Linkages Between Outbreaks and School Attendance

While it is clear that illnesses often cause absences, there is also substantial evidence suggesting that illnesses in student populations can be detected using absenteeism as an indicator of health status (Weitzman et al., 1986). Simple absenteeism rates have been correlated with environments with known environmental toxins by Houghton et al. (2003). Perhaps the most elegant and forward-looking work has been performed by Gilliland et al. (2001, 2003). These researchers sought to overcome the problems with the imprecision of absenteeism data by collecting additional information using telephone interviews to define the symptoms that students were experiencing that caused their illness. Working backward from attendance records, these researchers called the parents of children and determined if absences were due to respiratory or other syndromes. They then correlated respiratory illnesses with daily ozone, respirable particle and nitric oxide concentrations in the atmosphere around the regions of the schools. The results of this analysis were remarkable. High concentrations of ozone during school hours were correlated with significant increases (up to 16%) in the rates of absenteeism due to respiratory illnesses with a two-week delay period (Figure 24.2). Gilliand et al. (2003) have also gone on to link indoor air pollution due to

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