Thousands of Georgia youngsters with asthma learned a hard lesson as they returned to school: Many of their parents and teachers weren't aware of the risks of the disease and often aren't prepared to help them, the American Lung Association reported in August.

According to a national survey of more than 2,000 parents, 27 percent said they were not familiar with asthma, which often shows up for the first time when children start school and are exposed for the first time to molds and other substances.

That's why six times more asthmatic children are admitted to hospitals and emergency clinics during late August and early September than during summer months, said Dr. Norman H. Edelman, the ALA's chief medical officer. Asthma can be life-threatening and is the leading cause of school absenteeism.

Among Georgia children age 17 and under, 9.6 percent have asthma — one of the highest rates in the country. African-Americans are more likely to be diagnosed with asthma; in 2004, the national prevalence rate in blacks of both sexes and all ages was 24 percent higher than that for whites, said Mike Tringale of the Asthma and Allergy Foundation of America.

Triggers for asthma include ground-level ozone or smog, a particular problem in traffic-clogged Atlanta until winter starts, he said. "There's also industrial carpeting, which gives off gases, cleaning chemicals, pesticides --- the triggers are everywhere," Tringale said.

Edelman said parents' lack of knowledge about asthma can cause afflicted children to fall behind in school and athletics. Parents who are aware of the risks can obtain medications, including inhalers, that can make their children feel better and function as normally as other kids, he said.

The poll found that:

• Only 48 percent of parents have alerted their child's teacher that their child has asthma.

• Only 42 percent have made sure their child's medicine is available at school.

• Only 27 percent talk to school administrators about their child's condition.

"There have been many studies that show increased risk of hospitalization for asthma in the fall," said Dr. Stanley Fineman of the Marietta office of the Atlanta Allergy & Asthma Clinic. "Asthma can rise with the rise of pollens and mold in the fall. Years ago I had a child [as a patient] whose teacher had brought in a rabbit as a pet for the class. The child had an attack, with itchy eyes, runny nose and coughing. Now a lot of schools don't allow furry pets in for that reason."

Asthma is highly treatable with a variety of inhalers, such as albuterol, Fineman said. In 2002, the Georgia Legislature passed a bill to allow asthmatic children to carry inhalers while in school. The legislation was inspired by the death of a Clayton County boy after an asthma attack.

School can be a trigger

Dr. Robert Geller, associate professor of pediatrics at Emory University School of Medicine, said children going to school for the first time are venturing into settings containing allergens such as vermin dander, dust mites and cockroaches.

And some asthmatic children who lead sedentary lives suddenly are expected to participate in physical education activities, which can trigger attacks.

"There are two things you can do," Geller said. "One is make sure the child has access to albuterol and knows how to use it. In some settings, that may mean the school nurse would do it. The child needs to be accessible to it."

Matt Cardoza, a spokesman for the Georgia Department of Education, said most schools have nurses to deal with asthma and other health problems.

At Sope Creek Elementary in Cobb County, Principal Karen Looft said the school's nurse works closely with parents of children who have asthma.

"She also works with teachers and the whole faculty to spot these problems," Looft said. "She finds out about asthma and allergies that parents know about, and when such things show up."

Albuterol, an inhaled drug, relaxes and opens air passages, and it almost instantly can make it easier to breathe. It's commonly prescribed to treat wheezing and shortness of breath. However, inhaling it improperly can cause jittery behavior, chest pains, headaches and seizures. Therefore, it's critical that parents make sure their youngsters know how to use their medication, Edelman said.

"Not taking basic steps, like having a fast-acting medication available at school in case of an asthma attack or communicating with the school about your child's asthma, could be setting the stage for an unmanageable medical crisis at school," Edelman said.

— This article is a reprint from The Atlanta Journal-Constitution.