School absence and treatment in school children with respiratory symptoms in The Netherlands: data from the Child Health Monitoring System.

STUDY OBJECTIVE To assess the prevalence of respiratory problems, and the relation of these problems with school attendance, medicine use, and medical treatment. DESIGN The Child Health Monitoring System. SETTING Nineteen public health services across the Netherlands. PARTICIPANTS 5186 school children aged 4-15 years, who were eligible for a routine health assessment in the 1991/1992 school year. MAIN RESULTS Respiratory symptoms were present in 12% of the children. Recent symptoms suggestive of asthma (wheezing or episodes of shortness of breath with wheezing in the past 12 months, or chronic cough, or a combination of these) were reported for 8%. These symptoms were most frequent in the younger children, and in children at school in towns with less than 20,000 inhabitants. Of the children with recent symptoms suggestive of asthma, 37% reported school absence for at least one week during the past 12 months, compared with 16% in children without respiratory symptoms. School absence because of respiratory illness was reported for 22%, and medicine use for respiratory problems for 38% of the children with recent symptoms suggestive of asthma. Of these children, 21% were receiving medical treatment, compared with 15% of the asymptomatic children. CONCLUSIONS Respiratory symptoms are a common health problem in children, and they are an important cause of school absence and medicine use. However, the percentage of children receiving medical treatment seemed quite low, indicating that proper diagnosis and treatment are probably still a problem.