Chronic absenteeism is defined as missing at least 15 days of school during the year.¹

it's a growing problem. There's no sign that absenteeism is declining, despite district and government incentives aimed at getting students in their seats.^2,3

Asthma and school absenteeism

Chronic absenteeism has no single cause. But air quality may be one of the most dangerouscauses as it’s both invisible and pervasive.

A 2001 study published in Epidemiology linked both particulate matter (PM) and ground-level ozone directly to students missing class due to respiratory illnesses, including asthma.⁴ When ozone concentrations rose by 20 parts per billion (ppb), school absences due to respiratory illness increased by an average of 83 percent.

A 2017 study published in Economics of Education Review suggested that, even if they don’t miss school, students with asthma don’t perform as well in class when pollutant levels increase.

According to the study, students with asthma score 1 to 2 percent lower on their math and reading assignments when PM counts are high.⁵ Their scores drop as much as 10 percent when ozone levels rise.

A 2019 study published in the Centers for Disease Control journal Preventing Chronic Disease estimated that 14 to 18 percent of student absenteeism could be attributed to asthma.⁶ 49 percent of schoolchildren with asthma have missed more than one school day.

What does air quality have to do with absenteeism?

Poor air quality doesn’t affect all students with asthma equally. The 2001 study of ozone-related absences also found that ozone disproportionately hurt communities with lower long-term PM levels, causing absences due to respiratory illness to spike by 224 percent.

Communities with higher long-term PM levels, which largely includes lower-income neighborhoods, only experienced a 38-percent increase in absences.

What was the underlying reality behind this difference? Lower incomecommunities suffer from poorer air quality than more affluent areas do. As a result, absences due to asthma and other respiratory conditions are more common, so pollutant increases don’t have as drastic an effect.

But this means that the impact of poor air quality on chronic absenteeism in lower-income areas is much more common.

In addition to being exposed to poor air quality in their neighborhoods, students living in low-income communities are more likely to attend schools with poor air quality. For example, the more students in a school who qualify for free lunch, an indicator of low family income, the more likely that school is to report poor indoor air quality.⁷

These same schools are much more likely to contain facilities that are outdated or in poor condition, including HVAC and ventilation systems whose disrepair contributes to poor classroom air quality. These conditions can trigger asthma at higher overall rates.⁸

How can I help prevent my child from falling behind?

Missing school days leads to consequences beyond falling behind on homework. Research shows that students who miss a lot of school due to asthma are at a higher risk of:^9,10,11

• Repeating classes
• Staying away from their peer groups
• Dropping out of school altogether

But you can help keep your child’s asthma symptoms from preventingtheir success.

Develop an asthma action plan

It’s important to manage your child’s asthma symptoms quickly and effectively after they flare up. Symptoms can quickly become severe enough to keep your child out of school.

Work with your doctor to create a plan that’s easy to work from when you first notice asthma symptoms.¹²Then, share your action plan with everyone in your child’s life. Share your asthma action plan for school with teachers and administrators. Outside of school, share the plan with friends and other parents so that your child is safe wherever they go.

Follow your doctor’s orders.

Medical treatment, which may include inhalers and medication, is vital to managing asthma symptoms. Follow your doctor’s instructions.Don't use asthma home remedies without asking your doctor first.

Change your lifestyle

Make environmental and lifestyle changes to reduce the frequency and severity of asthma symptoms:

• Monitor your indoor air quality.Keep an eye on pollutants in your indoor and outdoor air with an air quality monitor. Encourage your school to set up air quality monitors, too. Teachers can then take appropriate action to increase time indoors when air quality is bad outside.
• Avoid asthma triggers. Take precautions to help reduce flare-ups and the severity of symptoms:
  • Do physical activities inside when air quality is poor. Ask your child to stop playing outside or have them wear a KN95 respirator mask to keep triggers out of their respiratory system.
  • Take action to prevent and remove mould that may trigger asthma.
  • Limit time spent with dogs, cats, and birds. Make sure they’re not allowed where you eat, sleep, or spend a lot of time.
• Get involved at school.Join your school’s parent-teacher association (PTA) or school board to help improveyour schoolair quality. Encourage your school to installstandalone air purifiers. These actions can help mitigate poor indoor air quality in schools caused by outdated HVAC systems. Installing MERV 16 filtersin existing school HVAC systems can also help reduce classroom pollutants by at least 90 percent.¹³
• Have your child wear an air pollution mask. A KN95 face maskcan filter virtually all pollen and other allergens from your child's air and reduce their exposure to irritants that can trigger severe asthma attacks.
• Use an asthma air purifier at home to reduce airborne triggerslike dust, pet dander, and mould spores. Fewer triggers mean fewer symptoms and, most likely, less time spent out of the classroom.

The Takeaway

Poor air quality in classrooms is a problem for all students. But poor air quality can have far more overwhelming consequences beyond the classroom for students with asthma.

Increasing your school’s awareness of air quality and influencing school policies doesn’t just help students with asthma show up to class more often. It helps them stay on track to graduate high school, get into college, and live more meaningful lives as their classroom becomes less of an obstacle and more of an opportunity for success.