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End of school holidays linked to surge in asthma visits to GPs

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A seasonal peak in asthma cases known as “back to school asthma” has been linked to a surge in GP appointments across England in a new study by public health researchers.

The jump in asthma cases is associated with the start of the school year in September and accounts for a significant proportion of the most serious bouts of the condition.

“We found evidence of a back to school asthma peak in children across a range of healthcare systems”

Study authors

It seems to particularly affect the under fives and boys, according to the research published in the Journal of Epidemiology and Community Health.

Researchers from Public Health England explored the impact of the back to school asthma phenomenon on healthcare services, finding it was linked to a tripling in the rate of GP appointments.

They analysed data from GP consultations about worsening asthma within and outside normal practice hours, plus related visits to emergency care between 2012 and 2016.

The team looked at patterns for boys and girls in different age groups for the last four weeks of school summer holidays up to the first six to seven weeks of the autumn term.

They found use of health services for asthma was up to 2.4 times higher among boys aged from birth to five and aged five to 14 than for girls in those age groups.

The highest rate of asthma cases was among boys aged five to 14 for normal, and out of hours GP services and emergency care.

The study found rates of standard GP appointments for asthma fell during school holidays, followed by an increase in the first two to three weeks of the autumn term.

The sharpest rise in cases occurred at the start of the school year in September.

Patterns for out of hours GP services were similar to regular appointments. Meanwhile, visits to accident and emergency for asthma also peaked at the start of the school year for both age groups.

When it came to how soon the “back to school” asthma phenomenon kicked in, the researchers found it varied for each of the years studied, beginning as late as 17 days after term started and as early as seven days before children recommenced their studies.

Overall, the team found time GPs spent each day dealing with worsening asthma cases during standard surgery hours was more than three times as high during the back to school period compared with the summer holidays for children aged up to four.

The daily rate was 2.5 times higher for children aged 5 to 14.

For GP out of hours consultations, the rates were about twice as high for both age groups. No such obvious spikes were seen for children aged 15 and over.

The researchers pointed out this was an observational study so it could not establish a cause for the patterns they were seeing.

However, they suggested multiple factors were likely to be involved, which could include changes in the weather, air pollution, the stress of starting a new school year and seasonal peaks in certain viruses that can make asthma worse.

They said their findings highlighted the need for more work to prevent asthma at this key time of year.

“We found evidence of a back to school asthma peak in children using surveillance data across a range of healthcare systems, supporting the need for further preventative work to reduce the impact of back to school asthma in children,” they said.

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Readers' comments (1)

  • Why oh why does the nursing press continue to publish pictures of small children using high dose inhaled corticosteroids without a spacer? It drives me mad 😡 I can’t believe this picture was used.

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