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INSTITUTION

REPORT NOPUB DATENOTEAVAILABLE FROMPUB TYPEEDRS PRICEDESCRIPTORS

IDENTIFIERS

ABSTRACT

DOCUMENT RESUME

EF 005 800

IAQ Tools for Schools: Managing Asthma in the SchoolEnvironment.Environmental Protection Agency, Washington, DC. Office ofRadiation and Indoor Air.EPA-402-K-00-0032000-04-0024p.

For full text: http://www.epa.gov/iaq.Reports - Descriptive (141)MF01/PC01 Plus Postage.*Asthma; Cleaning; Educational Environment; ElementarySecondary Education; Guidelines; Pests; Public Schools*Indoor Air Quality; *Pollutants

This manual provides tips on improving indoor air qualitywithin the school environment by removing the elements that trigger asthmaattacks in children, and presents a list of organizations where asthmaresource information can be obtained. Air quality management tips coverremoving of animal and cockroach allergens, cleaning up mold and controllingmoisture, eliminating secondhand smoke exposure, and reducing dust miteexposure. Additionally covered are administrative initiatives to supportclean indoor air efforts such as the development of a school asthmamanagement plan and a school-based asthma education program, and the creationand filing of student asthma action cards. A sample asthma card is included.(GR)

Reproductions supplied by EDRS are the best that can be madefrom the original document.

PAPAUnited States Indoor Environments

Environmental Protection Division (6609J)

Agency Office of Air and Radiation

EPA 402-K-00-003

April 2000

-U.S, DEPARTMENT OF EDUCATIONOffice of Educational Researcn ana improvement

ED ATIONAL RESOURCES INFORMATIONCENTER (ERIC)

This document has been reproduced asceived from the person or organization

originating it.

Minor changes have been made toimprove reproduction quality.

Points of view or opalions stated in thisdocument do not necessarily representofficial OERI position or policy.

Managing Asthma in theSchool Environment

- `Mr Ig

10 Ways to Manage Asthma in the School Environment

1. Use the IAQ Tools for Schools Kit 7.

Help people with asthma by

improving the school environment

with IAQ practices recommended

in this kit.

2. Control Animal Allergens

Remove classroom animals from

the school, if possible.

If not, locate animals away from

sensitive students and ventilation

systems.

3. Control Cockroach Allergens

4.

S.

Use Integrated Pest Management

practices to prevent cockroach

and other pest problems (e.g.,

store food in tightly sealed con-

tainers and place dumpsters

away from the building).

Clean Up Mold and Control Moisture

Fix moisture problems and thor-

oughly dry wet areas within 24-48

hours to prevent mold growth.

Clean up hard, moldy surfaces

with water and detergent, then

dry thoroughly.

Eliminate Secondhand Smoke Exposure

Enforce no-smoking policies in

the school.

6. Reduce Dust Mite Exposure

Make sure the school is dusted

and vacuumed thoroughly

and regularly.

8.

10.

Develop an Asthma Management Plan in

Your School

Include school policies on

inhaler and other medication

usage, and emergency proce-

dures for school staff for use

when a student has an asthma

attack.

Obtain the National Asthma

Education and Prevention

Program's Managing Asthma: A

Guide for Schools.

Provide School-Based Asthma

Education Programs

Contact your local American

Lung Association about Open

Airways For Schools, a school-

based asthma management pro-

gram for students with asthma.

File Student Asthma Action Cards

Make sure students with asthma

obtain and turn in copies of their

Asthma and Allergy Foundation

of America action cards to

teachers, school nurse, etc.

Encourage students to find out

and identify their asthma triggers.

Gather Additional Asthma Information

and Resources

Establish a complete file on

existing asthma and allergy-

related information sources

to reference throughout the

school year.

The Asthma Epidemic

Asthma has reached epidemic propor-tions in the United States affectingabout 17 million people of all ages andraces, particularly children. Nearly onein 13 school-aged children has asthma,and the percentage of children withasthma is rising more rapidly in pre-school-aged children than in any otherage group. Asthma is the leading causeof school absenteeism due to a chronicillness, accounting for over 10 millionmissed school days per year. Asthmaalso accounts for many nights of inter-rupted sleep, limitation of activity, anddisruption of family and care-giver rou-tines. Asthma symptoms which are notsevere enough to require a visit to anemergency room or to a physician canstill be serious enough to prevent a childwith asthma from living a fully active life.

Asthma is a long-term, inflammatorydisease in which the airways of the lungtighten and constrict causing wheezing,breathlessness, chest tightness, andcoughing. These symptoms can be at

least partially reversed, either sponta-neously or with treatment. Theinflammation also causes the airways ofthe lung to become especially sensitiveto a variety of asthma triggers. In addi-tion, the particular trigger or triggers andthe severity of symptoms can differ foreach person with asthma.

Since Americans spend up to 90% oftheir time indoors, exposure to indoorallergens and irritants may play a signifi-cant role in triggering asthma episodes.Some of the most common asthmatriggers found indoors include:

animal dandercockroachesmoldsecondhand smokedust mites

Other asthma triggers include: respira-tory infections, pollens (trees, grasses,weeds), outdoor air pollution, food aller-gies, exercise, and cold air exposure.

Asthma in Schools

Each day, one in five Americans occu-pies a school building and the majorityof these occupants are children.Environmental asthma triggers com-monly found in school buildings arecockroaches and other pests, moldresulting from excess moisture in thebuilding, and dander from animals in theclassroom. Secondhand smoke anddust mites are other known environ-mental asthma triggers found inschools. In addition, some literaturesuggests children with asthma may beaffected by other pollutants found inschools from such sources as unventedstoves or heaters and common prod-ucts such as cleaning agents,perfumes, and sprays.

Effectively managing a child's asthmacan best be accomplished through acomprehensive plan that addressesboth the medical management of thedisease and avoidance of environmen-tal triggers. Since children spend mostof their time in schools, day care facili-ties, or at home, it is important toreduce their exposure to environmentalasthma triggers as much as possible ineach of these environments. This pub-lication focuses on steps that schoolscan take to help children breathe easier.

5

Use the Indoor Air Quality

Tools for Schools Action Kit

Many indoor air quality problems inschools can impact the health of stu-dents and staff, including those withasthma. Some of the indoor air quality

problems include: chemical pollutantsfrom building or building maintenancematerials; chemical pollutants fromscience and art classes; improperlymaintained ventilation systems; andallergens from classroom animals andcockroaches or pests. Mold growthmay result from standing water in main-tenance rooms and near piping, or fromexcess moisture in ceiling tiles, carpets,and other furnishings. Also, outdoor airpollutants and pollens may enter theschool through ventilation systemsand/or open doors and windows.

In order to help improve indoor airquality problems in school buildings, the

Environmental Protection Agency (EPA)developed the Indoor Air Quality (lAQ)

Tools for Schools Action Kit. This kithelps school personnel identify, solve,and prevent indoor air quality problemsin the school environment. Through theuse of a 19-step management plan andchecklists for the entire building,schools can also lower their students'and staff's risk of exposure to asthmatriggers. The checklists cover the build-ing's ventilation system, maintenanceprocedures, classrooms (especially ani-mals and mold), and food service areas.

Included in the kit is a Coordinator'sGuide, which explains the fundamentalsof indoor air quality in schools and pro-cedures for improving the air inside theschools. The kit also contains check-lists, a background informational piecefor staff, a problem-solving wheel toidentify potential indoor air quality caus-es and solutions, a guide for healthprofessionals, and a 30-minute, two-part video covering the ventilationchecklist and a school's implementationof IAQ Tools for Schools.

To use the IAQ Tools for Schools Kit,most schools form an IAQ coordinatingteam which implements the kit duringthe school year. Because IAQ problemscan originate anywhere in the schoolbuilding, usually the entire staff isinformed and brought into the processof improving the indoor air. In addition,

IAQ Tools for Schools

students can be involved in the process.Information about available curricula onindoor air quality can be found on EPA'sweb site (www.epa.govilaq/schools).

School districts across the UnitedStates have adopted IAQ Tools forSchools, thus improving the air quality inall of the districts' buildings. The 1AQTools for Schools Kit can be used aloneor in conjunction with the AmericanLung Association's Open Airways ForSchools asthma curriculum for eight to11-year old children (see informationincluded in this publication on AsthmaManagement and Education).

EPA has developed additional toolsand programs to help schools andschool districts implement the 1AQTools for Schools Kit. Thisincludes a step-by-step guide tosuccessfully implementing theIAQ Tools for Schools Kit. Thisquick-start guide will help yougain a valuable understanding ofthe IAQ Tools for Schools pro-gram and provide you with abrief review of the kit, helpfulimplementation ideas, andcase studies of several

schools that have success-fully implemented the kit.

Schools (or school districts)and non-profit groups mayreceive a copy of the IAQ Tools

for Schools Kit at no cost

IAQ Tools for Schools

simply by faxing a request on school orcompany letterhead to IAQ INFO at 703-356 -5386. For more information, pleasecall IAQ INFO at 1-800-438-4318. Theentire IAQ Tools for Schools Kit can bedownloaded from EPA's website(www.epa.govfiaq /schools).

11.011..

Control Animal Allergens

Classes may commonly adopt animalsas a classroom pet or science project.School staff may not realize that anywarm-blooded animals including gerbils,birds, cats, dogs, mice, and rats maytrigger asthma. Proteins which act asallergens in the dander, urine, or salivaof warm-blooded animals may sensitizeindividuals and can cause allergic reac-tions or trigger asthma episodes inpeople sensitive to animal allergens.

Common Sources Found in School Settings

The most common, obvious source ofanimal allergen is having a pet in the

classroom or school. If an animal is

present in the school, there is a possibil-ity of direct, daily exposure to theanimal's dander and bodily fluids. It is

important to realize that, even afterextensive cleaning, pet allergen levels

may stay in the indoor environmentfor several months after the animal

is removed.

The most effectivemethod to con-trolling exposureto animal aller-gens in schools isto keep yourschool free offeathered or furred

animals. However,for some individuals,isolation measuresmay be sufficientlyeffective. Isolation

measures include: keeping animals in

localized areas; keeping animals away

from upholstered furniture, carpets, andstuffed toys; and keeping sensitive indi-viduals away from animals as much as

possible.

For schools with animals, it is importantto make sure that classrooms contain-ing animals are frequently andthoroughly cleaned. In addition, animalallergens can readily migrate to otherareas of the school environment throughthe air and on children who handle petsTherefore, the entire building should becleaned thoroughly.

Schools are sometimes advised to useair cleaners. Although properly usedand maintained air cleaners may beeffective for reducing animal dander insmall areas, they should only be consid-ered as an addition to other controlmethods. It is also important to careful-ly review information on the type of air

cleaner used to makesure it is suitably sized

and has high particleremoval efficiency. In

addition, someair-cleaningdevices marketedas air purifiers

emit ozone, whichmay be harmful to

people with asthma.

8Environmental Asthma Triggers

6atiar--

Suggestions for Reducing

Exposures in Schools

Remove animals from the school, if

possible.

If completely removing animals from theschool is not possible, then:

Keep animals in cages or localizedareas as much as possible; do not letthem roam.

Clean cages regularly. Consider usingdisposable gloves when cleaning.

Locate animals away from ventilation

system vents to avoid circulating aller-gens throughout the room or building.

Locate sensitive students as far awayfrom animals and habitats as possible.

Keep animals away from upholsteredfurniture, carpets, and stuffed toys.

These action items are included on the FAQ

Tools for Schools Teachers Checklist.

Control Cockroach and Pest Allergens

Cockroach allergens may play a signifi-

cant role in asthma throughoutinner-city, suburban, and rural schools.Certain proteins which act as allergensin the waste products and saliva ofcockroaches can cause allergic reac-tions or trigger asthma symptoms insome individuals.

Pest allergens are a significant cause ofoccupational asthma symptoms amonglaboratory workers, such as scientistswho work with animals in scientific

Environmental Asthma Triggers

investigations. These allergens mayalso contribute to allergies and asthmain the general population.

Common Sources Found in School Settings

Cockroaches and other pests, such asrats and mice, are often found in theschool setting. Allergens from thesepests may be significant asthma triggersfor students and staff in schools. Pestproblems in schools may be caused orworsened by a variety of conditions

9

such as plumbing leaks, moisture prob-lems, and improper food handling andstorage practices. In order to manage apest problem, water and food sourcesneed to be controlled in the school envi-ronment. Therefore, it is important toavoid exposure to these allergensthrough the use of common sense,Integrated Pest Management (IPM)practices throughout the entire school.

There are four key IPM methods forreducing exposure to pests in the schoolsetting: 1) look for signs of pests; 2) donot leave food, water, or garbageexposed; 3) remove pest pathways andshelters; and 4) use pest control prod-ucts such as poison baits, traps, andpesticide sprays, as needed.

Integrated Pest Management Practices for

Reducing Exposures in Schools

Check food preparation, cooking, and stor-age areas regularly for signs of cockroaches

and pests:

ri Look for dead cockroaches or pests.

c Look for waste products(e.g., pest droppings).

c Look for greasy smears on walls,which could indicate possible rat runs.

Confirm that appropriate food preparation,cooking, and storage practices are

implemented:

Review food handling and storagepractices. Containers should be well-sealed, with no traces of food left onoutside surfaces of containers.

O Make sure food is not kept in the

classroom overnight.

o Animal food should be kept in sealedcontainers.

Maintain general cleanliness:

Sweep and wet mop floors to remove

food.

im Clean stoves and ovens after use.

Wipe counters clean with soap andwater or a disinfectant, according toschool policy.

c Make sure trash is removed daily.

Fix plumbing leaks and othermoisture problems.

o Do not let water stand in air condition-ing or refrigerator drip pans.

Select waste containers by considering thekind of waste that is placed in them:

e Food waste or contaminated papersand plastics should be disposed ofproperly in secured, covered contain-

ers or tied off plastic bags todiscourage pests.

1 0 Environmental Asthma Trigger:

Empty waste containers regularly andfrequently, and store them in anappropriate location:

Follow a regular schedule of emptyingwaste containers in order to minimizeodors and deprive pests of their foodsources.

Place dumpsters away from the build-ing to minimize opportunities for peststo enter the building.

Eliminate pest entryways, pathways,and shelters:

Remove clutter (e.g., stacks of papers)where cockroaches may hide.

Seal small spaces where cockroachesmay live (e.g., near where plumbing orelectrical wiring goes through walls,and cracks or spaces in walls aroundbaseboards and window sills.)

Block possible entry points for rodentsand other pests.

Do not rely on widespread, indiscriminateuse of pesticides to control pests:

Try using poison baits, boric acid, ortraps before using pesticide sprays.

Track cockroach populations by usingsmall sticky traps or monitoring trapswhich contain no pesticide.

Rats and mice should be trappedrather than baited.

Pesticide sprays should only be usedin classrooms as a last resort.

Environmental Asthma Triggers

If pesticide sprays are used in the school:

Consider notifying school staff andparents well in advance of pesticideapplications.

Schedule pesticide applications forunoccupied periods so that the affect-ed area can be well ventilated beforeoccupants return.

Use pest control chemicals in strictaccordance with regulations and theinstructions on the container.

-These action items can be fond on the

following checklists in the IAQ Tools for

Schools Action Kit:

Teachers Checklist, Waste Management

Checklist, Food Service Checklist, BuildingMaintenance Checklist, Ventilation Checklist

11

Clean Up Mold and Control Moisture

Molds can be found almost anywhere;they can grow on virtually any sub-stance, providing moisture is present.Outdoors, many molds live in the soiland play a key role in the breakdown ofleaves, wood, and other plant debris.Without molds we would be strugglingwith large amounts of dead plant matter.

Molds produce tiny spores to repro-duce. Mold spores travel through theindoor and outdoor air continually.When mold spores land on a damp spotindoors, they may begin growing anddigesting whatever they are growing onin order to survive. There are molds thatcan grow on wood, paper, carpet, andfoods. If excessive moisture or wateraccumulates indoors, extensive moldgrowth may occur, particularly if themoisture problem remains undiscoveredor unaddressed. There is no practicalway to eliminate all mold and moldspores in the indoor environment; theway to control indoor mold growth is tocontrol moisture. If mold is a problem inyour school, you must clean up themold and eliminate sources of moisture.

When mold growth occurs in buildings,it may be followed by reports of healthsymptoms from some building occu-pants, particularly those with allergies orrespiratory problems. Potential healtheffects and symptoms associated withmold exposures include allergic reac-tions, asthma, and other respiratorycomplaints.

Common Moisture Sources found in Schools

Moisture problems in school buildingscan be caused by a variety of condi-tions, including roof and plumbing leaks,condensation, and excess humidity.Some moisture problems in schoolshave been linked to changes in buildingconstruction practices during the pasttwenty to thirty years. These changeshave resulted in more tightly sealedbuildings that may not allow moisture toescape easily. Moisture problems inschools are also associated withdelayed maintenance or insufficientmaintenance, due to budget and otherconstraints. Temporary structures inschools, such as trailers and portableclassrooms, have frequently been asso-ciated with moisture and moldproblems.

Suggestions for Reducing Mold

Growth in Schools

Reduce Indoor Humidity:

Vent showers and other moisture-generating sources to the outside.

Control humidity levels and damp-ness by using air conditioners and

de-humidifiers.

Provide adequate ventilation to main-tain indoor humidity levels between

30-60%.

Use exhaust fans whenever cooking,dishwashing, and cleaning in food

service areas.

12Environmental Asthma Triggers

Inspect the buildingfor signs of mold,

moisture, leaks, orspills:

Check for moldy odors.

Look for water stains or discolorationon the ceiling, walls, floors, and win-dow sills.

Look around and under sinks forstanding water, water stains, or mold.

Inspect bathrooms for standing water,water stains, or mold.

Do not let water stand in air condition-ing or refrigerator drip pans.

Respond promptly when you see signs ofmoisture and/or mold, or when leaks orspills occur:

Clean and dry any damp or wet build-ing materials and furnishings within24-48 hours of occurrence to preventmold growth.

Fix the source of the water problem orleak to prevent mold growth.

Clean mold off hard surfaces withwater and detergent, and dry com-pletely. Absorbent materials such asceiling tiles, that are moldy, may need

to be replaced.

Check the mechanical room and rooffor unsanitary conditions, leaks, orspills.

Environmental Asthma Triggers

Fl

Prevent moisture condensation:

Reduce the potential for con-densation on cold surfaces (i.e.,

windows, piping, exterior walls, roof,

or floors) by adding insulation.

or and carpet cleaning:

Remove spots and stains immediately,using the flooring manufacturer's rec-ommended techniques. Use care toprevent excess moisture or cleaning

residue accumulation and ensure thatcleaned areas are dried quickly.

In areas where there is a perpetualmoisture problem, do not install car-peting (i.e., by drinking fountains, byclassroom sinks, or on concretefloors with leaks or frequent conden-sation).

These action items are included on the fol-

lowing checklists found in the IAQ Tools for

Schools Action Kit:

Ventilation Checklist, Building Maintenance

Checklist, Administrative Staff Checklist,Teachers Checklist, Food Service Checklist,

Renovation and Repair Checklist

13

11140tifitkftrag&10-,....keak4SIMLNeAdaa

Eliminate Secondhand Smoke Exposure

Secondhand smoke is the smoke fromthe burning end of a cigarette, pipe, orcigar and the smoke breathed out by asmoker. Secondhand smoke exposurecauses a number of serious healtheffects in young children, such ascoughing and wheezing, bronchitis andpneumonia, ear infections, reduced lungfunction, and worsened asthma attacks.Secondhand smoke is an irritant whichmay trigger an asthma episode, andincreasing evidence suggests second-hand smoke may cause asthma inchildren. The Environmental ProtectionAgency estimates that between 200,000and 1,000,000 children with asthmahave their condition made worse byexposure to secondhand smoke.Secondhand smoke can also lead tobuildup of fluid in the middle ear, themost common cause of children beinghospitalized for an operation.

-441111111110"" ""4111110

Common Sources found in School Settings

The majority of schools in the UnitedStates prohibit smoking on schoolgrounds. However, often times smoking

occurs in school bathrooms, lounges,and on school grounds. This may causeproblems for students and staff whohave asthma.

It is important to enforce smoking banson school grounds in order to preventexposure from secondhand smoke. Ifsmoking occurs within the building, sec-ondhand smoke can travel through theventilation system to the entire school.Also, even when people smoke outside,secondhand smoke may enter theschool through the ventilation system,open windows, and doors.

Suggestion for Reducing Exposure in Schools

ci Enforce smoking bans on school

property.

Refer to the lAQ Tools for Schools Health

Officer/School Nurse Checklist.

14Environmental Asthma Triggers

vist~adifaideutrakatitomotaittiselMileafflueii

Reduce Exposure to Dust Mites

Dust mite allergens play a significantrole in asthma. These allergens maycause an allergic reaction or trigger anasthma episode in sensitive individuals.In addition, there is evidence that dustmites cause new cases of asthma insusceptible children.

Dust mites are too small to be seen butare found in homes, schools, and otherbuildings throughout the United States.Dust mites live in mattresses, pillows,carpets, fabric-covered furniture, bed-covers, clothes, and stuffed toys. Theirfood source is dead skin flakes.

Common Sources Found in Schools

Dust mites may be found in schools incarpeting, upholstered furniture, stuffedanimals or toys, and pillows. Stuffedanimals or toys, as well as pillows fortaking naps, are used mostly in theprimary grades.

Suggestions for Reducing

Exposure in Schools

Choose washable stuffed toys; washthem often in hot water.

Cover pillows in dust-proof (allergen-impermeable), zipped covers.

I Remove dust from hard surfaces oftenwith a damp cloth, and vacuum car-peting and fabric-covered furniture toreduce dust buildup. Allergic peopleshould leave the area being vacu-

umed. Vacuums with high efficiencyfilters or central vacuums may behelpful.

Refer to IAQ Tools for Schools Teachers and

Building Maintenance Checklists.

Environmental Asthma Triggers

15

Asthma Management and Education

Experts convened by the NationalAsthma Education and PreventionProgram (NAEPP) and coordinated bythe National Institutes of Health (NIH)

have reviewed the scientific literatureand produced guidelines which definethe best diagnosis and managementpractices for asthma. These NAEPPguidelines include recommendations formedical diagnosis and treatment,including the use of inhalation therapyand specific recommendations for con-trolling indoor environmental factors thatcontribute to asthma severity.

Develop an Asthma Management

Plan in Your School

Schools can play an important role inhelping students manage their asthmaby providing support through the devel-opment of an asthma managementplan. Each school should develop anoverall asthma management plan whichincludes school policies on the use ofinhalers and medications, actions oremergency procedures school staffshould take when a student has anasthma attack, and student asthmaaction cards. The student asthmaaction card serves as an individual man-agement plan for each student withasthma. It provides pertinent informa-tion to school officials on each student'sasthma condition.

The asthma action card should containthe student's medical information, iden-tified asthma triggers, emergencyprocedures, and phone numbers. This

action card should be signed by aphysician and parent or care-giver andkept on file at school. The Asthma andAllergy Foundation of America's (AAFA)asthma action card is provided in thispublication. AAFA encourages duplica-tion and distribution of the asthmaaction card in the school setting.

Provide School-Based Asthma

Education Programs

The school setting provides an opportu-nity for directly educating children,parents, and care-givers about asthmamanagement and indoor environmentaltriggers. An example of a school-basedasthma education program is theAmerican Lung Association's (ALA)Open Airways For Schools. This ele-mentary school-based programempowers children and their parents byteaching them to take control of asthma.

1

16 Asthma Management and Education

Through the ALA's Open Airways ForSchools program, children learn thattheir asthma can be controlled and whatsteps they can take to manage theircondition. Specifically, they learn toprevent asthma episodes by reducingtheir exposure to environmental asthmatriggers and using their asthma "control"medication correctly. Children alsolearn what to do when asthma symp-toms develop, how to use "episodic"medications correctly, and when to seekhelp from adults.

Designed for eight toll-year old chil-dren with asthma, this curriculumconsists of six lessons and is designedto be easy for trained volunteers orschool staff to present. Generally heldduring the school day, each lessontakes about 40 minutes and is flexibleenough to fit any school's schedule.The program's hands-on teachingapproach utilizes group discussion, sto-ries, games, and role-playing to promotechildren's active involvement in thelearning process.

,

Children enrolled in this program havedemonstrated: increased school per-formance; more confidence in theirability to manage asthma; greater influ-ence on their parents' asthma manage-ment decisions; fewer episodes of asth-ma, as well as episodes of shorterduration; and more active managementof their asthma. The program isapproved and recommended by theNational Association of School Nurses.

Although asthma affects children of allbackgrounds, minority groups are dis-proportionately affected. To reachchildren from all backgrounds, artworkin the curriculum was designed with adistinctive multi-cultural appeal withspecially designed cartoon illustrationsof children in urban, rural, and suburbansettings. To reach an even broaderaudience, ALA's Open Airways ForSchools is now available with bothEnglish and Spanish language text on

the handouts and posters.

For more information about the AmericanLung Association's Open Airways ForSchools program, contact your local Lung

Association at 1-800-LUNG-USA (1 -800-

586 -4872) or visit the ALA website

(http://www.lungusa.org.)

Asthma Management and Education 1?

lisnrom /16 lion 04e1Asthma and Allergyfoundation of America

Reviewed by

45 WANobarl Asthma Educam and

Prmrdice Prticryn

Name: Grade: Age:

Homeroom Teacher. Room:

Parent/Guardian Name: Ph: (H)

Address: Ph: (W)

Parent/Guardian Name: Ph: (H)

Address: Ph: (W)

Emergency Phone Contact #1:Name Relationship Phone

Emergency Phone Contact #2:Name Relationship Phone

Physician Treating Student for Asthma: Ph:

Other Physician: Ph:

Emergency Plan

Emergency action is necessary when the student has symptoms such as

or has a peak flow reading of

Steps to take during an asthma episode:

1. Check peak flow.

2. Give medications as listed below. Student should respond to treatment in 15-20 minutes.

3. Contact parent/guardian if:

4. Re-check peak flow.

5. Seek emergency medical care if the student has any of the following:

Coughs constantly

No improvement 15-20 minutes after initial treatment with medication and a relative cannot

be reached

Peak flow of

Hard time breathing with:

Chest and neck pulled in with breathing

Stooped body posture

Struggling or gasping ID Photo

Trouble walking or talking

Stops playing and can't start activity again

Lips or fingernails are grey or blue

Emergency Asthma Medications

Name Amount When to Use

1

2.

3.

4

16

"';',,-7'.(1-;,-

Daily Asthma Management Plan

(Identify the things which start an asthma episode. Check each that applies to the student.)

Exercise Strong odors or fumes Other

Respiratory infections Chalk dust/dust 0 Change in temperature

Carpets in the room 0 Animals Pollens

Food Molds

Comments

Control of School Environment

(List any environmental control measures, pre-medications, and/or dietary restrictions that the student needs to prevent an

asthma episode.)

Peak Flow Monitoring

Personal Best Peak Flow Number:

Monitoring Times:

Daily Medication Plan

Name Amount When to Use

1.

2.

3.

4.

CommentsSpecial Instructions

For Inhaled Medications

I have instructed in the proper way to use his/her medications.

It is my professional opinion that

use that medication by him/herself.

should be allowed to carry and

It is my professional opinion that should not carry his/her inhalec

medication by him/herself.

Physician Signature Date

Parent/Guardian Signature Date

AAFA 1233 20th Street, N.W., Suite 402 , Washington, DC 20036 www.aafa.org 1-800-7-ASTHMA

II. Asthma Action Cord

9BEST COPY AVAILABLE

Additional Resources

For more information on asthma contact:

U.S. Environmental Protection Agency

http://www.epa.gov/iagDownload the IAQ Tools for SchoolsAction Kit from EPA's website.

U.S. EPA Indoor Air Quality Information

Clearinghouse (IAQ INFO)

(800)438-4318(703)356-5386 FaxCall and request the IAQ Tools forSchools Action Kit.

Allergy and Asthma Network/Mothers of

Asthmatics, Inc.

(800)878-4403www.aanma.orgAsk about obtaining their SchoolInformation Packet.

American Lung Association

(800)LUNG-USAwww.ala.orqAsk about the Open Airways ForSchools program.

Asthma and Allergy Foundation of America

(800)7-ASTHMAwww.aafa.orgAsk about AAFA's Asthma Managementat School presentation for parents andschool personnel. Also available areadditional school-based child and teeneducation materials.

Center for Disease Control and Prevention

(770)488-7320www.cdc.govFind out more information on theAsthma Prevention Program by visitingthis website.

Integrated Pest Management

in Schools Website

www.ifas.ufl.edu/-schoolipm/Find out more IPM information byvisiting this website.

20Additional Resources

National Association of School Nurses

(207)883-2117www.nasn.orgAsk about obtaining Asthma Modules topresent to school staff.

National Asthma Education and

Prevention Program

(301)592-8573www.nhlbi.nih.govAsk about obtaining four publications:Managing Asthma: A Guide for Schools,Asthma and Physical Activity in School, HowAsthma Friendly is your School?, and theAsthma Awareness Curriculum.

National Education Association Health Information

Network

(800)718-8387www.neahin.orgCall to request information on a varietyof health issues in schools, includingasthma. Check website for IAQ inschools information.

National Parent Teacher Association

(800)307-4PTAwww.pta.orgAsk about obtaining an Asthma Moduleto present at PTA meetings.

School Asthma Website

www.school asthma.comAn educational website designedfor school nurses.

Additional Resources

EPA has included the names, phone numbers, and

E-mail addresses of these non-profit organizations in

this publication for informational purposes only. This

does not imply Agency endorsement of the products,

services or general policies of any of these organiza-

tions. Further, the organizations mentioned in this

publication are not the only sources of information

on asthma in schools. Additional information may

be obtained from your physician or other health care

provider, insurance carrier, school system, or state

or local public health agency as appropriate.

EPA REGIONAL OFFICES

US EPA/Region 1

1 Congress StreetSuite 1100Boston, MA 02114-2023(617)918-1533(617)918-1505

US EPA/Region 2

290 Broadway28th FloorNew York, NY 10007-1866(212)637-4010(212)637-4942

US EPA/Region- 3

1650 Arch StreetPhiladelphia, PA 19103-2029(215)814-2704(215)814-2101

US EPA/Region 4

61 Forsyth Street, SWAtlanta, GA 30303-3104(770)562-9100(770)562-9059

US EPA/Region 5 (AE-17J)

77 West Jackson BoulevardChicago, IL 60604(312)353-6686(312)886-0617

US EPA/Region 6 (6PD-T)

1445 Ross AvenueDallas, TX 75202-2733(214)665-6714(214)665-6762

US EPA/Region 7 (ARTD/RALI)

901 North 5th StreetKansas City, KS 66101(913)551-7605(913)551-7065

US EPA/Region 8 (8P-AR)

999 18th StreetSuite 500Denver, CO 80202-2466(303)312-6147(303)312-6064

US EPA/Region 9 (Air -6)

75 Hawthorn StreetSan Francisco, CA 94105(415)744-1048(415)744-1073

US EPA/Region 10 (OAQ -107)

1200 Sixth Avenue10th FloorSeattle, WA 98101(206)553-7660(206)553-0110

22Additional Resources

Remember...

10 Will to

111:7;):13 ill

Use the IAQ Tools for Schools Kit

2 Control Animal Allergens

3 Control Cockroach Allergens

4 Clean Up Mold and Control Moisture

Eliminate Secondhand Smoke Exposure

6 Reduce Dust Mite Exposure

7Develop an Asthma Management

Plan in Your School

8 Provide School-Based

Asthma Education Programs

9 File Student Asthma Action Cards

10bather Additional Asthma

Information and Resources

23

C11'

U.S. Department of EducationOffice of Educational Research and Improvement (OERI)

National Library of Education (NLE)

Educational Resources Information Center (ERIC)

NOTICE

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This document is covered by a signed "Reproduction Release(Blanket)" form (on file within the ERIC system), encompassing allor classes of documents from its source organization and, therefore,does not require a "Specific Document" Release form.

This document is Federally-funded, or carries its own permission toreproduce, or is otherwise in the public domain and, therefore, maybe reproduced by ERIC without a signed Reproduction Release form(either "Specific Document" or "Blanket").

EFF-089 (3/2000)