Transcript Slide 1
Asthma Friendly School Environments
Jennifer Cofer, MPH, CHES, AE-C
Executive Director, American Lung Association of
Mississippi
Our Mission
Prevent lung disease and promote lung health in
Mississippi through:
Education
Advocacy
Research
Lung Health Focus
• Asthma
• Clean Air – indoor and outdoor
• Chronic Obstructive Pulmonary Disease (COPD
– chronic bronchitis & emphysema)
• Tobacco Control
Burden of Asthma in the US
• An estimated 20 million Americans suffer from
asthma (1 in 15 Americans).
• Asthma accounts for one-quarter of all
emergency room visits in the U.S. each year.
• Asthma is the #1 cause of school absenteeism
among children.
• The annual cost of asthma is estimated to be
nearly $18 billion.
Burden of Asthma in MS
• 1 in every 14 adults have asthma
– More women than men (8% v. 5%).
• 1 in every 10 children have asthma
– About 2 per classroom.
– More black children than white children
(13% v. 8%).
– More boys than girls (12% v. 8%).
Source: Behavioral Risk Factor Surveillance System, 2007
What is Asthma?
Asthma:
Is a life-long disease found in the airways of the lungs,
causes swelling and muscle tightening.
Produces frequent symptoms such as shortness of breath,
tightness in the chest, wheezing and coughing.
Asthma cannot be cured, but it can be controlled.
What is Asthma?
When asthma is triggered, airways tighten and swell,
making it difficult to get air out of the airways.
Early Signs of Asthma
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Dry cough
Feeling tired
Feeling restless
Trouble sleeping
Stuffy nose, runny
nose
• Watery eyes
• Congestion
• Stomachache
• Headache
• Shortness of breath
Asthma Medications
• Inhaled corticosteroids (anti-inflammatories):
reduce/prevent airway inflammation (swelling)
• Bronchodilators: relax tight airways
– Short-acting Beta Agonist: quick-relief inhaler
– Long-acting Beta Agonist: daily inhaler
• Combination Medications
• Nebulizer/liquid forms of medicines
• Other oral medications
Medication Demonstration
Spacers/Holding Chambers
Environmental Asthma Triggers
Allergens
• Substances that
cause you to have an
allergic reaction.
• Exposure in a patient
who is sensitive
increases airway
inflammation and
symptoms.
Irritants
• Substances
that irritate the lungs
and cause asthma
symptoms.
• Exposure causes
increased symptoms
or limits airflow.
Allergens
Examples
• Require sensitization
• Tree pollen (spring)
• Affects only those
• Grass pollen (summer)
that are sensitized to
• Weed pollen (fall)
the allergen
• House dust mite
• Furry animals
• Not usually dosedependent
• Fungi/mold (fall to
perennial)
Trigger: Animal Dander
Trigger: Grass, Trees
Trigger: Pollen
Trigger: Mold
Trigger: Cockroach
Triggers: Food Allergies
Examples
Irritants
• Tobacco smoke
• Dose dependent
• Ozone
response.
• Exhaust fumes/diesel
• Will affect everyone fumes
at high enough
• Sulfur dioxide
dose.
• Nitrogen dioxide
• Perfumes
• Cleaners
• Weather
Trigger: Smoke
Trigger: Fumes
Trigger: Pollution
Other Asthma Triggers
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Colds, flu, sinus problems
Exercise
Bursts of emotion
Some medicines in sensitive individuals
Anxiety
Trigger: Colds/Infections
Green zone - when
symptoms are controlled
Yellow zone – when
symptoms are present
Red zone – when symptoms
do not go away or get worse
Asthma Action Plan
Peak Flow
A peak flow meter is a simple device that measures the
air a person can blow during the first second.
A peak flow meter can help a person monitor their asthma
symptoms.
It is useful for persons
who do not wheeze or
can’t tell they’re having
asthma symptoms.
Symptoms of an Asthma Episode
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Wheezing
Coughing
Respiration rate >20
Retractions
(sunk in neck)
• Anxious
• Stooped body posture
• Shortness of breath
• Nasal Flaring
• Depressed Sternal
Notch
• Nausea/Vomiting
• Fatigue
• Decreased peak flow
Childhood Asthma
A child should stay home when he or she:
• Has trouble breathing even after taking the
quick-relief inhaler.
• Gets winded after speaking or playing quietly.
• Has a fever.
• Has an infection or sore throat.
• Peak flow is in the yellow or red zone after
taking the quick-relief inhaler.
What a child should do?
If you feel symptoms of an asthma episode:
1. Tell an adult immediately.
2. Measure peak flow.
3. Take medication according to the Asthma
Action Plan.
4. Sit up, stay calm, deep breathing/belly
breathing.
5. If asthma symptoms continue or you recognize
a sign of an asthma emergency, seek medical
care.
What to do if Asthma Episode Occurs
• Review the child or adult’s asthma action plan.
• Have person sit upright and check peak flow.
• Administer prescribed medication:
– Quick-Relief Inhaler or Nebulizer (Albuterol)
• Reassure person to keep calm. Move them
away from people or move the people away
from them.
• Controlled breathing.
Indoor Air Quality (IAQ)
• Each school day, some 53 million students and 5
million staff are in our nation’s schools, (20% of
American population)
• Half this population may be exposed to polluted
indoor air, lead, asbestos, chemical fumes,
pesticides, molds and other toxins, along with
overcrowding and poor sanitation
Health Impacts & IAQ
• Asthma
– 20 million people have asthma-- including 6.2 million children under the age of 18
– The cause of over 14 million missed school days each year
– Costs society $18 billion/year in medical and indirect costs
• Sick Building Syndrome and Building Related
Illnesses
• Allergies and sensitivities
• Absenteeism
• Reduced productivity and lower test scores
Indoor Air Quality Problems:
Pollutant
Pathway
People
Source: Environmental Protection Agency (EPA) Indoor Air Quality Tools for Schools National Symposium, December 2007
Indoor Air Quality & Asthma (cont.)
Elements of IAQ:
1. Contaminant Source Control
2. Humidity Management
3. Ventilation
4. Filtration
Source: Environmental Protection Agency (EPA) Indoor Air Quality Tools for Schools National Symposium, December 2007
What do we add to our air?
Source: Environmental Protection Agency (EPA) Indoor Air Quality Tools for Schools National Symposium, December 2007
How do we improve IAQ?
Simple things first:
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Stop using scented products & deodorizers
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Dispose of sources
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Unblock vents
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Move sources away from intake vents
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Learn/teach about ventilation controls
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Report problems!
Source: Environmental Protection Agency (EPA) Indoor Air Quality Tools for Schools National Symposium, December 2007
Why GREEN Cleaning
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Helps Students Stay Healthy and Learn
Protects the Health of Custodial Staff
Increases the Lifespan of Facilities
Preserves the Environment
Source: Healthy Schools Campaign, Green Cleaning in Schools
What does “GREEN” mean?
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Products that Prevent Pollution
Products that are Sustainable
Multiple Attributes
Has been tested by several agencies:
– Green Seal
- Green Buildings
- US EPA
– American Society for Testing & Materials
Source: Healthy Schools Campaign, Green Cleaning in Schools
Choose GREEN Cleaning Products
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Ecolab
Johnson Diversey
Unisource
Spartan
PortionPac
Source: Healthy Schools Campaign, Green Cleaning in Schools
Choosing a Product
• Less-toxic, effective cleaning products are readily
available through most manufacturers and distributors
• Independent third-party certification of institutional
cleaning products is crucial
• Common third-party programs are:
– Green Seal™ (GS) – US
– EcoLogo™ (formerly known as Environmental Choice) - Canada
Source: Cleaning for Healthy Schools, www.cleaningforhealthyschools.org
What chemicals not to use
• What to look for on an MSDS:
– Volatile Organic Compounds (VOC) content of 1% or lower
– pH between 5 – 9, 7 is neutral
• Avoid:
– Aerosols
– Products labeled as corrosive, that can cause eye or
mucous membrane damage, or that can burn the skin
– Ingredients that are carcinogens, mutagens, teratogens
Source: Cleaning for Healthy Schools, www.cleaningforhealthyschools.org
Environmentally preferable product
ingredients
Use these:
Instead of these:
• Alcohol ethoxylates
and/or polyglucosides
• Hydrogen peroxide
• Corn-based esters
• Vegetable-derived
surfactants
• Fruit-derived solvents
and acids
• Nonylphenol ethoxylates or
alkylphenol ethoxylates
• Harsh acids/alkali builders
• Petroleum distillates
• Petroleum-derived surfactants
• Petroleum solvents or harsh
acids
Better Cleaning Equipment
Use updated equipment to reduce particulates in the air
• Install dirt-grabbing walk-off mats inside and outside
entrances, recommended 15’ – 20’
• Use microfiber cloths and mops that pick up dirt while using
a reduced amount of chemicals
• Employ HEPA vacuums or microfiber mops instead of
conventional dust mops
• Install high-filtration vacuum attachments on other floorcare equipment
Source: Cleaning for Healthy Schools, www.cleaningforhealthyschools.org
Best Practices for ALL employees
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Keep dirt out
Leave classrooms ‘ready to clean’
Clean from the top down
Select durable easy to clean flooring; maintain/replace
carpets
• Clean up spills right away
• Cleaning with all-purpose cleaners removes most germs.
Disinfect only in target areas.
• Reduce dust with vacuuming instead of damp mopping
Source: Cleaning for Healthy Schools, www.cleaningforhealthyschools.org
Cleaning for Healthy Schools Principles
• Keep the dirt out
• Use less-toxic, third-party certified, all purpose
cleaners, paper products and hand soaps
• Update and maintain equipment
• Cleaning with all-purpose cleaners removes
most germs. Disinfect only in target areas.
• Breathe easier – clean doesn't have an odor
Source: Cleaning for Healthy Schools, www.cleaningforhealthyschools.org
Asthma Programs
Asthma Programs
Asthma Camps
Tobacco Programs
Jennifer Cofer, MPH, CHES, AE-C
Deputy Executive Director
American Lung Association of
Mississippi
601.206.5810 or 800.LUNG.USA
[email protected]
We will breathe easier when the air in every
American community is clean and healthy.
We will breathe easier when people are free from the addictive
grip of cigarettes and the debilitating effects of lung disease.
We will breathe easier when the air in our public spaces and
workplaces is clear of secondhand smoke.
We will breathe easier when children no longer
battle airborne poisons or fear an asthma attack.
Until then, we are fighting for air.