Why paediatricians should advocate for stock inhalers in schools

The UK passed a law in 2017 allowing an unnamed Epipen to be kept at school for anaphylactic emergencies.  Now, they are also advocating for asthma reliever inhalers to be kept at schools in case of emergencies, for children who do not have a pump at school. South Africa has some way to go in “catching up” with such laws, for which we should be advocating (please note: albuterol in the USA is equivalent to salbutamol in SA).

50 states in the United States permit children with asthma to self-carry personal inhalers if they have been prescribed one by a physician.  However, few children – approximately 14% – have access to emergency inhalers.  Every child could have access when needed if albuterol were allowed to be stocked at schools. This problem affects all children: rich or poor, private-schooled or public-schooled, urban or rural.

In an article published online in the journal Pediatrics Perspective (June 2019), Dr. Lynn Gerald, professor of health promotion sciences at the University of Arizona Mel & Enid Zuckerman College of Public Health, and associate director for clinical research with UA Asthma & Airway Disease Research Center, and her colleague Dr. Andrea Pappalardo in the Division of Pediatric Allergy-Immunology at the University of Illinois Health, urge paediatricians to advocate for stock inhaler policies in schools.

Schools can purchase a single inhaler containing albuterol to administer to anyone who experiences the sudden onset of cough, shortness of breath, and chest tightness that signals an asthma attack.

Each of the states that have adopted stock albuterol policies did so by amending their stock epinephrine laws to include albuterol. Currently, stock albuterol legislation exists in 12 states: Arizona, Georgia, Illinois, Indiana, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, New York, Ohio, and West Virginia. This strategy was employed because amending an active policy or legislation is often easier than creating a new legislation.

Stock albuterol legislation allows schools to have access to rescue asthma medications that can be available to all students who may be experiencing an acute asthma exacerbation. The authors strongly urge colleagues to undertake such actions in other states to ensure such policies are universal.

If you have a child with asthma or anaphylaxis in a school in South Africa, we welcome you to share your experiences?  Or if you wish to help with advocacy of this law – please contact info@allergyfoundation.co.za