[Detection of exercise-induced bronchospasm in sixth-grade students: impact of health education]

Underdiagnosis of asthma is frequent in children and may be improved by the development of school-based health programs.

We developed an educational program in 11-year-old schoolchildren who participated in a screening test for exercise-induced asthma (EIA). All children were given an asthma questionnaire before and after two educational sessions.

Mean score for asthma knowledge quiz increased from 63 to 85% (p < 0.001). Thirty-six children (3.7%) were initially considered as asthmatic and showed better responses than non-asthmatic children. Peak expiratory flow (PEF) was measured before and after an outside running exercise. A fall in PEF of at least 15% was considered an abnormal result. Seventy-height children (8%) had a decrease in PEF, including 65 children initially not recognized as asthmatic. For these latter, a medical evaluation was recommended to parents. Only 28 of these children gave informations on follow-up: 19 had lung function tests, two received a treatment without preliminary function test, and seven had neither lung function test nor treatment. Among the children who realized lung function tests, five had criteria for airway obstruction at baseline, and ten had significant bronchial hyperreactivity.

However, a new screening test revealed that only a small minority of children initially not recognized as asthmatic but having decreased their PEF, were consequently considered as asthmatic by their practitioner, even in case of positive lung function test.