ISTOCK.COM/AVECTOR

At the 2024 Summer Olympics, sprinter Noah Lyles became the world’s fastest man—and he accomplished this despite his lifelong battle with asthma. Before you heard Lyles’ story, you probably already knew that asthma is one of the most common chronic diseases among school-aged children, but did you recognize the extent of your legal responsibilities for students with asthma?

The goal of this article is to increase your awareness by 1) detailing how asthma can negatively impact students; 2) explaining how federal law protects students with asthma; and 3) offering recommendations to support students with asthma. Who knows? By improving asthma management at your school, you may not only be preventing legal liabilities, but you also may unknowingly be supporting the success of a future Olympian!              

Negative Effects of Asthma

Simply attending school could aggravate a student’s asthma. School buildings often contain environmental asthma triggers such as mold, animal hair/dander, pesticides, chemicals, and cleaning agents. When these triggers are not carefully addressed and managed, students with asthma may have an asthma attack where their airways swell, and breathing becomes difficult. Failing to address asthma triggers in school buildings can result in drops in students’ academic performance and attendance (Environmental Protection Agency [EPA], 2024a). When students with asthma miss school or are fearful that they may experience an asthma attack, it not only negatively impacts their learning but also their opportunities for social interactions.

Asthma is a type of chronic lung disease that can be controlled by prescription medications or reducing exposure to environmental triggers. However, when left uncontrolled, students with asthma may need to be hospitalized. In 2013, students with asthma missed almost 14 million days of school per year (EPA, 2024a).

As of 2021, 6.5% of individuals under 18 had asthma and 38.7% of them had experienced an asthma attack in the past year. The prevalence of asthma increased as students got older. Specifically, 8.7% of students ages 12 to 17 had asthma (Centers for Disease Control and Prevention, 2024).

When asthma attacks occur during the school day or at extracurricular activities, they can be life-threatening. Unfortunately, preventable tragedies have occurred when school employees failed to recognize the symptoms of an attack such as wheezing, rapid breathing, chest tightness or pain, fatigue, and/or coughing (Allergy & Asthma Network, n.d.). After a 13-year-old California student died from an asthma attack at school, her parents claimed the school district negligently failed to train its staff, and the district had to pay nearly $16 million to settle the lawsuit (Lin, 2022).

Legal Protections

To ensure all school personnel recognize their legal responsibilities, they should understand how federal law applies to students with asthma. The Individuals with Disabilities Education Act (IDEA) ensures that eligible students receive a Free Appropriate Public Education (FAPE) through special education and related services tailored to meet their needs. Students with asthma could be eligible to receive special education and related services via IDEA’s classifications of “other health impairment” (OHI). The federal regulations list asthma as one of many “chronic or acute health problems” that fall under the OHI classification (Child with a Disability, 34 C.F.R. § 300(c)(9)(i), 2017).

Two other federal laws, Section 504 of the Rehabilitation Act of 1973 (Section 504) and the Americans with Disabilities Act (ADA) also protect students with asthma because these statutes prohibit disability-based discrimination. Of these two, the most relevant to public schools is Section 504 because it applies to schools receiving federal funding, whereas the ADA extends protections to students at most private facilities (U.S. Department of Education [USDOE], 2024).

Section 504 provides protections for students who may not qualify for services under IDEA if their asthma does not directly impact their education. Asthmatic students qualify as having a disability under Section 504 when their asthma “substantially limits one or more of their major life activities.” Because asthma impacts the major life activity of breathing, students with asthma are typically eligible for Section 504 protections (USDOE, 2024). Specifically, Section 504 requires schools to provide asthmatic students with reasonable accommodations such as allowing students with asthma to:

1)  carry and self-administer medication through an inhaler;

2)  excuse students from activities that risk triggering an asthma attack;

3)  ensure students’ educational environment is free of asthmatic triggers; and

4)  allow students to make up missed work and/or excuse absences that are due to medical reasons (USDOE, 2024).

In January 2021, Congress passed the School-Based Allergies and Asthma Management Program Act. Under this law, states that require certain public schools to have allergy and asthma programs must also implement policies to recognize and create individual management plans for each student diagnosed with allergies or asthma (School-Based Allergies and Asthma Management Program Act, 2021). The legislation also provides federal grants for states to adopt management programs and policies.

Recommendations to Improve Asthma Management

Because students with asthma have unique needs and legal protections, we encourage you to take steps to improve asthma management at your school. Fortunately, organizations with asthma expertise have provided the following recommendations.

THE ASTHMA AND ALLERGY FOUNDATION OF AMERICA (AAFA, 2021) SUGGESTS SCHOOLS:
Create action plans for each student with asthma
Train staff members to administer medications properly
Reduce common triggers in indoor areas
Ensure all employees can recognize the signs and symptoms of asthma attacks
Coordinate management of care with the student’s family
THE ENVIRONMENTAL PROTECTION AGENCY (EPA, 2024B) SUGGESTS SCHOOLS IMPROVE INDOOR AIR QUALITY BY:
Providing and maintaining quality HVAC systems
Controlling mold and moisture in school buildings
Implementing integrated pest management systems to reduce infestations
Using effective cleaning and maintenance techniques
Making smart materials selections for construction, ventilation, and furnishings
Exercising careful source control and chemical management

Because asthma can be a life-threatening condition, we hope you continue to research how to improve your school’s policies and procedures. Both the AAFA and EPA provide more extensive guidance in the resources linked in this article’s references. Asthma should not limit a student’s ability to thrive in school. School leaders should ensure all school employees 1) recognize the serious and negative impacts that asthma can have on students and 2) understand their legal responsibilities under IDEA, Section 504, and the ADA. Students with asthma should be able to thrive as long as they are not surrounded with asthma triggers and are surrounded by staff who support their unique needs.

Janet R. Decker, JD, PhD, is an associate professor of education law at Indiana University and a co-author of Legal Rights of School Leaders, Teachers, and Students. Emily Supergan is the assistant principal of Smoky Row Elementary School in Carmel, IN, and a mother of a student with asthma.

References

Allergy & Asthma Network. (n.d.) Managing asthma in schools: A guide for schools. Retrieved August 21, 2024, from allergyasthmanetwork.org/allergies-and-asthma-at-school/managing-asthma-a-guide-for-schools/.

Asthma and Allergy Foundation of America. (2021, January 5). It’s OFFICIAL: Huge AAFA advocacy victory! School-based allergies and asthma management program act, H.R. 2468 becomes law. community.aafa.org/blog/school-based-allergies-and-asthma-management-program-act-h-r-2468-becomes-law.

Centers for Disease Control and Prevention. (2023, May 10). Most recent national asthma data. cdc.gov/asthma/most_recent_national_asthma_data.htm.

Child with a disability, 34 C.F.R. § 300.8(c), (2017). sites.ed.gov/idea/regs/b/a/300.8/c/9.

Lin, S. (2022, Nov. 18). Yucaipa School District reaches $15.75-million settlement in student’s death from asthma attack. Los Angeles Times. latimes.com/california/story/2022-11-18/yucaipa-school-district-reaches-15-75-million-settlement-in-13-year-old-student-asthma-attack-death https://community.aafa.org/blog/school-based-allergies-and-asthma-management-program-act-h-r-2468-becomes-law.

School-Based Allergies and Asthma Management Program Act, P.L. 116–292 (2021). congress.gov/116/plaws/publ292/PLAW-116publ292.pdf.

U.S. Department of Education. (2024, February). Section 504 protections for students with asthma. ed.gov/about/offices/list/ocr/docs/ocr-factsheet-asthma-202402.pdf.

U.S. Environmental Protection Agency. (2024a, June 16). Managing asthma in the school environment. epa.gov/iaq-schools/managing-asthma-school-environment.

U.S. Environmental Protection Agency. (2024b, March 26). Framework for effective school IAQ management. epa.gov/iaq-schools/framework-effective-school-iaq-management.