Back to school (BTS) asthma is associated with a tripling in the rate of GP appointments across England with the increase in health service appointments particularly marked in boys.

The study published in the Journal of Epidemiology & Community Health aimed to describe the timing and magnitude of BTS asthma using surveillance data from different health services in England.

Asthma morbidity data from emergency department attendances and GP consultations between April 2012 and December 2016 were used from national syndromic surveillance systems in England. Age-specific and sex-specific rates and time series of asthma peaks relative to school term dates were described.

BTS asthma among children aged below 15 years was most pronounced at the start of the school year in September. This effect was not present among those aged 15 years and above. After controlling for sex and study year, the adjusted daily rate of childhood GP in-hours asthma consultations was 2.5–3 times higher in the BTS excess period, with a significantly higher effect among children aged 0–4 years. A distinct age-specific pattern of sex differences in asthma presentations was present, with a higher burden among males in children and among females aged over 15 years.

The researchers said there could be many reasons for the "back to school" effect and most likely involves seasonal viruses and environmental factors and a greater understanding of these elements will help design future public health approaches."

Parents should identify potential triggers for asthma

Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: "Asthma is an extremely distressing condition affecting one in 11 children, but in the majority of cases can be well-managed by parents with the support of GPs and our teams who are highly trained to identify symptoms, prescribe appropriately and monitor treatment to help patients of all ages.

"Part of keeping symptoms under control and preventing asthma attacks can be identifying and avoiding potential ‘triggers’ such as cigarette smoke, pets or alcohol. But other triggers like pollen, pollution, and very cold or very hot weather are much harder, if not impossible, to control."

Some children find the start of the new school term an anxious time which could set off an attack in some vulnerable individuals, and there are clearly other factors at work that are not yet fully understood. Therefore, it is crucial that schools are aware of the pupils who have asthma, and that there are adequate steps in place to support them including knowing when it is appropriate to summon additional medical assistance.

Stokes-Lampard added: "When a child has asthma, it is important to follow the treatment plan agreed with medical professionals and never ignore symptoms if there are changes or the asthma is getting worse. Keep an eye on your child’s weight, help them stay active, and ensure they carry their inhaler with them at all times.

"While attacks can never be completely predicted or prevented, making sure that the action plan is up-to-date is one of the best ways to reduce the risk.

"If there’s anything non-urgent about your child’s asthma that’s worrying you, this can be discussed at your child’s next routine GP appointment where any changes can be made to medication or the treatment plan and inhaler technique can be reviewed."