PROVIDENCE – He was only six, but he’d already stayed overnight at the hospital more times than most adults. This time he was tripoding, leaning forward on both arms and positioning himself in the stretcher to get as much air as possible.

The wheezing was audible from the door and with each breath, his neck and chest muscles contracted willing the air into narrowed airways. Despite Jamal’s mother’s efforts with his medication compliance, I learned he had already missed two weeks of school that year and it was only October.

Asthma is the leading cause of chronic school absenteeism, which often results in difficulty learning to read and failure to graduate. My own kindergartner was in school learning her alphabet and making first attempts at spelling out words. I knew every day missed of school was another day Jamal was falling behind, potentially for good. While he’d eventually “grow out” of his asthma, the learning loss could be irreparable.

Fortunately, we’ve learned a lot about what triggers asthma and how to control it. Tobacco smoke and outdoor air pollution are key culprits. Avoidance of triggers is the mainstay of therapy.

My patient attends school in Providence near I-195. During the day particulate matter -- black carbon, and nitrogen dioxide from industrial waste from the port and vehicle emissions – enter his classroom through the open window, infiltrating his airways, and eventually his blood stream. At night, he coughs and wheezes,using his inhaler every four hours just to breathe.

Air pollution has been associated with brain and lung inflammation, respiratory infections, and asthma exacerbations. In kids, we see asthma, mental and motor development,poor math scores, and behavior problems.

Students spend 1,200 hours per year at school during peak traffic hours. In Providence, 24 schools are within 1,000 feet of the highway, affecting some 12,000 children. Outside air pollution invades our school buildings and degrades indoor air quality along with other factors such as molds, pests, dust mites and poor ventilation systems.

Heightened awareness
This pandemic has heightened awareness that air quality is key to a healthy school environment. School walk throughs can be done expeditiously, and we have the local expertise to perform repairs and enhance school safety.

We now have an opportunity to improve air quality in schools. State Sen. Gayle Goldin has introduced a bill, S-0030, to ensure yearly air quality monitoring in all Rhode Island schools, make results publicly available, and implement a plan to improve problems identified.

But what do we need to make this bill lead to lasting change? We need interagency cooperation between the R.I. Department of Health, the R. I. Department of Environmental Management, and the R.I. Department of Education, and we need a commitment from our leaders to fund the personnel, equipment, and building updates that are lacking.

It’s my hope that kids like Jamal will breathe clean air when they sit in our schools, that they will have an opportunity to develop healthy lungs and brains, and graduate. I hope we’ll show we’re truly committed to our kids, their teachers, and a turnaround of the Providence Public Schools. Passing this bill could mean hundreds of kids with asthma and their parents could rest easy at night.

Elizabeth Goldberg, MD, is a parent of Providence public school kids and local emergency medicine doctor. She says that she is committed to doing what she can to help with the school turnaround.