Asthma And The School Asthma And The School EnvironmentEnvironment

Developed and Prepared by the Developed and Prepared by the Minnesota Department of HealthMinnesota Department of Health

June 2004June 2004

Minnesota Department of HealthMinnesota Department of Healthwww.health.state.mn.us/divs/hpcd/cdee/asthmawww.health.state.mn.us/divs/hpcd/cdee/asthma

Common Asthma TriggersCommon Asthma Triggers AllergensAllergens

Mold, dust mites, Mold, dust mites, cockroaches, animal cockroaches, animal dander, pollens, foodsdander, pollens, foods

IrritantsIrritantsSecondhand smoke, Secondhand smoke,

strong odors, volatile strong odors, volatile organic compounds, organic compounds, ozone, particulate ozone, particulate matter, aerosolsmatter, aerosols

OtherOtherViral respiratory Viral respiratory

infectionsinfectionsChanges in weather Changes in weather

(cold air, wind, (cold air, wind, humidity)humidity)

ExerciseExerciseMedicationMedication

Indoor School EnvironmentIndoor School Environment

All of the common allergen and irritant All of the common allergen and irritant triggers are found indoorstriggers are found indoors

Americans spend about 90% time indoorsAmericans spend about 90% time indoors Reducing exposure to indoor allergens & Reducing exposure to indoor allergens &

irritants can reduce asthma symptomsirritants can reduce asthma symptoms Prevention is an important asthma Prevention is an important asthma

management toolmanagement tool

Most Common Indoor Most Common Indoor Environmental TriggersEnvironmental Triggers

Animals in the classroomAnimals in the classroom Dust MitesDust Mites MoldMold Pests such as cockroaches & rodentsPests such as cockroaches & rodents Secondhand smokeSecondhand smoke

Animals In The ClassroomAnimals In The Classroom

Skin flakes, urine and saliva of warm Skin flakes, urine and saliva of warm blooded animals can be asthma triggersblooded animals can be asthma triggers

Triggers can remain for several months Triggers can remain for several months after the animal is removedafter the animal is removed

Avoiding Animal TriggersAvoiding Animal Triggers

Remove animals from school, if possibleRemove animals from school, if possible If removing animals is not possible:If removing animals is not possible:

Keep animals in cages or localized areasKeep animals in cages or localized areas Clean cages regularlyClean cages regularly Locate animals away from ventilation systemLocate animals away from ventilation system Locate sensitive students away from animalsLocate sensitive students away from animals Keep animals away from upholstered furniture Keep animals away from upholstered furniture

and carpetsand carpets

Dust MitesDust Mites

Found in most schoolsFound in most schools Live in soft bedding such as pillows, carpet, Live in soft bedding such as pillows, carpet,

stuffed toys, fabric-covered furniturestuffed toys, fabric-covered furniture Feed on skin flakesFeed on skin flakes Mites and mite droppings can cause asthma Mites and mite droppings can cause asthma

and trigger existing asthmaand trigger existing asthma

Avoiding Dust Mite TriggersAvoiding Dust Mite Triggers

Select washable stuffed toys and wash them Select washable stuffed toys and wash them often in HOT wateroften in HOT water

Cover pillows and mattresses in dust-proof Cover pillows and mattresses in dust-proof zipped coverszipped covers

Vacuum often when people who are allergic Vacuum often when people who are allergic aren’t around aren’t around

MoldMold

Found almost everywhere and can grow on Found almost everywhere and can grow on almost any damp substancealmost any damp substance

Key to mold control is moisture controlKey to mold control is moisture control Eliminate excess moisture and clean up Eliminate excess moisture and clean up

moldmold Reducing moisture also reduces other Reducing moisture also reduces other

triggers such as dust mites and cockroachestriggers such as dust mites and cockroaches

Avoiding Mold TriggersAvoiding Mold Triggers

Wash mold off hard surfacesWash mold off hard surfaces Absorbent materials such as ceiling tiles Absorbent materials such as ceiling tiles

and carpet may need to be replacedand carpet may need to be replaced Fix leaky plumbing and roofsFix leaky plumbing and roofs Reduce condensation on cold surfaces such Reduce condensation on cold surfaces such

as exterior walls by adding insulationas exterior walls by adding insulation Don’t install carpet in areas with regular Don’t install carpet in areas with regular

moisture problems such as drinking moisture problems such as drinking fountains and classroom sinksfountains and classroom sinks

PestsPests

Cockroaches and other pests such as rats Cockroaches and other pests such as rats and mice can be found in schoolsand mice can be found in schools

Droppings or body parts of pests can trigger Droppings or body parts of pests can trigger asthmaasthma

Avoiding Pest TriggersAvoiding Pest Triggers

Integrated pest management (IPM) is used Integrated pest management (IPM) is used to avoid exposureto avoid exposure

Key IPM methodsKey IPM methodsLook for signs of pestsLook for signs of pestsDo not leave food, water or garbage exposedDo not leave food, water or garbage exposedRemove pest pathways and sheltersRemove pest pathways and sheltersUse pest control products, such as poison baits, Use pest control products, such as poison baits,

traps and pesticide sprays only as neededtraps and pesticide sprays only as needed Avoid eating or drinking in classroomsAvoid eating or drinking in classrooms

Parents Right To Know ActParents Right To Know Act

Applies to public and non-public K-12 Applies to public and non-public K-12 schools schools

Must notify parents and employees when Must notify parents and employees when plan to apply specific pesticidesplan to apply specific pesticides

MDH has model notices available on the MDH has model notices available on the environmental website pageenvironmental website page

Secondhand SmokeSecondhand Smoke

Also called environmental tobacco smokeAlso called environmental tobacco smoke Contains over 4,000 substancesContains over 4,000 substances Can cause asthma in young childrenCan cause asthma in young children Can trigger asthma attacksCan trigger asthma attacks

Avoiding Secondhand SmokeAvoiding Secondhand Smoke

Minnesota law prohibits tobacco use in all Minnesota law prohibits tobacco use in all K-12 public schoolsK-12 public schools

Enforce smoking bansEnforce smoking bans

Outdoor EnvironmentOutdoor Environment

Can trigger asthmaCan trigger asthma Outdoor air qualityOutdoor air quality

OzoneOzoneParticulate matterParticulate matter

School busesSchool busesDiesel emissionsDiesel emissionsState lawState law

Outdoor Air QualityOutdoor Air Quality

School staff have little control over most School staff have little control over most pollutantspollutants

Sign up for Air Quality Index alertSign up for Air Quality Index alert Pollution Control Agency sends electronic Pollution Control Agency sends electronic

alerts when poor outdoor air is expectedalerts when poor outdoor air is expected

School BusesSchool Buses

State law requires schools to:State law requires schools to:Reduce unnecessary bus idling in front of schoolsReduce unnecessary bus idling in front of schoolsReroute bus parking zones away from air intake Reroute bus parking zones away from air intake

vents, if possiblevents, if possible Actions includeActions include::

Post “no idling” signsPost “no idling” signsMaintain bus fleetMaintain bus fleet Invest in cleaner fuelsInvest in cleaner fuelsPurchase newer, cleaner buses over the long-termPurchase newer, cleaner buses over the long-term

Other Environmental IssuesOther Environmental Issues

Indoor Air Quality Management PlanIndoor Air Quality Management Plan Cleaning and cleaning productsCleaning and cleaning products FlooringFlooring Air cleanersAir cleaners

Indoor Air Quality Indoor Air Quality Management PlanManagement Plan

State law requires school districts to State law requires school districts to develop an Indoor Air Quality (IAQ) develop an Indoor Air Quality (IAQ) Management PlanManagement Plan

Health and Safety funds are tied to an Health and Safety funds are tied to an approved planapproved plan

IAQ Management PlanIAQ Management Plan

IAQ Management Plan must include:IAQ Management Plan must include:Certified (trained) IAQ CoordinatorCertified (trained) IAQ CoordinatorWalkthrough of all school buildingsWalkthrough of all school buildingsEvaluate specific building systemsEvaluate specific building systemsWritten policiesWritten policies

» Correct existing problemsCorrect existing problems» Prevent future problemsPrevent future problems» Respond to emergencies and concernsRespond to emergencies and concerns

School board approvalSchool board approval

Cleaning And Cleaning ProductsCleaning And Cleaning Products

Remove spots and stains immediately using Remove spots and stains immediately using manufacturer’s recommendationsmanufacturer’s recommendations

Keep the dirt out by using walk-off mats at Keep the dirt out by using walk-off mats at ALL entrancesALL entrances

Use recommended amounts of productsUse recommended amounts of products Avoid products with irritants, chemicals or Avoid products with irritants, chemicals or

strong odors that may affect students and strong odors that may affect students and staffstaff

Don’t mix cleaning productsDon’t mix cleaning products

FlooringFlooring

No one floor covering works for all situationsNo one floor covering works for all situations Maintenance is keyMaintenance is key Keep out dirt, use walk-off matsKeep out dirt, use walk-off mats Regular vacuuming helps reduce allergensRegular vacuuming helps reduce allergens Carpet and Rug Institute “Green Label” Carpet and Rug Institute “Green Label”

program for vacuum cleanersprogram for vacuum cleaners Consider carpet with high density, short pile Consider carpet with high density, short pile

& short level loop& short level loop

Air CleanersAir Cleaners

Consider other control methods firstConsider other control methods first Need to consider type and size for best resultsNeed to consider type and size for best results Avoid ozone air cleanersAvoid ozone air cleaners

Acknowledgements & ResourcesAcknowledgements & Resources

Resources and materials usedResources and materials usedUS Environmental Protection AgencyUS Environmental Protection Agencyhttp://www.epa.gov/iaq/schools/asthma/index.htmlhttp://www.epa.gov/iaq/schools/asthma/index.html

Minnesota Pollution Control AgencyMinnesota Pollution Control Agency http://aqi.pca.state.mn.us/hourly/http://aqi.pca.state.mn.us/hourly/

Minnesota Office of Environmental AssistanceMinnesota Office of Environmental Assistancehttp://www.moea.state.mn.us/ee/noidle.cfmhttp://www.moea.state.mn.us/ee/noidle.cfm

Acknowledgements & ResourcesAcknowledgements & Resources

Resources and materials usedResources and materials usedMDH Environmental Health DivisionMDH Environmental Health Divisionhttp://www.health.state.mn.us/divs/eh/indoorair/schools/index.htmlhttp://www.health.state.mn.us/divs/eh/indoorair/schools/index.html

Minnesota Department of AgricultureMinnesota Department of Agriculture

http://www.mda.state.mn.us/ipm/ipminschools.htmlhttp://www.mda.state.mn.us/ipm/ipminschools.html

Institute of MedicineInstitute of Medicine Clearing the Air: Asthma and Indoor Air ExposuresClearing the Air: Asthma and Indoor Air Exposures

http://www.nap.edu/books/0309064961/html/http://www.nap.edu/books/0309064961/html/