Screening for Exercise-induced Asthma

A Free-Running Asthma Screening Test (FRAST) with peak expiratory flow rate measures provides a simple, objective strategy for identification of students with, or at risk of, exercise-induced asthma (EIA) .

College of nursing faculty, nursing students and a school nurse piloted the screening process with 437 students, ages 10-13, in three rural Alabama schools. History of asthma and use of medications was assessed by student inquiry and checking school health records. Students engaged in a four-minute free run, in or outdoors (depending on weather). Peak expiratory flow rate (PEFR) was measured three times, both prior to and immediately after the run, with a simple peak flow meter. The criterion for suspected EIA was a 15% or greater decrease in personal best post-exercise PEFR.

The project identified 25 (6%) students with EIA from the original 437 tested. This is consistent with the national average of 5-10%. Of the 25, only ten had a history of asthma according to the school nurse. This screening demonstrated cost-effective identification of students who had not previously been evaluated for EIA; these students also had higher than average school absences.

(Heaman, D., et al., J Schl Health 1997; 67: 83-88)

COMMENT: The nursing faculty demonstrated a simple measure that could be replicated in other schools. Identification of students with EIA should lead to an individual asthma management plan (if not already in place) which may include medication prior to exercise and/or adapted physical education. - J.O.