School absence--a valid morbidity marker for asthma?

Objective: To determine how often children with asthma are absent from school compared to the 'average' child and to assess the validity of school absence as a marker of morbidity for asthma.

Design: Case control study.

Setting: Children registered with 12 general practices, attending 98 primary and secondary schools in the Tayside region.

Subjects: 773 children with asthma or related symptoms and 773 controls from school registers.

Main Outcome Measures: Episodes of school absence and days absent per term, recorded from school registers.

Results: Comparing children taking asthma medication against their controls showed a significant difference for both days absent and episodes of absence. This increase in absence was approximately one school day each term. Severity of asthma was not related to increased school absence. Children receiving no asthma medication, but with asthma related symptoms, were absent no more than their age/sex matched controls. Applying a deprivation index to the cases on asthma medication, gave a significant difference in episodes of absence between Primary children classified as highly deprived and other Primary children.

Conclusion: The increase in school absence of around one day per term for children with asthma is less than previously reported and could be caused by clinic attendance rather than ill health due to asthma. Recorded absence varied according to deprivation index but not asthma severity. The use of school absence as a marker of morbidity in childhood asthma needs to be reassessed.