Tracking Pediatric Asthma:The Massachusetts Experience Using School Health Records

Massachusetts Department of Public Health, Center for Environmental Health, Boston, Massachusetts, USA
Environmental Health Perspectives (Impact Factor: 7.98). 10/2004; 112(14):1424-7. DOI: 10.1289/ehp.7146
Source: PubMed


The Massachusetts Department of Public Health, in collaboration with the U.S. Centers for Disease Control and Prevention Environmental Public Health Tracking Program, initiated a 3-year statewide project for the routine surveillance of asthma in children using school health records as the primary data source. School district nurse leaders received electronic data reporting forms requesting the number of children with asthma by grade and gender for schools serving grades kindergarten (K) through 8. Verification efforts from an earlier community-level study comparing a select number of school health records with primary care provider records demonstrated a high level of agreement (i.e., > 95%). First-year surveillance targeted approximately one-half (n = 958 schools) of all Massachusetts's K-8 schools. About 78% of targeted school districts participated, and 70% of the targeted schools submitted complete asthma data. School nurse-reported asthma prevalence was as high as 30.8% for schools, with a mean of 9.2%. School-based asthma surveillance has been demonstrated to be a reliable and cost-effective method of tracking disease through use of an existing and enhanced reporting structure.

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Available from: Robert S Knorr, Jun 09, 2014
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    • "School health records have been utilized for allergytracking because they are readily accessible through the existing school data collection and storage infrastructure [9]. In many Pennsylvania schools student health records are compiled through a web-based software application portal called " Health eTools for Schools " (hereafter referred to as " eTools " ) that was funded by the Highmark Foundation through its Healthy High Five Initiative [10] and developed by InnerLink, Inc., a private, for-profit company. "
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    ABSTRACT: Objectives of this study are to determine if a relationship exists between occurrence of allergies among elementary school children and daily upper-air observations (temperature, relative humidity, dew point, mixing ratio) and daily air pollution (particulate matter, sulfur dioxide, nitrogen dioxide, carbon monoxide, and ozone); and, if so, to derive a mathematical model that predicts allergies. Using an ecological study design, school health records of 168,825 students in elementary schools enrolled in "Health eTools for Schools" within 49 Pennsylvania counties were analyzed. Upper-air measurements from ground level to the 850mb pressure level and air pollution measurements were obtained. Appropriate data mining techniques were utilized to validate and integrate three databases. Binary logistic regression used for analysis. A Generalized Estimating Equation model was used to predict the occurrence of more than 13 cases, the daily mean for 2008-2010. Results showed that the prevalence of allergies among school children in Pennsylvania increased over last three years. The primary occurrence of allergies among school children was in August-September, followed by December and April, while the lowest in January and May. Upper-air temperature and mixing ratio, as well as SO 2 , CO, O 3 , PM 10 were significantly associated with occurrence of allergies (p<0.01). In conclusion, monitoring of upper-air observation and air pollution data over time can be a reliable means for predicting outbreaks of allergies among elementary school children. Such predictions could help parents and school nurses implement effective precautionary measures.
    WORLDCOMP'12 - International Conference on Data Mining (DMIN'12); 07/2012
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    • "This mini-monograph presents results of some unique and innovative methods for adapting and integrating non-traditional information systems for use in EPHT. For example, the work of Knorr et al. (2004) demonstrates the feasibility and utility of working with school nurses to get a more reliable estimate of asthma prevalence in school-age children at the local level than was previously available through traditional sources. "
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    ABSTRACT: In January 2001 the Pew Environmental Health Commission called for the creation of a coordinated public health system to prevent disease in the United States by tracking and combating environmental health threats. In response, the Centers for Disease Control and Prevention initiated the Environmental Public Health Tracking (EPHT) Program to integrate three distinct components of hazard monitoring and exposure and health effects surveillance into a cohesive tracking network. Uniform and acceptable data standards, easily understood case definitions, and improved communication between health and environmental agencies are just a few of the challenges that must be addressed for this network to be effective. The nascent EPHT program is attempting to respond to these challenges by drawing on a wide range of expertise from federal agencies, state health and environmental agencies, nongovernmental organizations, and the program's academic Centers of Excellence. In this mini-monograph, we present innovative strategies and methods that are being applied to the broad scope of important and complex environmental public health problems by developing EPHT programs. The data resulting from this program can be used to identify areas and populations most likely to be affected by environmental contamination and to provide important information on the health and environmental status of communities. EPHT will develop valuable data on possible associations between the environment and the risk of noninfectious health effects. These data can be used to reduce the burden of adverse health effects on the American public.
    Environmental Health Perspectives 11/2004; 112(14):1409-13. DOI:10.1289/ehp.7144 · 7.98 Impact Factor
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    • "Nationwide, asthma accounts for an average of 14 million missed school days each year and results in some $9 billion dollars in health care costs (American Lung Association 2004). A recent survey of school health records in Massachusetts found that 9.2% of the children reported having asthma (Knorr et al. 2004). Asthma rates in the Northeast are higher than the national average, and within the state (Bloom et al. 2003), this burden is borne disproportionately by minority communities. "
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