摘要：Students who possess and self-administer their asthma medications can prevent or reduce the severity of asthma episodes. In many states, laws or policies allow students to possess and self-administer asthma medications at school. In the absence of a state or local law or policy allowing public school students to possess inhalers and selfmedicate to treat asthma, 3 federal statutes may require public schools to permit the carrying of such medications by students: the Individuals With Disabilities Education Act, Section 504 of the Rehabilitation Act of 1973, and Title II of the Americans with Disabilities Act. Local policies and procedures can be based on these federal laws to ensure that students with asthma can take their medicines as needed. MORE THAN 6 MILLION AMERICAN children aged younger than 18 years have asthma, making it one of the most common chronic diseases among children. 1 In 2001, more than 4 million children younger than 18 years had an asthma episode in the previous year (a rate of 57/1000), suggesting that many young people with asthma may not have their asthma under control. 1 As many as an estimated 1.4% of all American children experience some level of limitation owing to asthma, such as an inability (or limited ability) to engage in school or play activities. 2 Young people with asthma miss an estimated 14 million days of school each year because of the disease, 3 and some children’s school performance consequently suffers. 4 Provided parents or guardians and a health care provider, preferably with input from the child’s school and especially the school nurse, deem it appropriate for a student to self-medicate and have granted authorization, it is beneficial to students with asthma to have unobstructed access to their medication before, during, and after school. 5, 6 Students who self-administer their asthma medications can prevent or reduce the severity of asthma episodes. 7 However, some schools perhaps as part of a drug use prevention program or in hopes of minimizing liability claims, do not allow students to carry their inhalers in school. 8, 9 In 2000, students were allowed to self-medicate with prescription inhalers in 68% of all schools nationwide (79% of middle/junior and senior high schools). 10 Restrictions on students carrying their inhalers may preclude the immediate use of medication at the onset of symptoms. For example, the room in which the medication is kept may be too far from the student’s classroom or playing field, some students may believe it is too disruptive to go to another part of the school building to take their medication, 11 and many students are embarrassed about needing to take medications. 12 Restrictions on the use of inhalers may ultimately compromise medication adherence, increase the risk of a full-blown asthma episode, and cause unnecessary suffering, emergency treatment, and asthma-related school absences. 2, 8, 13 In 2000, approximately 223 children aged 0 through 17 years died as a result of asthma (a rate of 0.3/100 000). 1 Furthermore, asthma results in substantial increased use of the health care system. In 2000, children aged 0 through 17 years had an estimated 4.6 million asthma-related outpatient visits to doctors’ offices and hospital outpatient departments (a rate of 649/10 000), approximately 728 000 asthma-related emergency department visits (a rate of 104/10 000), and approximately 21 000 asthma-related hospitalizations (a rate of 30/10 000). 1 Asthma-related missed school days among children aged 5 through 17 years resulted in an estimated cost of $726.1 million in caretakers’ time lost from work. 14 By knowing the rights of students with asthma, school administrators, educators, physicians, and other health care providers can help ensure that students have appropriate access to medications. This article explores state laws and policies that allow students to carry and self-administer asthma inhalers in school and federal statutes that may, under certain circumstances, require schools to allow students to do so.
