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Reviewed by the Faculty of Harvard Medical School

How Safe Is Your School?

By Leann M. Lesperance, M.D., Ph.D., and Henry H. Bernstein, D.O.

We work hard to keep our children safe. For example, we always buckle them into car seats, remind them to look both ways before crossing the street, and keep medicines and other poisons out of their reach. We even worry about their safety while they spend the day at school.

The terrible tragedy at Columbine in 1999 made school shootings a reality for many of us, prompting some schools to increase their efforts to prevent violence. Although this was important, schools actually were already doing a good job in this area. School shootings are extremely uncommon, with children between 12 and 18 years of age twice as likely to be victims of a serious (nonfatal) violent crime when they are away from school as when they are at school.

But safety in schools means more than security cameras and metal detectors to prevent violence. It also means thinking about other potential dangers to our students, such as:

Food allergies. The number of children noted to have severe food allergies has increased dramatically in recent years, affecting as many as 3% to 4% of school-aged children. If your child has this potentially life-threatening condition, it is important that you work with the school nurse to make sure teachers and other staff know how to keep your child safe during school, and also how to treat your child in case of a reaction.

It is most important that children with severe allergies not be exposed to the offending food(s). Special care must be taken to avoid accidental exposures, such as may happen with food shared during activities in any class. Each school should have a nurse or other properly trained personnel who can give emergency medicines when needed, while in the building and on school trips.

Indoor air quality. Indoor air pollution can be just as harmful as outdoor air pollution, triggering asthma attacks and causing other short- and long-term health problems, including cough, eye irritation, headaches and allergies. Indoor air pollution is a common problem, affecting old and new school buildings. For example, older buildings may have damaged asbestos tiles, other dangerous building materials, or leaking roofs which cause mold growth. Newer buildings are built "tight" to save energy, limiting the outdoor air that gets in for ventilation. In an effort to help schools prevent and solve indoor air problems, the national Environmental Protection Agency has put together an Indoor Air Quality toolkit. Check how your school is handling this issue.

Obesity. The number of children (and adults) who are overweight has increased steadily in recent years, with almost one out of every five kids in the United States now overweight. Since kids spend much of their day in school and eat their lunches there, schools play an important role in preventing this harmful condition.

Cafeteria meals must meet federal nutrition guidelines and usually are "healthy" overall. However, kids often don't eat everything that is offered as part of these balanced meals. Instead, they choose their own lunch from high-fat items such as burgers and fries. Talk with the cafeteria staff about replacing less-desirable items with more nutritious, lower-fat selections, such as turkey sandwiches, a well-stocked salad bar and fresh fruits.

Many schools raise money to buy textbooks and sports equipment by selling snacks and drinks in vending machines. Check to see what your school offers in these machines. Some districts have replaced soda and high fat foods with water, low-fat milk, juice, fruit, yogurt and other more nutritious snacks, and still are raising just as much money. Some of the major food manufacturers are pledging to improve their offerings for schools.

Facing budget cuts and pressure to teach for competency exams, many school districts have cut the amount of time students spend in physical education classes each week and some may have no gym class at all. Health-education classes also are being crowded out of what kids learn in favor of more academic subjects. But "health is academic," and the link between good health and academic success has been proven. Health classes also can help to prevent risky behaviors, such as bullying, substance abuse and early sexual activity. Get involved with your local school, working to keep high-quality physical education and health classes for all kids, grades K through 12.

Leann M. Lesperance, M.D., Ph.D., is a lecturer on the Harvard Medical School faculty and a clinical assistant professor at SUNY-Upstate Medical University. She practices pediatrics in Binghamton, New York. She also holds a doctorate in medical engineering and is a research assistant professor in the Department of Bioengineering at Binghamton University.

Henry H. Bernstein, D.O., is an associate professor of pediatrics at Harvard Medical School and the chief of general pediatrics at Dartmouth-Hitchcock Medical Center. He is the former director of primary care at Children's Hospital Boston.

Last updated August 20, 2010




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