asthma triggers, recognise early signs of an attack and carry essential help like an inhaler. The school infirmary must be informed, and keep specific medication. An emergency protocol can be laid down.
Teens, it turns out, are particularly unreliable when it comes to their own health. A 2008 University of Michigan study shows that up to one-fourth of inhaler-using teens use them to get high. Two other 2008 studies show that teens “dramatically overestimate their ability to control the condition”, which means they may neglect treatment and fail to avoid triggers. So they may need closer monitoring than younger children.
