School Asthma Research Articles

Asthma management efficacy of school nurses in Taiwan

As the key health care providers in school settings, the school nurses’ asthma management efficacy is crucial to children's health and their continued participation in school learning activities. This article describes the psychometric testing of the asthma management efficacy scale (AMES) for use with school nurses. A cross-sectional survey design was used to assess the asthma management efficacy of 60 school nurses in Taipei, Taiwan. Factor analysis resulted in four factor domains including asthma medication administration, asthma pattern identification, school management behaviour, and monitoring peak expiratory flow rate which explained 76.4% of the variance in school nurses’ asthma management efficacy. The school nurses’ experience in performing school asthma management activities was positively correlated to their asthma management efficacy ( r=0.33, p<0.05). School nurses who had experience with the inhaled asthma medicines had significantly higher efficacy scores on the medication administration subscale ( t=−2.89, p<0.01) than did the school nurses who lacked this experience. School nurses who had experience in using peak expiratory flow meters had significantly higher efficacy scores on the total AMES ( t=−1.90, p<0.05) and on the monitoring peak expiratory flow rate subscale ( t=−5.37, p<0.001) than the school nurses who lacked this experience. Given the need to have nurses who are well prepared to provide asthma care in school settings, implications for nursing education, practice, and further research are discussed.

Schoolboys with Bronchial Asthma in Al-Khobar City, Saudi Arabia: Are They at Increased Risk of School Absenteeism?

The objective of this cross-sectional study was to determine the mean period of school absenteeism (MPSA) among asthmatic Saudi schoolboys of Al-Khobar City and to determine the factors associated with the absenteeism. The methodology included the distribution of a self-administered questionnaire, which was completed by the parents of 1482 schoolboys who satisfied the selection criteria of the study. The prevalence rate of questionnaire-diagnosed asthma (QDA) was 9.5% (141/1482). The MPSA among questionnaire-diagnosed asthmatic boys (QDAs) was 13.6 ± 3.4 days compared to 3.7 ± 2.2 days among non questionnaire-diagnosed asthmatic boys (non QDAs). Among QDAs, the MPSA was associated significantly and positively with those who were younger, and with decreasing levels of socioeconomic class, histories of pets at home, presence of a currently smoking family member (father or both parents), visit to a hospital emergency room, and admission to hospital. It was significantly and negatively associated with concomitant use of prophylactic medication(s), including those used appropriately. The QDAs from middle and lower socioeconomic classes showed less use of prophylactic medication(s) but more histories of visits to an emergency room and of admissions to hospital. The multiple linear regression equation for the total period of school absenteeism (TPSA) during the 1995 academic year was generated. Asthmatic school children have a higher MPSA compared to their non asthmatic classmates. The risk of suffering the impacts of this disease is shown to be particularly increased among QDAs belonging to less socioeconomically advantaged families.

A school-based asthma intervention program in the Buffalo, New York, schools.

This project investigated the feasibility and effectiveness of a school asthma program in reducing asthma exacerbations among school children. In 1997-1998, two schools were selected for a case control pilot study. The intervention required that students with asthma, who needed medication daily at school, must present a written plan from the health care provider. Students with asthma were identified through parent/guardian or school reports. The pilot program was expanded into five schools in 1998-1999. All schools kept records of rescue treatments for asthma episodes. The pilot intervention resulted in an 80% decrease in rescue treatments from 1996-1997 to 1997-1998. In the additional five schools, an overall decrease of 17% occurred in rescue treatments during 1998-2000. Overall, 65% of physicians provided requested Asthma Care Plans (ACP). In two schools, the number of asthma care plans that required anti-inflammatory medications tripled. Preliminary results indicate this school asthma program proved feasible and effective in reducing the frequency of asthma exacerbations at school.

Environmental Allergens and Irritants in Schools: A Focus on Asthma

As part of the Partners in School Asthma Management Program, environmental data were collected from 385 rooms in 60 elementary schools in southeast Texas, using an Environmental Observation Checklist and a Q-TRAK Indoor Air Quality Monitor. Dust samples for allergen analysis were collected from floors, carpets, and area rugs in 80 classrooms in a subset of 20 schools. CO2 levels > 1,000 ppm were found in 86% of rooms; 69% had indoor humidity above recommended levels. Der p I dust mite allergen levels > 2,000 ng/g were present in 20% of rooms, but only 2.5% of rooms had Der f I mite allergen levels exceeding recommended tolerances. Detectable levels of cockroach allergen (Bla g II) were found in all schools (median 5.5 ng/g), with 10% of rooms over the recommended threshold. Almost two-thirds of classrooms had mold spore counts > 10,000 col/g (median, 14,400 col/g; range, 2,000-52,000 col/g).

Asthma knowledge and management in primary schools in south Essex, UK

This study was designed to establish the levels of knowledge about the management of asthma among primary school teachers in South Essex. A total of 135 primary schools participated in a questionnaire survey, with data analysis being carried out on responses from 517 teaching staff. Findings showed that 47 per cent of respondents reported concern about dealing with a child suffering from asthma. Only 16.1 per cent felt confident in dealing with a child suffering from a severe asthma attack. Less than a third of respondents (29.6 per cent) had received training in the management of asthma. These results reflect the requirement to put new emphasis on greater collaborative and partnership working between the NHS and local education authorities to provide appropriate opportunities to meet this need. Increasing teachers’ knowledge and access to resources should result in improved care of children with asthma in schools.

Asthma, wheeze and cough in 7‐ to 9‐year‐old British schoolchildren

ABSTRACTBackground Report on the characteristics of a cohort of children, aged 7–9 years, attending schools in the south of England and participating in a controlled intervention study to improve the care and knowledge of asthma in junior and primary schools and highlight problems for potential intervention.Methods A survey employing the International Study of Asthma and Allergies in Childhood (ISAAC) asthma questionnaire was undertaken to record the prevalence of asthma and the characteristics of children with asthma and wheeze in Year 3 and 4 pupils (age 7–9 years) in 25 schools, and to define disease severity and its management.Results Responses on 1732 children were received. Reports of asthma and wheeze in this study were similar to those in recent ISAAC studies. The frequency and severity of symptoms was associated with appropriate therapeutic intervention suggesting adherence to published British Thoracic Society (BTS) guidelines. However, 80% of children with asthma at any BTS level of treatment reported exercise‐induced wheeze, indicating a need for education on pre‐exercise inhaler use. One in 20 children who had wheezed in the past 12 months reported a symptom profile suggestive of unrecognised asthma. Significant associations were found between maternal smoking and both wheeze in the last 12 months [odds ratio (OR), 1.35; confidence interval (CI): 1.01–1.81, p &lt; 0.05] and nocturnal cough [OR, 1.70; CI: 1.31–2.20, p &lt; 0.001].Conclusions The characteristics of this sample are similar to those found for children of a similar age group in other studies. Therapeutic intervention is appropriate for the severity of disease but there are high levels of exercise‐induced wheeze despite adequate control of other symptoms. Five percent of children who reported wheezing in the previous 12 months had a symptom profile of untreated asthma. Maternal cigarette smoking was associated with wheeze and cough.Implications for practic Recurrent untreated wheeze remains a problem for 5% of children reporting wheeze. A therapeutic hole has been identified – there is a need for further education on pre exercise inhaler use. Both these problems could be addressed by a school‐based asthma management strategy. Maternal smoking and its effects on childhood asthma and wheeze need to be addressed.

Managing asthma within the context of the rural family.

The purpose of this qualitative study was to describe the experiences of rural families caring for children with asthma. The chief caregivers from six rural families were interviewed about the family's daily experiences in living with asthma, their knowledge of asthma triggers, and strategies for managing asthma. Parental knowledge about asthma and asthma management strategies was quite good. The cost of asthma regimens and school policies about medications were major barriers to better control. Other management strategies were directed at maintaining normality of family life.

Bilan des mercredis de l’asthme

Therapeutic education is becoming essential in the management of asthmatic children. The objective of this type of education is to modify in a durable manner the knowledge and behaviour of parents so as to decrease the morbidity of the disease. Objectives. – To describe the population of patients whose parents attend the asthma school at Necker–Enfants-Malades Hospital and to evaluate the impact of this educational activity. Methods. – We included the 54 children whose parents attended the asthma school from September 27th to December 31st, 2000. Two educational sessions were offered. Socio-demographic and medical data were collected and markers of this educational activity were assessed by means of three questionnaires. The parents first answered questions immediately after the educational session. The second questionnaire was completed 3 to 6 months later. Results. – The mean age of the patients was 8 years and 3 months. The patients were of French origin, living in traditional family structures in the Île-de France region. All had symptomatic asthma, affecting their quality of life and requiring active treatment. During the immediate evaluation, the knowledge and behaviour of the parents were judged to be correct. Some parents changed attitudes or behaviour later, particularly with respect to the means of managing asthma episodes or their beliefs concerning possible secondary effects of the treatment or the origins of the childˈs asthma. The follow-up period was too short, and the sample too small to draw any firm conclusions on the impact of this educational action on morbidity. Conclusion. – The structured educational action is effective. It should be adapted to patients and reinforced later because its effects may be transient.

Healthy Environment, Healthy Children, and Healthy Future: You Take My Breath Away

Having introduced this three part series on children's health and the environment in my previous column (EGJ 13, December 2000), this issue will focus on the air we breathe and the impact of environmental agents on the respiratory illnesses of children. My next and final column in this series will focus on environmental hazards, such as pesticides, and the danger they present to children, along with recent efforts to introduce organic agricultural programs in an urban setting, with an emphasis on the educational opportunities these programs present to elementary schools in some of our largest cities. The more we study, the more we find that we don't understand. This is certainly the case with respiratory diseases, such as asthma, and allergies, which afflict a growing number of individuals in developed as well as developing countries around the world. The list of references included at the end of this column is only the tip of the iceberg, but indicative of the significant research investment that has been made in search of a cure for asthma and allergies over the past 50 years. Yet, many of the questions about allergies remain unanswered. What causes allergies? Why are they more common than ever? Will a cure ever be found? Grand claims to have found the answers to these problems are frequently oversimplifications based on unsubstantiated generalizations. The complexity of these diseases makes finding a cure one of the most daunting tasks facing the medical profession as we step into the 21st century. Asthma alone is influenced by the following factors: age, gender, genetics, pollution, allergies, economics, race, house dust mites, ozone, anxiety, life style, stress, cockroaches, temperature, moisture, smoking, obesity, physical activity, cats, dogs, acid reflux, viral infections, emotions, and pollen. Any suggestion that by addressing only one or two of these factors asthma relief will be forthcoming reflects little understanding and appreciation of reality. Asthma is the most severe and widespread respiratory disease afflicting today's children. It is becoming more common and it is the leading cause of school absenteeism. Therefore, asthma will be the focus of our discussion and serve to represent environmentally induced respiratory or allergenic maladies that are especially problematic for children. The scope of the problem has grown to alarming proportions, for reasons that are not well understood (Table 1). While a single definition of asthma, applicable to all cases, is not available, let us use the following description. Asthma is characterized by an intermittent, reversible airway obstruction, occurring as a result of chronic airway inflammation and hyper responsiveness to a variety of stimuli (Etzel & Balk, 1999). Representative information sources from the news media, scholarly research literature, popular medical books, and Web sites will be examined to shed some light on this growing medical problem. Making the News Mark Henle (2001)of the Arizona Republic newspaper recently ran a series of street wise articles on the daily struggles faced by asthmatic school children and farm workers in southern Arizona. The interplay and drama of feeding your family and finding affordable medical treatment for asthma between U.S. and Mexican doctors is not something you see in the peer reviewed medical literature. He described long rides to the fields in smoke-filled buses and how school children from the poorer side of town negotiate daily with siblings and school nurses for hits from their inhalers. For some, the cultural and economic traditions of many generations have locked them into a cycle of asthma attacks, a cycle that won't be broken with a simple trip to a primary care physician or a drug store. The escalating rates of asthma and the most severe cases are more likely to be found among the poor. Confusion, illiteracy, and lack of health insurance trap many children into a life of wheezing and gasping for air when 98% of these symptoms could be controlled with proper medications, education, and life style adjustments. …

Comparación de dos modelos de educación para pacientes asmáticos

The education programs have demonstrated to be an important point in the management of asthmatic patients. The aim of the present study was to assess if an intensive group asthma education program was able to improve a simplified and individual asthma education program, both with a self-management plan included. A prospective randomised controlled trial was conducted over 12 months and 73 moderate-severe asthmatic patients were included. Patients were randomly assigned to control or study group. Patients in control group received individual and simplified education with a self-management plan and patients in study group attended an <<asthma school>> in small groups where they received a three hours education program in three weeks.The outcome measures were: number of hospital admissions, observation unit admissions, emergency visits and unscheduled general practice consultations. Knowledge, adherence to treatment, ability with inhaler devices, airway function, environmental control measures and quality of life. They were assessed at the beginning and the end of the study. At the end of the study period the outcome of morbidity had improved in both groups but the number of observation unit admissions (p = 0.028) and unscheduled general practice consultations (p = 0.022) was substantially lower in study group. This group also demonstrated improvement in environmental control measures and better inhaler technique and knowledge (p = 0.007). In adherence, lung function or quality of life there were no differences between groups. In patients with asthma better results can be obtained with an intensive group asthma education program than with the individual and simplified program.

Personal exposures of children to nitrogen dioxide relative to concentrations in outdoor air

OBJECTIVESTo investigate the relation between fluctuations in personal exposure to nitrogen dioxide (NO2) in school children and changes in outdoor NO2 concentrations.METHODS114 Asthmatic school children aged 7–12 years were recruited...

Smoking status, disease duration, and educational level in females, are related to asthma school participation.

Limited data is available on those who do not want to attend an asthma school. Two hundred and forty-five asthmatics aged 18-65 yrs with an FEV1 >50% predicted who had been seen at our outpatient asthma clinic within the last 3 yrs were invited to participate in an asthma school. The patients were contacted by phone by a nurse, offered a 2 day asthma school without personal costs. Altogether 78% of those contacted answered positively. In a logistic regression analysis including sex, age, smoking status, educational level, asthma duration and own opinion of the disease, the-adjusted odds ratio (OR) for nonsmokers wanting to participate versus smokers was 4.0 (95% confidence interval (CI): 1.8-8.3). The corresponding figure for patients with a recent asthma attack was 3.4 (95% CI: 1.5-7.6) compared to those without. For every 10 yr duration of disease the OR for wanting to take part in the asthma school increased by 1.6 (95% CI: 1.0-2.3). When analysing males and females separately, highly educated females were less willing to take part, while an opposite tendency was present in males. In conclusion those interested in taking part in an asthma school were characterized by highly motivated nonsmokers with long duration of disease and with a recent asthma attack, and not being highly educated females.

Teaching asthma management: an evidence-based educational approach.

Asthma management plans and asthma education have been incorporated into recent guidelines, and implementation of these reduces asthma morbidity. Junior doctors are frequently involved in asthma management, but teaching about asthma in medical school is seldom assessed. We studied asthma knowledge, confidence in practical asthma management, and the effectiveness of an interactive asthma education workshop in final year medical students. Thirty-five students attended the workshop, with 26 returning questionnaires on both of the two sessions. Students attended a two hour asthma workshop comprising interactive teaching sessions on management of acute and stable asthma, and a practical session using asthma devices. Theoretical knowledge was assessed by a 20 item questionnaire, completed immediately prior to the workshop and after two weeks, at a feedback session. Practical knowledge was assessed by confidence scores in use of asthma devices on a five point scale (not at all confident to very confident), before, immediately after the workshop, and after two weeks. Students scored poorly in questions on: predictors of asthma mortality, nebuliser and Turbuhaler use, asthma management plans, and physical signs in acute asthma. Mean (SE) knowledge score increased significantly from 64.4% (6.1) to 74.2% (5.6) (p<0.05; paired t-test) at two weeks. Confidence scores rose significantly for all practical aspects of asthma management (p<0.01; Wilcoxon matched pairs test), and declined at two weeks, but still remained significantly higher than at baseline (p<0.05). Medical students had poor knowledge about several important features of asthma care. The asthma workshop was effective in increasing knowledge and confidence in management of asthma in the short term, and could be useful in optimising implementation of asthma guidelines in clinical practice and potentially later in training of junior medical officers.

Validation of the Brief Pediatric Asthma Screen

The purpose of this study was to confirm the validity of a brief screen for pediatric asthma in schools. Asthma is the most common chronic disease of childhood, yet the frequency with which this condition is recognized among school-aged children varies widely. Several methods are used to increase the accuracy of detection of asthma, but many are cumbersome and difficult to apply on a large scale. We elected to validate a five-question instrument, the Brief Pediatric Asthma Screen (BPAS), to screen for the presence of asthma among children attending school in Region 5 of the Chicago school district, where the schools report a 2.7% frequency of asthma. The questionnaire was distributed to the parents of grade-school children at the time of report-card pick-up. A clinical assessment was performed on a selected group of children whose parents completed the questionnaire in a school and in a hospital outpatient clinic. Of 4,147 questionnaires that we distributed, 1,796 (43%) were returned. We excluded 341 children (19% of the total sample) whose parents reported that they had been diagnosed with asthma. The remaining pool indicated that the children of 183 responders (10%) had symptoms suggestive of asthma, while 1,272 parents (71%) indicated that their children did not have symptoms of asthma. We selected 90 of the respondents who did not indicate that their children had a diagnosis of asthma. Of this group, 81 completed the validation, in which their responses suggested symptoms of asthma (n = 34) or no asthma symptoms (n = 47). The children of these respondents were given a blinded clinical evaluation consisting of history, physical examination, and spirometry. The survey demonstrated a sensitivity of 75% and a specificity of 81.2% for the presence of asthma among those who were unaware of the diagnosis. The BPAS is brief, can be filled out by parents, and appears accurate in detecting asthma.

SYNCOPE - CROSS-COUNTRY RUNNER

2034 HISTORY: A 19 year-old Ball State cross-country runner presented to the clinic with an "episode" while running in practice. While running, she began having difficulty breathing. As her run progressed, she began feeling dizzy, and experienced numbness into both hands. Eventually she fell down, though she denied losing consciousness and had full recollection of the event. She denied incontinence or convulsions. This type of episode had occurred once previously during the summer, on an unusually hot day. She had also had similar episodes in high school while walking in the hallway. A holter monitor done at that time was negative. The patient denied further work-up. PHYSICAL EXAMINATION: Slender white female in no distress, fully oriented. Temperature was 100.6 degrees. Blood pressure 90/50, without orthostasis. Respirations 18 and non-labored. HEENT was normal. Breath sounds clear to auscultation bilaterally. Cardiac exam was normal. Pulses were normal. Peak flow averaged 290 over three successive attempts. Neurological exam was normal PAST MEDICAL HISTORY: Exercise-induced asthma in high school, currently off all medications at her physician's advice. History of mild iron-deficiency anemia. History of thyroiditis without residual symptoms. Medications: None. Medical allergies: None. Social history: Negative. Family history: Negative. Review of systems: Negative. Exercise-induced asthma Neurocardiogenic presyncope Cardiogenic presyncope Anemia Atypical seizure activity/neurogenic causes of syncope Hypothyroidism DIAGNOSTIC STUDIES: Exercise treadmill testing revealed a 10% drop in average peak flow after a 30 minute exercise challenge, without significant symptoms. EKG: RSR prime pattern, non-specific ST-T wave abnormalities. A CBC: hemoglobin - 13.1, hematocrit - 39.1% (normal). TSH - normal. FOLLOW-UP: Albuterol therapy was reinstituted. The patient followed up the next week after having another episode, this time syncopal in nature. On further questioning, she admitted to a more extensive work-up while in high school, including echocardiogram, which showed mild tricuspid regurgitation without chamber enlargement, a normal exercise stress test, and a normal sleep-deprived EEG. EKG done at that time showed no interval change from the one done after presentation to our clinic. DIAGNOSTIC STUDIES: Table tilt test was positive with isoproterenol-induced syncope. FINAL/WORKING DIAGNOSIS: Neurocardiogenic syncope confounded by mild exercise-induced asthma. TREATMENT: The patient was referred to cardiology for opinion regarding medication options. Recommendation was to treat with low dose Atenolol and slowly titrate up as needed, while monitoring the patient's airway reactivity. The patient is currently maintained on 25mg Atenolol daily, and is tolerating the medication well. She has not had recurrence of presyncopal, syncopal or pulmonary symptoms. She continues to run after two months of follow-up.

Evaluation of a nurse-run asthma school

Important aims of the study were to investigate whether an educational program (the `Asthma School') directed by a nurse led to improved knowledge of the disease, to improved self-medication and self-management and to improved, self-rated, functional status. A total of 32 patients (6 males, 26 females, mean age 43 years) was included. The following methods were used to collect the data before and one year after the Asthma School was completed; two study-specific questionnaires for collecting demographic data and measuring different aspects of the patients' knowledge of the disease and its treatment, monthly diary cards, lung-function tests (FEV 1) and the Sickness Impact Profile (SIP) questionnaire. The main results of the study were an improved knowledge of the disease and its treatment, better self-management, i.e. more frequent use of the peak expiratory flow meter (PEF-meter) and use of inhaled bronchodilators on an as-required basis, fewer patients on sick-leave and a better, self-rated, physical health status. However, in spite of these encouraging results, the lungfunction was found to be unaffected, no pronounced changes in the use of asthma drugs could be found and the patients' need for medical care remained the same.

National school teachers' knowledge of asthma and its management.

Asthma is the most common chronic medical condition that school teachers may encounter among their pupils. However management of asthma in schools and the role school teachers adopt in this condition has only recently been explored. The aim of this study was to determine teachers' knowledge of asthma and its management. A postal questionnaire was circulated to 199 school teachers from 46 schools in Dublin City. A 74 per cent response rate was obtained. The number of children with asthma as identified by teachers was 7.8 per cent which suggests that asthma may be unrecognised in a number of pupils. Knowledge on signs and symptoms of asthma, provoking factors of asthma and the nature of the disease was generally satisfactory. However, knowledge on asthma medications, the purpose of inhalers and teachers' understanding of the treatment and management of asthma was considered poor. Knowledge on exercise-induced asthma was limited. There is a need to provide school teachers with education on asthma and its management. School policies on asthma also need to be developed with particular reference to action necessary in the event of an acute severe attack of asthma.

Screening for asthma in an inner-city elementary school in Minneapolis, Minnesota.

To the extent that the asthma morbidity so prevalent in children today is due to underdiagnosis or lack of appropriate treatment, schools are increasingly faced with the issue of defining their role in the care of children with asthma. This paper describes efforts to conduct schoolwide screening for asthma in an inner-city elementary school over the past two years. Screening methodology adopted for the project resulted in a simple and noninvasive approach for identifying children with current asthma in a school setting. While not as medically comprehensive as would be required to conclusively diagnose asthma, the simple screening approach proved efficient in identifying a population of elementary school children with a significant level of asthma morbidity. The paper discusses the effectiveness and feasibility of the screening efforts and proposes how such a screening program might be incorporated into the routine health activities undertaken at any elementary school.

Association of sensitization to Alternaria allergens with asthma among school-age children

Background: Molds in the Alternaria genus, normally found on outdoor vegetation, produce some of the most common fungal allergens to elicit a skin test response. Objectives: The objectives of this study were to evaluate a serum assay for IgE antibodies to Alternaria allergens and to establish the prevalence of sensitization to Alternaria allergens among children and adults enrolled in epidemiologic studies of asthma. In addition, the significance of sensitization to Alternaria allergens as a risk factor for asthma was compared with that of sensitization to indoor allergens or pollens. Methods: Using the Pharmacia Capsulated Hydrophobic Carrier Polymer (CAP) system, we have evaluated the significance of Alternaria allergens by using sera from several epidemiologic studies of asthma. Results: Comparisons between serum assays and skin test results suggest that this in vitro assay yields results similar to those for traditional RASTs and is as sensitive as skin prick testing. In each of the groups studied, sensitization to Alternaria allergens was more common among asthmatic than control subjects, and in two studies the relationship was highly significant. Alternaria allergens were significantly associated with asthma in middle schools in Charlottesville, Virginia and Los Alamos, New Mexico but not in Albemarle County, Virginia. Logistic regression analysis of the results for the three schools identified an association between sensitization to Alternaria allergens and asthma independent of, but not as strong as, that found between sensitization to indoor allergens and asthma ( p < 0.001). Conclusions: The Pharmacia CAP system is a useful tool for measuring specific IgE to Alternaria allergens. Although not as important as sensitization to dominant local indoor allergens, sensitization to Alternaria allergens appears to be a significant independent risk factor for asthma in children in some locations of the United States.(J Allergy Clin Immunol 1998;101:626-32.)

Blood Eosinophilia and Degree of Sensitization to House Dust Mites in Preschool and School Children with Asthma

In allergic asthma, there is convincing evidence that changes in eosinophil and lymphocyte state of activation in blood may reflect disease activity. We evaluated whether simple blood eosinophil or lymphocyte counts in atopic children with asthma could reflect the degree of allergic sensitization. Seventy-six asthmatic children, sensitized to house dust mites (HDM), in stable conditions at the time of the study, and 53 sex- and age-matched controls (CTR) were studied.As compared to CTR, allergic patients showed higher eosinophil numbers and percentages (p < 0.001) but similar lymphocyte numbers and proportions (p > 0.1). Both in CTR and in allergic patients, eosinophil counts did not correlate with lymphocyte counts (p > 0.05; each comparison) but positive correlations were observed between eosinophil numbers and percentages and paper radio immunosorbent test (PRIST) levels or radio-allergo sorbent test (RAST) classes (p < 0.001; each comparison). When allergic asthmatic individuals were subdivided according to their age into two subgroups (Gr), no differences were found in eosinophil and lymphocyte counts and in PRIST levels and RAST values between Gr1 (> 5 years old [preschool children]) and Gr2 (>5 years old [school children]) (p > 0.05; each comparison). Interestingly, although positive correlations between eosinophil counts and PRIST levels were found in both subgroups (p < 0.05; each comparison), only in Gr2 did eosinophil counts correlate positively with RAST classes (p < 0.001). No correlations between lymphocyte counts and PRIST levels or RAST classes were demonstrated (p > 0.05; each comparison). These data suggest that although blood eosinophilia was similar in preschool and in allergic asthmatic school children sensitized to HDM, only in the oldest children did blood eosinophil counts appear to be related to the degree of HDM-specific sensitization.