Mold, Asthma, and School Attendance

Environmental awareness can prove cost effective for school districts. Take San Antonio, Texas' North East Independent School District, for instance. Faced with state education funding cuts in 2005, Superintendent Richard Middleton set out to maximize revenue. He looked at the attendance rate. Increased attendance rate means increased money for the district. Middleton knew that if he could increase the number of kids coming to school every day by just 1 percent, NEISD would get an additional $3.4 million in funding.

What caused kids to miss two to three weeks (or more) of school each year? Asthma. What is one of asthma's contributing factors? Exposure to toxic mold. (A 2004 study conducted by an Institute of Medicine expert panel concluded that an association exists between damp buildings and upper respiratory tract symptoms, wheeze, cough, and exacerbation of chronic lung diseases such as asthma.)

In 2002, mold was discovered in three of NEISD’s elementary schools. The cause: a combination of flawed construction, contractor error and failure of maintenance to notice. “It became clear to me that the construction management and maintenance departments did not share the common goal of understanding environmental health,” recalls Middleton.

Ironically, the mold discovery was the first of three events Middleton calls “a positive perfect storm” toward NEISD’s wellness overhaul. From there, Middleton created a new Department of Environmental Health to oversee air quality issues and advocate and maintain a healthy environment for staff and students. He promoted Ron Clary, his first-in-command custodian, to executive director for facilities and maintenance to run that department. Says Middleton, “We then had departmental leadership that equally understood both their role and responsibility in building health.”

Clary’s department conducts classroom evaluations, removes mold on ceilings and handles teacher concerns regarding more absenteeism or respiratory-related issues among students. In 2008, the district was honored by the federal Environmental Protection Agency for implementing successful indoor air quality programs.

In 2006, Rhodes approached Middleton about state and nationwide data showing how asthma affects school attendance and shared ideas for how to combat the district’s condition. Middleton hired her that year as the district’s director of asthma education for the new department.

Under Rhodes’ guidance, communitywide “Asthma Blow-Outs” would inform parents and students about asthma and fostering wellness at home. School nurses, physical education teachers and asthma professionals ran those evening information sessions.

The effect of the Middleton-Clary-Rhodes trifecta of asthma prevention has been staggering. According to Rhodes, in early fall 2006, the number of inhalers used districtwide due to asthma during the first six weeks of school was more than 9,000. After implementing education outreach and classroom strategies, in early fall 2007 inhaler use dropped to 4,500.

Surprisingly, these changes and improvements haven’t increased NEISD’s overall budget. “We’re the ninth-largest district in the state,” Middleton says, “and of 100 districts in Texas, 97 spend more than we do on maintenance and custodial costs, yet we’re achieving excellent results.” In addition, Middleton says the district’s attendance-based revenue from the state has significantly increased.

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