Number of children in hospital with life-threatening asthma attacks could quadruple as they return to school

Children with asthma in England could be over four times more likely to be hospitalised with life-threatening asthma attacks once they return to school next week, a leading lung charity has warned.

The most recent official figures show a 348% rise in the number of 5-14-year-olds admitted to hospital with an asthma attack in September, when most children tend to go back to school, compared to the previous month.¹

The biggest increase is among five to nine-year-olds, with a 370% rise in the number of hospital admissions in September compared to August - 4.7 times higher. Among the 10-14-year age group the increase is 307% and 4.1 times higher.²

The analysis also revealed a disparity between the number of boys affected compared to girls in the 5-14-year age group, with 825 boys hospitalised in September and 538 girls – a difference of 53%.³

Asthma + Lung UK says the increased risk is due to the ‘perfect storm’ of factors that occurs when children go back to school. Some children get out routine during the summer holidays and do not take their preventer medicines every day as prescribed. This can lead to their asthma being poorly controlled when they go back to school. Exposure to asthma triggers including colds and flu viruses, dust mites, pollen and strong emotions (such as fear and excitement), can all of trigger potentially life-threatening asthma attacks or worsen symptoms such as breathlessness, coughing and wheezing. 

With children across most parts of England due to return to school in just over a week, Asthma + Lung UK is urging parents to be on their guard and look out for signs that their child’s asthma may be worsening, such as wheezing, coughing, chest tightness, and breathlessness, and advises them to make an urgent appointment with their GP or asthma nurse if they have any concerns.

Emma Rubach, Head of Health Advice at Asthma + Lung UK, said: “For parents of children with asthma, September can be a very worrying time because the return to school means they may be exposed to more triggers that can bring on an asthma attacks or make their asthma symptoms worse.

“Colds and flu viruses are two of the biggest culprits as these viruses circulate more from September because children are mixing once again after the summer break. Other reasons could be that pollen levels are often higher than usual in the first half of September which can worsen asthma symptoms too, as can the cleaning products used to clean schools over the holidays.

“The best thing parents can do is to ensure their children take their preventer inhaler (usually brown) every day as prescribed and maintain their care and treatment plans during the holidays. Some children may fall out of their usual preventer inhaler routines over the summer break which can leave them much more vulnerable to an asthma attack. But preventer medication is vital as it helps calm the inflammation in their airways and reduces the risk of an asthma attack.

“They should also ensure their child always has their reliever inhaler with them when they return to school and have an up-to-date asthma action plan they share with the school. This ensures that school staff will also know what to do if the child’s asthma symptoms worsen or in the event of an asthma attack. You can find more advice on managing your child’s asthma at asthma.org.uk/advice/child/back-to-school/."

Data has shown that a spike in asthma attacks when the school summer holidays end is a trend that happens year-on-year, which is why Asthma + Lung UK is urging parents to start taking action now. A previous study funded by the charity found that 2.8 million school days are lost every year because of asthma symptoms.⁴

An estimated 1 in 8 children have asthma and every 2.5 minutes a child has a potentially life-threatening asthma attack.⁵ The warning signs that a child’s asthma symptoms are getting worse include coughing and wheezing, especially at night or early in the morning, breathlessness, complaining about chest or stomach pain, or needing their reliever inhaler (usually blue) three or more times a week.

If you are a parent or teacher and you believe a child in your care is having an asthma attack, Asthma + Lung UK urges you to call 999 immediately, as this is a medical emergency. While you wait for the ambulance, help them sit up and give them a puff of their reliever inhaler every 30-60 seconds – you can give them up to 10 puffs. Repeat this every 15 minutes while you are waiting for the ambulance.

Asthma + Lung UK also advises parents who have children with asthma returning to school to:

• Arrange for your child to have an asthma review, as this will help to pick up any early symptoms 
• Make sure your;child’s written asthma action plan is up to date and that it has been shared with your child’s school.
• If your child is old enough, you can support them by making sure they can take their inhaler properly by themselves. Watch a video on how to correctly use an inhaler. 
• Check the school’s policy for needing to tell parents when an inhaler is used. If your child is in primary school, make sure they know to tell an adult if they have had to use their inhaler and it hasn’t helped, or if they’ve used it and their symptoms have come back. If they are in secondary school, ask them to tell you when they use their inhaler. 

For further information on how to protect your child when they go back to school this September, visit: Asthma at school and nursery | Asthma + Lung UK (asthmaandlung.org.uk).
If you are concerned about your child’s asthma, please call Asthma + Lung UK’s helpline, which is run with thanks to funds raised by players of People’s Postcode Lottery. The number to call is 0300 222 5800. You can also access the charity’s virtual Parent and Carer Support Network, which is designed to help parents deal with their children’s asthma and other lung conditions, on www.asthmaandlung.org.uk

For schools, Asthma + Lung UK would also encourage staff to download the charity’s free poster, so staff know what the vital five lifesaving steps are if a pupil is having an asthma attack.

ENDS

References:  

1. Asthma + Lung UK analysis of bespoke data supplied by NHS England, 2022/23. The 348% increase represents an increase in emergency admissions for asthma from 304 in August to 1363 in September for ages 5-14 in England.

2. Asthma + Lung UK analysis of bespoke data supplied by NHS England, 2022/23 shows a 370% increase in emergency admissions for asthma from 199 in August to 936 in September for ages 5-9 in England.

3. Asthma + Lung UK analysis of bespoke data supplied by NHS England, 2022/23 showing number of cases of male and female emergency admissions for asthma for children aged 5-14 in August and September in England.

4. From the British Medical Journal’s at Risk with Asthma: A Systematic Review https://thorax.bmj.com/content/73/9/813
5. Calculated using figures from Health Survey for England 2018 [NS] - NHS England Digital