HARRISBURG -- Schools in Pennsylvania are not meeting the needs of students with asthma, nor are they fully prepared to deal with student asthma attacks, a newly released study suggests.

The study's authors at Penn State University say the subject is important because asthma is the leading health-related reason children miss school or athletics. It affects one of every eight children 17 years old or younger.

The study was being released yesterday in the September issue of Pediatrics, the official journal of the American Academy of Pediatrics.

Surveys of 757 schools in Pennsylvania in 2004 found that one-fifth did not always have adults on hand who know what to do for a severe asthma attack, and more than half of the state's urban schools did not allow students to carry inhalers.

Given that many schools face tight budgets, one of the researchers said it was not surprising that some were ill-prepared.

"We knew it was going to be hard for them to have everything they want to have for asthma care," said Marianne M. Hillemeier, an assistant professor of health policy and administration at Penn State.

As benchmarks for their study, the authors relied on recommendations on asthma management made in 2002 by the National Heart, Lung, and Blood Institute.

Those recommendations specify what schools should have, including a policy that allows safe and prompt access to medication; access to a nurse who has written an asthma management plan for each student with asthma; and a school-wide emergency plan for handling asthma attacks.

Of the schools surveyed in the study, more than 90 percent had nurses' offices with inhalers on hand to give to students, while 72 percent of rural schools and 47 percent of urban schools allowed students to carry their own inhalers. Three schools reported having no inhalers on the premises, the study said.

About two-thirds of secondary schools and three-fourths of elementary schools had nurses on campus for less than 40 hours a week, although many schools train other adults on how to respond to asthma attacks.

An emergency response plan was in place at more than 90 percent of schools and about two-thirds had a rapid response link to emergency responders. However, less than one-fourth of schools had support services for children with asthma and one-third provided case management.

In addition, most school nurses reported at least one instance of having discovered a student's asthma only when he or she showed up with symptoms.

Given tight school budgets, Ms. Hillemeier said there are ways schools can improve their asthma management at little cost.

In the last two years, the state has taken steps to improve asthma care in schools. A 2004 law now requires schools to allow students to carry inhalers.

In addition, the state Department of Health last year encouraged each school district to request an "asthma action plan" from the doctors of its students with asthma. The plan would tell school nurses the kind of treatment that each student was receiving for asthma, and how to treat the student in case of an asthma attack.

Later this year, an asthma task force organized by the department will release recommendations on how to better manage asthma.